Babesiosis in a renal transplant recipient acquired through blood transfusion

Background. The success of organ-replacement therapies has resulted in a po pulation of chronically immunosuppressed but active people who experience i ncreased vulnerability to tick-borne zoonoses. Several of these infections may be life threatening. Human babesiosis is an emerging zoonosis that is t ransmitted by the same Dick that transmits Lyme disease and human granulocy tic ehrlichiosis. Methods. We briefly review these zoonoses and present a case of a renal tra nsplant recipient who survived infection by Babesia microti contracted thro ugh blood transfusion. Results. A recipient of a living-related renal transplant developed acute p ostoperative hemolytic anemia. The etiology of this anemia was diagnosed by peripheral red blood cell smear as Babesia microti. The patient was manage d by a reduction in transplant immunosuppressive therapy and administration of clindamycin and quinine antimicrobials. Conclusions. Transplant patients may contract babesiosis after tick exposur e and/or via blood transfusion. The diagnosis of babesiosis may be confused with malaria and should be included in the differential diagnosis of postt ransplant hemolytic-uremic syndrome in organ transplant patients.