title: Pancytopenia due to hemophagocytic syndrome as the presenting manifestation of babesiosis.
abstract: We present a case of hemophagocytosis during infection with the intraërythrocytic protozoan Babesia microti in a 47-year-old splenectomized renal allograft recipient. After therapy with clindamycin and quinine a relapse responded to atovaquone; durable remission was not achieved until trimethoprim/sulfa was added. We postulate the severity of our patient's syndrome was due to splenectomy and chronic immunosuppression. Babesiosis should be considered when immunocompromised patients develop pancytopenia.
authors.affiliation: Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.
authors.forename: P
authors.initials: P
authors.lastname: Gupta
authors.forename: R W
authors.initials: RW
authors.lastname: Hurley
authors.forename: P H
authors.initials: PH
authors.lastname: Helseth
authors.forename: J L
authors.initials: JL
authors.lastname: Goodman
authors.forename: D E
authors.initials: DE
authors.lastname: Hammerschmidt
mesh_terms: D001404:Babesiosis / Q000150:complications*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000150:complications* / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology*; D013156:Splenectomy