ARarePresentation of Babesia-Associated Splenic Infarction in an Immunocompetent Young Male With Mild Parasitemia

Q: What rare complication is highlighted in this case of babesiosis?

The case emphasizes spontaneous splenic infarction occurring despite low parasitemia.

Q: Does severe babesiosis always correlate with high parasitemia levels?

No. The report notes that significant complications, including splenic infarction, can arise from low parasitemia and do not always correlate with higher levels.

Q: When should clinicians consider babesiosis in splenic injury cases?

Babesiosis should be ruled out in patients with atraumatic splenic injuries or injuries disproportionate to trauma, even when fever or systemic symptoms are absent.

Sep 28, 2026

Uploaded by Noah

Babesiosis is a tick-borne protozoal infection that can range from mild flu-like symptoms to severe disease with disseminated intravascular coagulation and severe hemolytic anemia. The report describes a young immunocompetent man who developed severe hemolytic anemia and an uncommon complication—splenic infarction—despite low parasitemia. The case highlights that serious splenic injury may not correlate with higher parasitemia levels, and that a patient’s clinical course should guide management. It also stresses the need to consider babesiosis in atraumatic splenic injuries to avoid treatment delays.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Learning Points

1. Introduction

2. Case Presentation

Wiley Case Reports in Medicine Volume 2026, Article ID 5210024, 12 pages [https://doi.org/10.1155/carm/5210024](https://doi.org/10.1155/carm/5210024) Case Report ARarePresentation of Babesia-Associated Splenic Infarction in an Immunocompetent Young Male With Mild Parasitemia Jamal A. Anthony , 1,2 Dejan Nikolic ,2,3 Rosalie Pepe, 1,2 and Henry Fraimow 1,2 1 Department of Infectious Disease, Cooper University Hospital, 1 Cooper Plaza, Camden, New Jersey, USA 2 Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA 3 Department of Pathology and Laboratory Services, Cooper University Hospital, 1 Cooper Plaza, Camden, New Jersey, USA Correspondence should be addressed to Jamal A. Anthony; [anthony-jamal@cooperhealth.edu](anthony-jamal@cooperhealth.edu) Received 15 April 2025; Revised 13 December 2025; Accepted 17 December 2025 Academic Editor: Ionut Simion Coman Copyright © 2026 Jamal A. Anthony et al. Case Reports in Medicine published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Babesiosis is a vector-borne protozoal disease primarily transmitted by the Ixodes scapularis tick, though it can also be transmitted through blood transfusions from infected donors. Te illness can be asymptomatic or present with mild fu-like symptoms. Still, in severe cases, it can lead to disseminated intravascular coagulation and severe hemolytic anemia, sometimes necessitating management in the intensive care unit. Traditionally, severe babesiosis has been linked to individuals over 50 years old, asplenia, and those who are immunocompromised. Notably, parasitemia levels greater than 10% are also associated with severe disease. However, we report a case of a young, immunocompetent male with severe babesiosis exhibiting severe hemolytic anemia anda rare complication of splenic infarction despite a low level of parasitemia. Tis case emphasizes that signifcant clinical complications, like spontaneous splenic infarction, can arise from low parasitemia levels, underscoring the need for heightened awareness of this potential outcome. Learning Points • Babesia-associated splenic injury is a serious manifestation of babesiosis that does not always correlate with higher parasitemia levels; most cases are associated with low levels (< 5%) . • Coinfection with other vector-borne diseases may amplify clinical severity. • Te patient’s clinical course should be the primary consideration in treating babesiosis, rather than the degree of parasitemia alone (except when the percent parasitemia is greater than 10%, in which case red cell exchange is recommended regardless of clinical presentation) . • For patients presenting with atraumatic splenic injuries or splenic injuries that are out of proportion to the trauma, it is essential to rule out babesiosis, as it isan emerging cause of atraumatic splenic injury. Tis helps to prevent treatment delays. • Atraumatic splenic injury may be the only presenting sign, occurring without fever or systemic symptoms. Babesia-associated splenic injury is a serious complication of the disease that does not require traditional risk factors for severe babesiosis, such as age over 50, immunocompromised state, or asplenia. 1. Introduction Babesiosis is a vector-borne illness caused by an intraerythrocytic protozoal parasite. It is most commonly transmitted by the Ixodes scapularis tick and, less commonly, by blood transfusion or organ transplantation [1–7] . Tere are many Babesia species. Most infect domestic and wild animals, with a few species causing human babesiosis [1–3] . Babesia microti, Babesia duncani, and Babesia divergens are known to cause human babesiosis [1–3] . It was frst discovered in 1969 in an immunocompetent male from Nantucket Island, Massachusetts, who was found

FAQs

What rare complication is highlighted in this case of babesiosis?

The case emphasizes spontaneous splenic infarction occurring despite low parasitemia.

Does severe babesiosis always correlate with high parasitemia levels?

No. The report notes that significant complications, including splenic infarction, can arise from low parasitemia and do not always correlate with higher levels.

When should clinicians consider babesiosis in splenic injury cases?

Babesiosis should be ruled out in patients with atraumatic splenic injuries or injuries disproportionate to trauma, even when fever or systemic symptoms are absent.

Sep 28, 2026

Uploaded by Noah