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Related Experiment Videos

Babesiosis. Diagnostic pitfalls.

J M Carr1, S Emery, B F Stone

  • 1Department of Pathology, Beth Israel Hospital, Boston, Massachusetts 02215.

American Journal of Clinical Pathology
|June 1, 1991
PubMed
Summary

This case study highlights a rare complication of babesiosis in a splenectomized patient, where quinine therapy unexpectedly caused severe hemolysis and Pappenheimer bodies, mimicking parasitic infection.

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Area of Science:

  • Medical Case Reports
  • Parasitology
  • Hematology

Background:

  • Babesiosis is a tick-borne parasitic disease.
  • Splenectomized individuals are at higher risk for severe babesiosis.
  • Quinine is an antimalarial drug with known hemolytic side effects.

Observation:

  • A splenectomized woman developed babesiosis after travel to an endemic region.
  • Initial presentation included fever and mild hemolysis, which worsened during treatment.
  • Increased red blood cell inclusions were observed, initially mistaken for Babesia.

Findings:

  • Quinine therapy, not babesiosis alone, was identified as the cause of increased hemolysis.
  • Iron staining revealed hemolysis-induced Pappenheimer bodies, distinct from Babesia parasites.
  • The clinical laboratory played a crucial role in differentiating these conditions.

Implications:

  • This case underscores the importance of considering drug-induced hemolysis in complex parasitic infections.
  • Accurate laboratory diagnostics are vital for distinguishing parasitic forms from artifactual inclusions.
  • Clinicians should be aware of potential quinine toxicity, especially in vulnerable patient populations.

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