ACUTE RESPIRATORY-FAILURE IN PATIENTS TREATED FOR BABESIOSIS

Babesiosis is a tick-borne protozoal disease with infrequent clinical complications. We report three cases of noncardiogenic pulmonary edema in patients from Nantucket Island, MA, with a history of Lyme disease and review the clinical presentation of babesiosis and its treatment. Respiratory complications in our patients, as well as in the four pre viously reported cases in the literature, occurred a few days after in itiation of medical therapy. We hypothesize that the pathophysiology o f the pulmonary edema is multifactorial, due to decreased deformabilit y of the infected erythrocytes, increased cytoadherence of red blood c ells in capillaries and venules, and a possible role of excessive prod uction of certain cytokines, such as tumor necrosis factor and interle ukin-1.