title: Babesiosis as a rare cause of fever in the immunocompromised patient: a case report.
abstract: BACKGROUND
  This is the case of a rare and regional disease not often considered in the immunocompromised patient presenting with a chief complaint of fever.
  
  
  METHODS
  A 37-year-old immunocompromised Indian woman presented with a chief complaint of fever, in the absence of localizing signs and symptoms, from an area endemic to Babesia microti.
  
  
  CONCLUSIONS
  Our patient's case is instructive in that Babesiosis and other arthropod born illnesses should be considered in immunocompromised patients presenting with fever in the absence of localizing signs or symptoms. This is especially true when he or she presents from an area with known endemic disease. While the management of fever in immunocompromised patients is largely standardized, considering Babesiosis from the beginning may prompt early investigation of a blood smear, which has the potential to alert the emergency department physician to Babesiosis. In addition, considering the disease from the outset has the potential to accelerate administration of the appropriate antimicrobial therapy and thus prevent unnecessary morbidity and possible mortality.
authors.affiliation: Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School 1 Robert Wood Johnson Place, MEB Room 104, New Brunswick, NJ USA. nelsond1@umdnj.edu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Nelson
authors.forename: Joanna K
authors.initials: JK
authors.lastname: Bradley
authors.forename: Rajiv
authors.initials: R
authors.lastname: Arya
authors.forename: Monica
authors.initials: M
authors.lastname: Ianosi-Irimie
authors.forename: Andreia
authors.initials: A
authors.lastname: Marques-Baptista
authors.forename: Mark A
authors.initials: MA
authors.lastname: Merlin