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Volume 9, Number 2—February 2003

Research

Endemic Babesiosis in Another Eastern State: New Jersey

Barbara L. Herwaldt*Comments to Author , Paul C. McGovern†, Michal P. Gerwel‡, Rachael M. Easton†, and Rob Roy MacGregor†
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA; ‡New Jersey Department of Health and Senior Services, Trenton, New Jersey, USA

Main Article

Table

Clinical data on selected dates for a patient who acquired babesiosis in New Jersey

Date Temperature (°C) Hematocrit (%) Leukocyte count (109/L) Platelet count (109/L) Parasitemia level (%) Creatinine level (mg/dL)a Total bilirubin level (mg/dL)a Lactate dehydrogenase level (U/L)a Comments
June 24
39.2
25
4.6b
92
5.0
1.1
2.2c
646
Hospitalized
June 25
38.2





3.2

Antibabesial therapy started; intubated
2 units packed erythrocytes transfused
June 26
40.0
31
6.0
55

1.1
2.9
1,019

June 28

28
8.6
93

0.9
2.7d

Transferred to the Hospital of the University of Pennsylvania
June 29
39.2
27
9.0
99
0.3
1.9

5,147

June 30
38.3
22
7.9
109

2.8
1.5
4,047
2 units packed erythrocytes transfused
July 1
38.7
26
9.7
138

3.5
1.9
4,140

July 2
38.0
26
9.0
139

2.9
1.6
3,669
2 units packed erythrocytes transfused
July 4
38.7
29
14.7
144

2.2
2.2
2,864
Extubated
July 7
38.2
28
19.3
277

1.5


Developed nosocomial pneumonia
July 8
38.1
23
16.3
308

1.7
2.1
2,008
2 units packed erythrocytes transfused
July 9
38.3
31
11.7
300
0.0
1.8


Antibabesial therapy stopped
July 11
Afebrile
28
15.3
310

1.8



July 16
Afebrile
29
15.8
396

1.5
1.0


July 19
Afebrile
30
15.8
322

1.6

1,081

July 21
Afebrile
26
12.3
71

1.9


Developed heparin-associated thrombocytopenia
July 23 Afebrile 28 12.4 50 Sent home

aNormal ranges for community hospital (June 24–June 27): creatinine level, 0.6–1.3 mg/dL; total bilirubin level, 0.2–1.0 mg/dL; indirect bilirubin level, 0.2–1.2 mg/dL; lactate dehydrogenase level, 91–180 U/L. Normal ranges for the Hospital of the University of Pennsylvania: creatinine level, 0.6–1.0 mg/dL; total bilirubin level, 0.0–1.2 mg/dL; indirect bilirubin level, 0.0-1.2 mg/dL; lactate dehydrogenase level, 313–618 U/L.

b25% segmented neutrophils, 33% band forms, 22% lymphocytes, 2% atypical lymphocytes, 8% monocytes.

cIndirect bilirubin level, 1.4 mg/dL.

dIndirect bilirubin level, 2.1 mg/dL; serum haptoglobin level, <38 mg/dL (normal range, 60–160 mg/dL); results of direct and indirect Coombs test, negative.

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