Splenectomy and Babesiosis
Patients without a spleen are particularly at risk of infection and a poor outcome with many infections proving fatal within five days to a week after first contracting the infection. Splenectomy patients have been found to have parasitemia levels of 85% compared to 1-10% in patients with competent immune systems and an intact spleen. Severe haemolytic anaemia and both hepatomegaly and splenomegaly have been observed in patients who have undergone splemectomy.
Acute Babesiosis Symptoms
Acute respiratory failure, congestive heart failure, and renal failure are all possible symptoms of infection with Babesia. Lyme carditis coupled with Babesiosis can further complicate a patient’s condition and Lyme disease co-infection increases the risk of fatality. Babesiosis is fatal in 5-10% of cases where the patient is sick enough to be hospitalized, and this risk increases for immunocompromised patients and the elderly, as well as for Lyme disease patients. These figures are for Babesia microti, so it should be noted that infection with the more virulent strain Babesia divergens poses an even higher risk of fatality, at 42%. This strain can cause symptoms such as haemoglobinuria, jaundice, high fever, chills, sweats, and shock-like symptoms if left untreated; kidney failure and pulmonary oedema may follow.
Early Signs of Babesiosis
A shorter latency period is found for B. divergens, with symptoms of infection usually arising in the first one to three weeks. B. microti infections may trigger symptoms one to eight weeks after a tick bite and, as always, it should be noted that more than one tick bite can occur leading to symptoms of Lyme disease and Babesiosis overlapping each other and confounding the diagnosis. Unfortunately, as Babesiois is caused by protozoa rather than bacteria, the Lyme disease antibiotics commonly used will not target a Babesia infection. Persistent symptoms of Lyme disease may in fact be symptoms of Babesiosis and could warrant further testing rather than continued antibiotic treatment for suspected Chronic Lyme disease.
Lyme Disease and Babesiosis Symptoms Worse
Some speculate that the incidence of Babesiosis in Lyme disease is as high as two-thirds of patients although the impact of this co-infection ranges from severe to unproblematic. More serious and potentially fatal co-infections of Babesia and Lyme disease tend to occur in the elderly and immunocompromised and milder infections are thought to often be overlooked with symptoms of Babesiosis dismissed as part of the Lyme disease symptom profile. Those presenting with atypical Lyme disease or who do not respond to standard treatment may need testing for co-infections such as Babesiosis to ensure appropriate treatment is given. Headaches and encephalopathy are thought to be more pronounced in patients with Lyme disease and Babesiosis co-infections.
As with untreated Lyme disease, Babesia infection may cause symptoms months or even years after the initial tick bite (or infection following blood transfusion) and those who remain asymptomatic may be at risk of transmitting Babesiosis to offspring or through blood or organ donation. Lyme disease transmission has not been confirmed via these routes, however, with the CDC maintaining that tick bites are the sole mode of Lyme disease transmission. Identifying symptoms of Babesia infection can be tricky when it exists as a co-infection with Lyme disease and patients may suffer as a result, making it important that physicians receive further education on the overlap of Lyme disease and Babesiosis symptoms and effective treatment for both.