Case report: Overwhelming babesia parasitemia successfully treated promptly with rbc apheresis and triple therapy with clindamycin, azithromycin, and atovaquone

Abstract

Babesiosis with high-grade parasitemia is life-threatening, especially in asplenic hosts. We report an asplenic patient with parasitemia >50% who was successfully treated with prompt red blood cell apheresis and triple therapy with clindamycin + azit hromycin + atovaquone. This regimen may be an alternative to poorly tolerated clindamycin + quinine in severe cases.