{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:10:18Z","timestamp":1756303818742,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,5,17]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Babesiosis is a tick-borne parasitic infection that can result in various haematological complications. This case report discusses a patient with severe Babesiosis complicated by an unorthodox presentation of Babesiosis-associated haemolytic uremic syndrome. Discussed here is the patient\u2019s clinical course and the management strategies employed, with an emphasis on early recognition and treatment of renal failure in the context of severe Babesiosis. Haematologic manifestations of Babesia are common and the severity of disease is dependent on parasite load. While treatment options such as red blood cell exchange have been proposed for severe cases, their impact on clinical outcomes is limited and they may not be readily available in resource-limited settings. Traditional management using antimicrobials has been proposed but there is limited discussion about managing unique presentations such as renal failure in Babesiosis. Hence, understanding the pathophysiology, early recognition and aggressive treatment strategies can optimise clinical outcomes and reduce mortality.<\/jats:p>","DOI":"10.1136\/bcr-2024-260735","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T22:35:24Z","timestamp":1718750124000},"page":"e260735","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Atypical haemolytic uremic syndrome in a patient with severe Babesiosis"],"prefix":"10.1136","volume":"17","author":[{"given":"Maryam","family":"Hajiabbasi","sequence":"first","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals \/ Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagma","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals \/ Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navin","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals \/ Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7373-8661","authenticated-orcid":false,"given":"Muhammad Saad","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals \/ Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"2025082706480702000_17.6.e260735.1","doi-asserted-by":"crossref","DOI":"10.1155\/2009\/984568","article-title":"Update on Babesiosis","volume":"2009","author":"Vannier","year":"2009","journal-title":"Interdiscip Perspect Infect Dis"},{"key":"2025082706480702000_17.6.e260735.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12941-017-0179-z","article-title":"Hematologic manifestations of Babesiosis","volume":"16","author":"Akel","year":"2017","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"2025082706480702000_17.6.e260735.3","doi-asserted-by":"publisher","DOI":"10.1086\/319742"},{"key":"2025082706480702000_17.6.e260735.4","unstructured":"Bhandari J , Rout P , Sedhai YR . Hemolytic Uremic Syndrome. Treasure Island: Statpearls Publishing, 2024."},{"key":"2025082706480702000_17.6.e260735.5","doi-asserted-by":"crossref","first-page":"2629","DOI":"10.1111\/trf.15346","article-title":"Adjunctive treatment of clinically severe Babesiosis with red blood cell exchange: a case series of nineteen patients","volume":"59","author":"Nixon","year":"2019","journal-title":"Transfusion"},{"key":"2025082706480702000_17.6.e260735.6","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.transci.2019.04.026","article-title":"Heavy Parasitemia in Babesiosis treated without Adjunctive red cell exchange","volume":"58","author":"Cervera-Hernandez","year":"2019","journal-title":"Transfus Apher Sci"},{"key":"2025082706480702000_17.6.e260735.7","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20197"},{"key":"2025082706480702000_17.6.e260735.8","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9082359","article-title":"Endothelial dysfunction in chronic kidney disease, from biology to clinical outcomes: A 2020 update","volume":"9","author":"Roumeliotis","year":"2020","journal-title":"J Clin Med"},{"key":"2025082706480702000_17.6.e260735.9","unstructured":"Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review - PMC, Available: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7076748"},{"key":"2025082706480702000_17.6.e260735.10","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1111\/jvim.12146","article-title":"Markers of coagulation activation, endothelial stimulation, and inflammation in dogs with Babesiosis","volume":"27","author":"Bari\u0107 Rafaj","year":"2013","journal-title":"J Vet Intern Med"},{"key":"2025082706480702000_17.6.e260735.11","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1053\/j.ajkd.2013.02.376","article-title":"Babesiosis-induced acute kidney injury with prominent urinary Macrophages","volume":"62","author":"Luciano","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"2025082706480702000_17.6.e260735.12","unstructured":"Prevention CC for DC and CDC - Babesiosis - resources for health professionals. 2023. 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