Probable Congenital Babesiosis in Infant, New Jersey, USA

Sonia Sethi; David Alcid; Hemant Kesarwala; Robert W. Tolan, Jr.


Emerging Infectious Diseases. 2009;15(5) 

In This Article

Abstract and Introduction


Only 2 neonates with transplacentally or perinatally acquired (congenital) babesiosis have been reported. We describe a probable third congenital case of babesiosis in a 26-day-old infant; transmission was determined on the basis of a blood smear from the infant (15% parasitemia) and serologic results from the infant and mother.


Victor Babes first described the pathogen of babesiosis in 1888.[1] Babesiosis is a tick-borne malaria-like illness transmitted by the same Ixodes spp. ticks that transmit Borrelia burgdorferi.[2] It is endemic to the northeastern and northwestern United States and also occurs in Europe and parts of Asia. Babesiosis is an intraerythrocytic parasitic infection that ranges from subclinical to severe (possibly fatal) disease with fever, thrombocytopenia, hemolytic anemia, and hyperbilirubinemia. Appropriate antimicrobial drug therapy, transfusion, and exchange transfusion remain the mainstays of treatment.

Babesiosis occurs rarely among neonates, although it is gaining increasing attention as an emerging tick-borne zoonosis. In 1987, Esernio-Jenssen et al.[3] reported an apparent case of transplacentally or perinatally transmitted congenital babesiosis. In 1997, New et al.[4] reported another case. We describe a third case of probable congenital babesiosis in a 26-day-old infant with 15% parasitemia. She was treated successfully with atovaquone (Mepron; GlaxoSmithKline, Research Triangle Park, NC, USA) and azithromycin (Zithromax; Pfizer, New York, NY, USA).


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