{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:45:03Z","timestamp":1793040303885,"version":"4.5.0"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"<jats:p>\n                    Babesiosis is an emerging tick-borne disease transmitted by the hard tick\n                    <jats:italic>Ixodes scapularis<\/jats:italic>\n                    , which also transmits Lyme disease. Better gradation of prognostic indicators are needed to determine which patients may develop serious complications requiring hospitalization, and to provide early guidance on appropriate therapy. In this study, we evaluated 128 patients with smear or real time polymerase chain reaction-confirmed\n                    <jats:italic>Babesia microti<\/jats:italic>\n                    infections over a period of 16 years. Patients with asplenia or immunocompromising conditions were more likely to have severe infection (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01), require hospitalization (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01), or receive prolonged courses of antimicrobials (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01). Nausea or vomiting (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01) and diarrhea (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01) along with hyperbilirubinemia (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.01) were predictive of severe infection, hospitalization, and prolonged antimicrobial therapy. Patients with concurrent Lyme disease were less likely to require hospitalization and had similar severity of disease and length of antibiotic treatment compared with those without Lyme disease.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.17-0146","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T03:00:43Z","timestamp":1499742043000},"page":"1218-1225","source":"Crossref","is-referenced-by-count":53,"title":["Risk Factors for Severe Infection, Hospitalization, and Prolonged Antimicrobial Therapy in Patients with Babesiosis"],"prefix":"10.4269","volume":"97","author":[{"given":"Neeharik","family":"Mareedu","sequence":"first","affiliation":[{"name":"Marshfield Clinic Health System, Marshfield, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Schotthoefer","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Research Institute, Marshfield, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Tompkins","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Health System, Marshfield, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Hall","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Health System, Marshfield, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas R.","family":"Fritsche","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Health System, Marshfield, Wisconsin;"},{"name":"University of Wisconsin, La Crosse, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly M.","family":"Frost","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Research Institute, Marshfield, Wisconsin;"},{"name":"Marshfield Clinic Health System, Minocqua, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"N Engl J Med","first-page":"936","article-title":"Tick-borne diseases in the United States","volume":"329","author":"Spach","year":"1993"},{"key":"b2","series-title":"Infect Dis Clin North Am","first-page":"357","article-title":"Babesiosis","volume":"29","author":"Vannier","year":"2015"},{"key":"b3","series-title":"Nat Microbiol","first-page":"16079","article-title":"A global map of genetic diversity in Babesia microti reveals strong population structure and identifies variants associated with clinical relapse","volume":"1","author":"Lemieux","year":"2016"},{"key":"b4","series-title":"Vector Borne Zoonotic Dis","first-page":"265","article-title":"Epidemiology and impact of coinfections acquired from Ixodes ticks","volume":"2","author":"Belongia","year":"2002"},{"key":"b5","series-title":"Emerg Infect Dis","first-page":"1318","article-title":"Vertical transmission of Babesia microti, United States","volume":"18","author":"Joseph","year":"2012"},{"key":"b6","series-title":"N Engl J Med","first-page":"2236","article-title":"Screening for Babesia microti in the U.S. Blood Supply","volume":"375","author":"Moritz","year":"2016"},{"key":"b7","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"505","article-title":"Babesiosis surveillance: 18 states, 2011","volume":"61","year":"2012"},{"key":"b8","series-title":"J Med Entomol","first-page":"349","article-title":"County-scale distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the continental United States","volume":"53","author":"Eisen","year":"2016"},{"key":"b9","series-title":"Infect Dis Clin North Am","first-page":"187","article-title":"Epidemiology of Lyme disease","volume":"29","author":"Mead","year":"2015"},{"key":"b10","series-title":"Clin Infect Dis","first-page":"1117","article-title":"Severe babesiosis in Long Island: review of 34 cases and their complications","volume":"32","author":"Hatcher","year":"2001"},{"key":"b11","series-title":"J Parasitol Res","first-page":"587131","article-title":"Human coinfection with Borrelia burgdorferi and Babesia microti in the United States","volume":"2015","author":"Knapp","year":"2015"},{"key":"b12","series-title":"Clin Infect Dis","first-page":"e92","article-title":"Spontaneous splenic rupture caused by Babesia microti infection","volume":"46","author":"Kuwayama","year":"2008"},{"key":"b13","series-title":"Clin Infect Dis","first-page":"1019","article-title":"Human babesiosis in New York state: an epidemiological description of 136 cases","volume":"15","author":"Meldrum","year":"1992"},{"key":"b14","series-title":"Am J Med","first-page":"696","article-title":"Babesiosis in splenectomized adults. 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