Pancytopenia due to hemophagocytic syndrome as the presenting manifestation of babesiosis.
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.
Gupta
P
P
Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.
Hurley
R W
RW
Helseth
P H
PH
Goodman
J L
JL
Hammerschmidt
D E
DE
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