Table. Characteristics of two men who had babesiosis in 1998 and 2000, respectively^a–c.

Characteristics	Italian patient	Austrian patient
Residence and outdoor activities	Lived in northern Italy, in a small town in the district of Romagna, on ~1 hectare of land; often hunted moles in his garden, even after he started chemotherapy	Lived in northeastern Austria, in a small town in the district of Krems Land, in the province of Lower Austria; had an off-site garden; often hunted in the Dunkelsteinerwald forest (usually wild boars, sometimes foxes and badgers)
Clinical illness and general laboratory data
Initial clinical manifestations	Fever (39°C) and chills developed on October 14, 1998; hospitalized on October 18 because of fever, headache, confusion, jaundice, and dark urine (discharged on November 6)	Marked fatigue developed on July 23, 2000; dark urine, without dysuria, developed on July 24; hospitalized on July 25 (discharged on August 2)
Hematologic parametersd
Hemoglobin (g/dL)	4.8	15e (13.2 on July 27, 2000)
Leukocyte count (x109/L)	4.4	7.3 (7.8, with 5% atypical lymphocytes, on July 26)
Platelet count (x109/L)	71	15 (8 on July 27)
Values of serum chemistriesd
Lactate dehydrogenase (U/L)	7,877 (normal range 230–460)	994 (July 26, 2000) (normal range 120–240)
Total bilirubin (mg/dL)	3.2 (normal range 0.2–1.10)	3.27 (July 26) (normal range 0.2–1.0)
Indirect bilirubin (mg/dL)	2.4 (normal range 0.2–0.85)	2.36 (July 26) (normal range 0.0–1.0)
Direct (conjugated) bilirubin (mg/dL)	0.8 (normal range 0.0–0.25)	0.91 (July 26) (normal range 0.0–0.25)
Creatinine (mg/dL)	2.5 (normal range 0.50–1.20)	1.04 (normal range 0.5–1.3)
Diagnosis of Babesia infection
Parasitemia level (% of erythrocytes that were infected) on first blood smear examined	~30% (October 24, 1998)	1.3% (July 25, 2000) (Figure 2)
Antibody titers in IFA testing for reactivity to B. divergens antigensf	Titers of 1:64 (specimen from October 28, 1998) and 1:256 (February 15, 1999) in testing at both CDC and the Clinical Institute of Hygiene of the University of Vienna	Titers of 1:256 (July 31, 2000) and 1:1,024 (August 8, 2000) in testing at CDC and titers of 1:64 (July 31) and 1:1,000 (August 8) in testing at the Clinical Institute of Hygiene of the University of Vienna
Therapy for babesiosis
Antimicrobial therapy	Clindamycin (600 mg thrice daily, by intravenous infusion) and quinine sulfate (650 mg thrice daily, by mouth) for 15 days, from October 24, 2000 (i.e., 10 days after onset of fever), through November 7	Clindamycin (600 mg thrice daily), by intravenous infusion, for 8 days, from July 25, 2000 (i.e., 2 days after onset of symptoms), through August 1, and by mouth, for 15 days thereafter (through August 15)
Blood transfusions	11 U packed erythrocytes, from October 19–31, 1998c,g	None
Response to therapy	Fever resolved by day 3 of therapy; no parasites found by blood-smear examination after day 6 of therapy; negative PCR analysis of blood from February 15, 1999	Blood from August 8, 2000, negative by blood-smear examination but positive by PCR analysis; negative PCR analysis of blood from November 7, 2000, and February 8, 2001
Long-term follow-up	Non-Hodgkin’s lymphoma remitted during hospitalization in 1998, but the lymphoma relapsed in February 2000; no parasites were found on blood smears during subsequent chemotherapy	Remained well

^aIFA, indirect fluorescent antibody; PCR, polymerase chain reaction; CDC, Centers for Disease Control and Prevention.
^bNon-Hodgkin’s lymphoma developed in the Italian patient (diagnosis: June 1998). Chemotherapy, begun on September 23, 1998, was stopped prematurely on October 14, after he became febrile. His chemotherapeutic regimen included daily prednisone (75 mg) and weekly administration of various drugs in rotation. He received 4 of the intended 12 weeks of therapy, which included doxorubicin and cyclophosphamide during odd-numbered weeks (weeks 1 and 3) and vincristine and either methotrexate (week 2) or bleomycin (week 4) during even-numbered weeks.
^cAlthough the possibility that he became infected by blood transfusion could not be excluded because he had been transfused before blood smears were examined, his febrile illness and hemolytic anemia preceded the transfusions.
^dLaboratory values were from hospital admission (October 18, 1998, for the Italian patient, and July 25, 2000, for the Austrian patient), unless otherwise specified. Values for the Austrian patient are from testing performed at the hospital to which he was transferred after a brief (<24-hour) stay at a local hospital.
^eEarlier on July 25, at a local hospital, his hemoglobin value was 16.2 g/dL, which had been his approximate baseline value during the previous 10 months.
^fIFA testing of serum specimens from both patients was negative for antibodies to B. microti. A specimen from the Italian patient (February 15, 1999) was negative for antibodies to WA1.
^gPlasma exchange was performed on October 23, when he mistakenly was thought to have thrombotic th