Volume 9, Number 2—February 2003
Research
Endemic Babesiosis in Another Eastern State: New Jersey
, Paul C. McGovern†, Michal P. Gerwel‡, Rachael M. Easton†, and Rob Roy MacGregor†
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.