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Case Report: A Fatal Case of Babesiosis in a Splenectomized Male Patient from Western India

Ravi GodboleDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Avantika GaurDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Priyanka NayarDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Kala Gnanasekaran KiruthigaDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Pradeep D’CostaDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Rumma ManchandaDepartment of Pathology, King Edward Memorial Hospital, Pune, India;

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Ajinkya KhilariBiochemical Sciences Division, National Chemical Laboratory, Pune, India;
Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India;

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Dhanasekaran ShanmugamBiochemical Sciences Division, National Chemical Laboratory, Pune, India;
Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India;

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Kalpana D. MuglikarWestern Regional Disease Diagnostic Laboratory, Pune, India;

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Krishnendu KunduDepartment of Veterinary Parasitology, Faculty of Veterinary and Animal Science, Rajiv Gandhi South Campus, Banaras Hindu University, Barkachha, Mirzapur, India

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ABSTRACT.

Human babesiosis is a rare disease, caused by Babesia species and commonly transmitted by tick bite. Although human babesiosis is known to be asymptomatic in immunocompetent hosts, clinical cases of severe babesiosis have been reported from splenectomized or immunocompromised individuals. To our knowledge, only one case of human babesiosis in India has been previously reported. Here, we report a case of severe babesiosis with high parasitemia (∼70%) in a 30-year-old asplenic farmer. The patient presented with fever, yellowish discoloration of skin, oliguria, and anemia; he eventually developed multiorgan failure syndrome and died. Peripheral blood films were prepared and used to confirm the presence of piroplasms by microscopy. Total DNA isolated from blood was used for 18S ribosomal RNA gene fragment amplification by polymerase chain reaction, which was subjected to Sanger sequencing. Although 18S sequence indicated that the Babesia species infecting the patient was similar to that of other Babesia species originating from wild mammals, species identification could not be done. Phylogenetic analysis revealed that the patient-derived pathogen is distinct because it forms a separate clade in the cladogram.

Author Notes

Address correspondence to Krishnendu Kundu, Department of Veterinary Parasitology, Faculty of Veterinary and Animal Science, Institute of Agricultural Sciences, Rajiv Gandhi South Campus, Banaras Hindu University, Barkachha, Mirzapur, Uttar Pradesh, India, PIN-231001. E-mail: krishkundu03@bhu.ac.in

Authors’ addresses: Ravi Godbole, Avantika Gaur, Priyanka Nayar, Kala Gnanasekaran Kiruthiga, Rumma Manchanda, Department of Pathology, King Edward Memorial Hospital, Pune, India, E-mails: docravigod@yahoo.com, avgaur1787@gmail.com, priyankanayar@hotmail.com, gnanasekarankiruthiga@gmail.com, and rman93@gmail.com. Pradeep D’Costa, Department of Medicine, King Edward Memorial Hospital, Pune, India, E-mail: pradeepdcosta@yahoo.co.in. Ajinkya Khilari, Biochemical Sciences Division, National Chemical Laboratory, Pune, India, E-mail: aa.khilari@ncl.res.in. Dhanasekaran Shanmugam, Biochemical Sciences Division, National Chemical Laboratory, Pune, India, E-mail: d.shanmugam@ncl.res.in. Kalpana D. Muglikar, Western Regional Disease Diagnostic Laboratory, Pune, India, E-mail: kdmuglikar@gmail.com. Krishnendu Kundu, Department of Veterinary Parasitology, Faculty of Veterinary and Animal Science, Rajiv Gandhi South Campus, Banaras Hindu University, Mirzapur, India, E-mail: krishkundu03@bhu.ac.in.

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