Burke A. Cunha MD, a, Yehuda Z. Cohen MDa and Brian McDermott DOa
Infectious Disease Division, Winthrop-University Hospital, Mineola, New York and State University of New York School of Medicine, Stony Brook, New York
Available online 30 September 2008.
Fevers of unknown origin (FUOs) are defined as prolonged fevers of 101�F or greater lasting 3 or more weeks that remain undiagnosed after comprehensive inpatient/outpatient laboratory testing.
Tick-borne infections are uncommon causes of FUOs.
Any infectious disease accompanied by prolonged fevers can present as an FUO if the diagnosis is not suspected or if specific laboratory testing is not done to confirm the diagnosis.
Babesiosis is transmitted by the Ixodes scapularis ticks endemic to areas in the northeastern United States.
We present the case of a 73-year-old, non-human immunodeficiency virus, male from Long Island who presented with FUO for 6 weeks.
As with malaria, there are usually few or no localizing signs in babesiosis.
During the patient's hospitalization, babesiosis was suspected on the basis of nonspecific laboratory findings, that is, relative lymphopenia, thrombocytopenia, thrombocytopenia, and an elevated lactate dehydrogenase.
When babesiosis was considered in the differential diagnosis, stained blood smears demonstrated the red blood cell inclusions of babesiosis.
In the hospital, the patient developed noncardiac pulmonary edema, which rapidly resolved which has been described as a rare complication of babesiosis.
He also had an elevated immunoglobulin-M Lyme titer indicating coinfection with Lyme disease.
Although his hemolytic anemia persisted for weeks, he only had 3% parasitemia and intact splenic function.
We believe this to be the first case of babesiosis presenting as an FUO in a normal host.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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merrygirl
Frequent Contributor (1K+ posts)
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posted
Ali thank you very much for this post. I am considered to have FUO and I find this very interesting.
Thanks for your hard work Melissa
Posts: 3905 | From USA | Registered: May 2007
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
I was chasing FUOs back in 2002, before some nice ID kindly pointed out that my 20-30 symptoms were somatoform and recommended that I seek alternative therapy.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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posted
I was discharged from Mayo Clinic with "Fevers of Unknown Origin" ....I am positive for Babesiosis through Stonybrook and the Igenex FISH Test. Very interesting.
Posts: 27 | From New York | Registered: Oct 2008
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
Melissa,
Have you been tested/Txd for Babesiosis yet?
I do believe that Babesia & the "BLO" can both cause FUOs.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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merrygirl
Frequent Contributor (1K+ posts)
Member # 12041
posted
Hey Ali.
I was tested months ago by quest, and I was negative.
I was treated for only 6 weeks. I am going to push for some more treatment.
My fever at the pcp office thursday was 101.1 !!
I have also done riampin, zith for Bart and BLO
Currently on my 2nd dose of Bicillin.
I may print this article out to give to my pcp and LLMD.
Thanks again. Melissa
Posts: 3905 | From USA | Registered: May 2007
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
FYI-
I was positive for Babesiosis AB through Quest (they only do microti, I believe)
After Txing & taking down those titres, I had another flare.
I tested negative for B. microti & positive for B.duncani through MDL.
Perhaps you have a different strain.
....of course there's always the possibility of it being one of the many strains they can't test for yet.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
^
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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