PANCYTOPENIA DUE TO HEMOPHAGOCYTIC SYNDROME AS THE PRESENTING MANIFESTATION OF BABESIOSIS

We present a case of hemophagocytosis during infection with the intrae rythrocytic protozoan Babesia microtiin a 47-year-old splenectomized r enal allograft recipient, After therapy with clindamycin and quinine a relapse responded to atovaquone; durable remission was not achieved u ntil trimethoprim/sulfa was added, We postulate the severity of our pa tient's syndrome was due to splenectomy and chronic immunosuppression. Babesiosis should be considered when immunocompromised patients devel op pancytopenia. (C) 1995 Wiley-Liss, Inc.