Risk Factors for Severe Infection, Hospitalization, and Prolonged Antimicrobial Therapy in Patients with Babesiosis

Neeharik Mareedu Marshfield Clinic Health System, Marshfield, Wisconsin;

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Anna M. Schotthoefer Marshfield Clinic Research Institute, Marshfield, Wisconsin;

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Jason Tompkins Marshfield Clinic Health System, Marshfield, Wisconsin;

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Matthew C. Hall Marshfield Clinic Health System, Marshfield, Wisconsin;

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Thomas R. Fritsche Marshfield Clinic Health System, Marshfield, Wisconsin;
University of Wisconsin, La Crosse, Wisconsin;

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Holly M. Frost Marshfield Clinic Research Institute, Marshfield, Wisconsin;
Marshfield Clinic Health System, Minocqua, Wisconsin

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Babesiosis is an emerging tick-borne disease transmitted by the hard tick Ixodes scapularis, which also transmits Lyme disease. Better gradation of prognostic indicators are needed to determine which patients may develop serious complications requiring hospitalization, and to provide early guidance on appropriate therapy. In this study, we evaluated 128 patients with smear or real time polymerase chain reaction-confirmed Babesia microti infections over a period of 16 years. Patients with asplenia or immunocompromising conditions were more likely to have severe infection (P < 0.01), require hospitalization (P < 0.01), or receive prolonged courses of antimicrobials (P < 0.01). Nausea or vomiting (P < 0.01) and diarrhea (P < 0.01) along with hyperbilirubinemia (P < 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy. Patients with concurrent Lyme disease were less likely to require hospitalization and had similar severity of disease and length of antibiotic treatment compared with those without Lyme disease.

Author Notes

Address correspondence to Holly M. Frost, Department of Pediatrics, Marshfield Clinic Minocqua Center, 9601 Townline Road, Minocqua, WI 54548. E-mail: frost.holly@marshfieldclinic.org

Financial support: Financial support was provided by Marshfield Clinic Research Institute.

Authors’ addresses: Neeharik Mareedu, Jason Tompkins, Matthew C. Hall, and Thomas R. Fritsche, Marshfield Clinic Health System, Marshfield, WI, E-mails: mareedu.neeharik@marshfieldclinic.org, tompkins.jason@marshfieldclinic.org, hall.matthew@marshfieldclinic.org, and fritsche.thomas@marshfieldclinic.org. Anna M. Schotthoefer, Marshfield Clinic Research Institute, Marshfield, WI, E-mail: schotthoefer.anna@mcrf.mfldclin.edu. Holly M. Frost, Marshfield Clinic Health System and Marshfield Clinic Research Institute, Minocqua, WI, E-mail: frost.holly@marshfieldclinic.org.

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