Relative bradycardia and lymphopenia in patients with babesiosis

The medical records of 17 patients with babesiosis were reviewed. Nine of 17 patients (52.9%) presented with fever (temperature, > 101 degrees F), and 8 of the 9 patients (88.9%) had relative bradycardia. Four of the nine patients (44.4%) had morning temperature spikes during initial hospitalization. As revealed by laboratory analysis, 13 of 17 patients (76.5%) with babesiosis had lymphopenia, and 5 of 17 patients (29.4%) had rouleaux formation in their peripheral blood smears. These newly described clinical and laboratory findings represent additional clinical and laboratory features that may be used as diagnostic clues in the differential diagnosis of babesiosis.