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Case Records of the Massachusetts General Hospital
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Volume 356:2313-2319 May 31, 2007 Number 22
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Case 17-2007 — A 25-Year-Old Woman with Relapsing Fevers and Recent Onset of Dyspnea
Christopher P. Stowell, M.D., Ph.D., Jeffrey A. Gelfand, M.D., Jo-Anne O. Shepard, M.D., and Alexander Kratz, M.D., Ph.D.

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Presentation of Case

Dr. Surajit Nundy (Department of Medicine): A 25-year-old woman was admitted to this hospital because of a 5-month history of relapsing fevers and a 3-day history of dyspnea. She had been well until early spring, 5 months before admission, when temperatures as high as 39.4°C, neck stiffness, and malaise developed. She was admitted to another hospital 1 month later, and examination of a peripheral-blood smear disclosed parasites that were consistent with babesiosis. Treatment with azithromycin and atovaquone was given for 7 days; her symptoms resolved, and she was discharged on the seventh hospital day.

After discharge, during the summer, she . . . [Full Text of this Article]

Pathological Discussion

Differential Diagnosis

Discussion of Management

Antibiotic Therapy for Babesiosis

            Fulminant Babesiosis

            Persistent or Relapsing Babesiosis

Red-Cell Exchange Transfusion

            Rationale for Exchange Transfusion

            Risks of Exchange Transfusion

Dr. Jeffrey A. Gelfand's Diagnosis

Pathological Diagnosis


Source Information

From the Blood Transfusion Service (C.P.S.), Infectious Disease Unit (J.A.G.), and the Departments of Radiology (J.-A.O.S.) and Pathology (C.P.S., A.K.), Massachusetts General Hospital; and the Departments of Pathology (C.P.S., A.K.), Medicine (J.A.G.), and Radiology (J.-A.O.S.), Harvard Medical School. (Dr. Kratz is now at the Department of Pathology, College of Physicians and Surgeons, Columbia University, New York.)




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