Babesiosis in the immediate postoperative period after splenectomy for trauma.
BACKGROUND
In an immunocompetent host, Babesia microti has not been reported as a cause of postoperative fever.


METHODS
Case report and literature review.


RESULTS
A 52-year-old woman living on Martha's Vineyard developed postoperative fever after splenectomy for trauma. The patient's mechanism of injury was a fall from a stationary bicycle. Intraoperatively, the patient was noted to have splenomegaly. Postoperatively, she developed fever and was found to have Babesia microti on blood smear with an otherwise negative fever evaluation. She was treated with atovaquone and azithromycin and made a full recovery.


CONCLUSIONS
For individuals who have lived or traveled in endemic areas, babesiosis should be considered as a possible cause of postoperative fever when other sources have been excluded. Patients undergoing splenectomy in an endemic area should be screened for babesiosis to prevent postoperative recrudescence of symptoms.
Semel
Marcus E
ME
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. msemel1@partners.org
Tavakkolizadeh
Ali
A
Gates
Jonathan D
JD
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D053626:Atovaquone / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D041001:Babesia microti / Q000302:isolation & purification*; D001404:Babesiosis / Q000175:diagnosis* / Q000469:parasitology; D005260:Female; D006801:Humans; D008875:Middle Aged; D013156:Splenectomy / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000469:parasitology; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*
D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents; D017963:Azithromycin; D053626:Atovaquone