Transfusion-Associated Babesiosis after Heart Transplant

Joseph Z. Lux, Don Weiss, Jeanne V. Linden, Debra Kessler, Barbara L. Herwaldt, Susan J. Wong, Jan Keithly, Phyllis Della-Latta, Brian E. Scully


Emerging Infectious Diseases. 2003;9(1) 

In This Article

Abstract and Introduction

We describe a 54-year-old spleen-intact man with transfusion-associated Babesia microti infection after a heart transplant. Adult respiratory distress syndrome developed in the patient, and he required mechanical ventilation. Our experiences with this patient suggest that babesiosis should be considered in the differential diagnosis of transplant patients who have fever and hemolytic anemia.

Babesiosis is a tick-borne protozoan illness caused by infection of erythrocytes with various species in the genus Babesia. In the United States, Babesia microti is the agent most commonly reported to cause human infection[1]. More recently, the MO1-type, WA1-type, and CA1-type Babesia species have been identified as causing clinical disease in the United States[2,3,4,5]. Babesia infection can also be acquired by blood transfusion[2,6,7]. More than 40 cases of transfusion-transmitted B. microti infection have been reported in the United States (R. Cable and B. Herwaldt, unpub. data). B. microti infection is often asymptomatic[8] but may cause a malaria-like illness characterized by fever and hemolytic anemia. Babesiosis can also be associated with severe complications that include renal failure[9,10], disseminated intravascular coagulation[9], and adult respiratory distress syndrome[1,9,10]. The risk of developing this clinical infection is increased for elderly, asplenic, or immunosuppressed patients[11]. Here we describe a case of B. microti infection in a 54-year-old spleen-intact man acquired by blood transfusion after cardiac transplantation.