A 42-year-old female patient with acute myeloid leukemia presented with fever and heavy chest pain after her first cycle of specific chemotherapy. Acute myocardial infarction was excluded, but surprisingly, parasitic inclusions in erythrocytes became obvious in Pappenheim and Giemsa-stained peripheral blood smears. The patient did not remember a tick bite but acknowledged having received several blood transfusions in her recent medical history. Suspicion of malaria was ruled out by use of a dip-stick test. The diagnosis of Babesia microti infection was finally established by specific polymerase chain reaction (PCR). Six weeks after initiation of specific treatment, PCR turned negative and a positive immunoflourescence assay (IFA) with an IgG titer of 1:128 indicated seroconversion. Subsequent screening of donors involved in the transfusion of blood products to the patient demonstrated borderline reactivity for Babesia microti (IgG-titer 1:32) in 1 out of 44 individuals. Neither the patient nor the positively tested blood donor had travelled to North America or Asia. Therefore, this is the first confirmed autochthonous human infection in Europe.
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We thank Ute Mackenstedt (Department of Parasitology, University of Hohenheim) for providing DNA of Babesia divergens and Babesia microti, Karl-Hermann Schmidt (Institute of Medical Microbiology, Jena) for laboratory support, Robert Siegmund (Institute of Clinical Chemistry and Laboratory Medicine, Jena) for providing patient material and helpful advice, Christel Kummer (Insitute for Transfusion Medicine, Jena) for providing the retain samples of the donors, and Anna-Dorothea Wagner (Department of Internal Medicine, Jena) for taking care of the patient.
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Hildebrandt, A., Hunfeld, KP., Baier, M. et al. First confirmed autochthonous case of human Babesia microti infection in Europe. Eur J Clin Microbiol Infect Dis 26, 595–601 (2007). https://doi.org/10.1007/s10096-007-0333-1
- Acute Myeloid Leukemia
- Borrelia Burgdorferi
- Tick Infestation