Babesiosis Presenting as Splenic Rupture in the Midwest: A Case Report

Area of Science:

• Infectious Diseases
• Hematology
• Emergency Medicine

Background:

• Babesia microti is an erythrocyte-invading parasite causing hemolysis and non-specific symptoms.
• Splenic rupture is a rare but severe manifestation of babesiosis, typically observed in younger individuals with low parasitemia.
• Conservative management of splenic rupture is possible depending on severity and patient condition.

Observation:

• This case details an elderly male with comorbidities and a history of hiking in endemic areas.
• The patient presented with a spontaneous American Association for the Surgery of Trauma (AAST) grade V splenic rupture, necessitating emergency splenectomy.
• Following initial treatment, the patient was readmitted and diagnosed with babesiosis, which was managed with pharmacotherapy and plasmapheresis.

Findings:

• The patient's splenic rupture was attributed to babesiosis in the absence of other identifiable causes.
• This case highlights a rare presentation of babesiosis in an elderly patient with multiple comorbidities.
• The successful management involved both surgical intervention (splenectomy) and pharmacotherapy combined with plasmapheresis for the parasitic infection.

Implications:

• Atraumatic splenic rupture in endemic areas warrants screening for parasitic infections like babesiosis.
• This case expands the understanding of babesiosis manifestations beyond typical presentations.
• Early diagnosis and appropriate management are critical for improving outcomes in complex cases of babesiosis-induced splenic rupture.