Infection with Babesia microti in humans with non-specific symptoms in North East Poland.
OBJECTIVE
The aim of the study was to evaluate the clinical course and effectiveness of diagnostics tools for Babesia spp. infection in patients bitten by ticks.


METHODS
Five hundred and forty-eight patients hospitalised or seen in outpatients department because of various symptoms after a tick bite were included in the study. PCR, nucleotide sequencing of Babesia 18S rRNA gene fragment, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi were performed in all patients. Six patients infected with Babesia were included in the final analysis. They had PCR, Babesia 18S rRNA gene fragment nucleotide sequencing, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi performed twice.


RESULTS
Tick-borne infection with Babesia microti in six immunocompetent patients with non-specific symptoms was confirmed for the first time in Poland. No severe course of the disease was seen. No piroplasm forms were noticed within erythrocytes on blood smear. Three patients developed a serological response.


CONCLUSIONS
Immunocompetent patients may be unaware of infection with Babesia microti after a tick bite. It must be included in the differential diagnosis after the tick bite. In patients with low parasitaemia PCR and serology seem useful when blood smear is negative. Self-elimination of Babesia spp. is possible, especially in cases with low parasitaemia.
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Anna
A
Moniuszko-Malinowska
b Department of Microbiology, Faculty of Biology and Chemistry , University of Białystok , Bialystok , Poland ;
Izabela
I
Swiecicka
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Justyna
J
Dunaj
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Joanna
J
Zajkowska
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Piotr
P
Czupryna
b Department of Microbiology, Faculty of Biology and Chemistry , University of Białystok , Bialystok , Poland ;
Grzegorz
G
Zambrowski
c Department of Allergology and Environmental Hazards , Institute of Rural Health , Lublin , Poland ;
Jolanta
J
Chmielewska-Badora
e Department of Health , Pope John Paul II, State School of Higher Education , Biala Podlaska , Poland.
Wioletta
W
Żukiewicz-Sobczak
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Renata
R
Swierzbinska
d Department of Allergy , Guy's and St Thomas' NHS Foundation Trust , London , UK.
Krzysztof
K
Rutkowski
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Adam
A
Garkowski
a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland ;
Sławomir
S
Pancewicz
D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D041001:Babesia microti / Q000235:genetics* / Q000276:immunology*; D001404:Babesiosis / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D011044:Poland; D012189:Retrospective Studies
D000913:Antibodies, Protozoan
Babesia microti; babesiosis; co-infection; humans; tick-borne diseases