A Case of Babesiosis in a Pregnant Patient Treated with Red Blood Cell Exchange Transfusion

Babesiosis, caused predominantly by Babesia microti, is an emerging health risk in the Northeastern and Midwestern United States. We present a case of a pregnant woman with history of splenectomy diagnosed with babesiosis at 23 5/7 weeks of gestational age refractory to antimicrobial therapy. She underwent the first reported red blood cell exchange transfusion for babesiosis in pregnancy, at 24 4/7 weeks of gestational age, which resulted in resolution of parasitemia. She had a full term, uncomplicated cesarean delivery. Exchange transfusion is potentially a safe treatment option for severe babesiosis infection in pregnancy and should be considered when other methods are poorly tolerated or ineffective.

[1]  G. Wormser,et al.  Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review. , 2016, JAMA.

[2]  R. Luckett,et al.  Babesiosis in Pregnancy , 2014, Obstetrics and gynecology.

[3]  D. Barto,et al.  Babesiosis , 2014 .

[4]  Jeffrey M Schussler,et al.  Drug-induced QT interval prolongation: mechanisms and clinical management , 2012, Therapeutic advances in drug safety.

[5]  J. Rich,et al.  Red cell exchange transfusion for babesiosis in Rhode Island , 2009, Journal of clinical apheresis.

[6]  Ivo M Foppa,et al.  Persistent and relapsing babesiosis in immunocompromised patients. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  P. Krause,et al.  Babesiosis in pregnancy. , 2003, The New England journal of medicine.

[8]  K. Grima,et al.  Exchange transfusion for malaria and Babesia infection. , 2002, Transfusion medicine reviews.

[9]  P. Greenberg,et al.  Severe babesiosis in Long Island: review of 34 cases and their complications. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  J. N. Black,et al.  Quinine May Trigger Torsades de Pointes During Astemizole Therapy , 1997, Pacing and clinical electrophysiology : PACE.

[11]  R. D. Wong,et al.  Treatment of severe falciparum malaria during pregnancy with quinidine and exchange transfusion. , 1992, The American journal of medicine.

[12]  C. Hudson,et al.  Exchange transfusion for severe falciparum malaria in pregnancy. , 1990, BMJ.

[13]  F. Rosner,et al.  Babesiosis in splenectomized adults. Review of 22 reported cases. , 1984, The American journal of medicine.

[14]  J. Benach,et al.  Red Cell Exchange: Treatment of Babesiosis in a Splenectomized Patient , 1981, Transfusion.

[15]  A. Spielman,et al.  Treatment of transfusion-transmitted babesiosis by exchange transfusion. , 1980, The New England journal of medicine.

[16]  M. Saary,et al.  EMERGENCY MATERNAL EXCHANGE TRANSFUSION FOR SICKLE‐CELL ANAEMIA COMPLICATING TWIN PREGNANCY , 1971, The Journal of obstetrics and gynaecology of the British Commonwealth.