title: Atraumatic splenic rupture from Babesia: A disease of the otherwise healthy patient.
abstract: Babesiosis, an infection caused by the protozoan Babesia microti and transmitted by the Ixodes scapularis tick, is commonly described in the literature with an approximate incidence of 1000 cases per year (Herwaldt et al., 2012). Infections in North America occur most frequently during the spring and summer months in the Northeastern and Midwestern United States. Babesia can cause a wide spectrum of clinical manifestations ranging from a self-limited febrile illness or mild anemia to severe illness causing acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC) and multisystem organ failure. Severe illness most commonly occurs in elderly, immunocompromised, or asplenic patients (Vannier and Krause, 2012). Splenic rupture has been generally described as a complication of severe illness secondary to babesiosis. We describe a case of spontaneous splenic rupture in an otherwise healthy woman that required emergent splenectomy. Recent case reports suggest that splenic rupture occurs in people without known risk factors for severe babesiosis. Physicians should be aware of this acute presentation in otherwise healthy individuals.
authors.affiliation: Waterbury Hospital, United States; Duke University, United States.
authors.forename: F R
authors.initials: FR
authors.lastname: Farber
authors.affiliation: Centers for Disease Control, United States.
authors.forename: A
authors.initials: A
authors.lastname: Muehlenbachs
authors.affiliation: Waterbury Hospital, United States; Yale University, United States. Electronic address: scienceandmedicine@gmail.com.
authors.forename: T E
authors.initials: TE
authors.lastname: Robey
mesh_terms: D000818:Animals; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D001403:Babesia / Q000302:isolation & purification; D001404:Babesiosis / Q000150:complications* / Q000188:drug therapy; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D006406:Hematoma / Q000209:etiology / Q000473:pathology; D006465:Hemoperitoneum / Q000209:etiology / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000469:parasitology*; D013156:Splenectomy; D013158:Splenic Diseases / Q000209:etiology* / Q000473:pathology* / Q000601:surgery
chemical_list: D017963:Azithromycin; D004318:Doxycycline
keywords: Babesia; Case report; Parasitemia; Splenic rupture