Table 1.
Demographic data, clinical features, management, and outcome of patients who developed splenic complications during acute Babesia microti infection.
| Case (ref) | Year (author) | Age | Sex | US state, country | Comorbid conditions | Symptoms duration PTP (days) | Dx missed initially | Remembers tick bite | SIRS/HD unstable on admission | Hgb (md/dl) | Platelet (×109/L) | Coinfection | Parasitemia level (%) | Splenomegaly | Type of splenic involvement PTA or AA | Transfusion (units) | ICS | Antibiotic treatment | Splenectomy |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 [19] | 2001 (Javed) | 85 | M | NJ, USA | HTN | Fever, chills, malaise (7–14) | Yes | No | No | 12 | 23 | Yes E.ch. | 8 | No | I | Yes (2) | No | TCV + CLIN + QI | No, expired |
| 2 [20] | 2008 (Kuwaya ma) | 61 | M | NJ, USA | None | Fever, chills, malaise, AP (180) intermittent | Yes | No (golfing) | No | 11 | 33 | No | 5 | Yes | R (AA) | Yes (4) | No | AZ + ATQ (7) | Yes |
| 3 [21] | 2008 (Froberg) | 56 | M | MN, USA | HTN | Night sweats, malaise (NR) | Yes | NR | Yes | 9.3 | 37 | Yes (LD) | NR | Yes | R (AA) | NR | No | NR | Yes |
| 4 [22] | 2008 (Florescu) | 58 | M | NJ, USA | None | Fever, AP, malaise, syncope (5) | Yes | No | No | 13.6 | 209 | APG | 0.5 | Yes | I | No | AZ + ATQ (NR) | No | |
| 5 [22] | 2008 (Florescu) | 75 | F | NY, USA | HTN | Night sweats, malaise (NR) | Yes | No | Yes | 8.7 | 55 | No | NR | Yes (massive) | I | NR | No | AZ + ATQ QI + CLIN | No, expired |
| 6 [23] | 2008 (Sidertis) | 50 | M | NJ, USA | None | Fever, AP, malaise, syncope (5) | Yes | No (golfing) | Yes | 9.3 | 458 | NR | 3 | Yes | R (PTA) | Yes (2) | No | AZ + ATQ (NR) | Yes |
| 7 [23] | 2008 (Sidertis) | 71 | M | NJ, USA | NR | Syncope (NR) | No | NR | Yes | 9.2 | 72 | NR | NR | Yes | R (PTA) | Yes (2) | No | CLIN + QI (10) | Yes |
| 8 [24] | 2011 (Tobler) | 54 | M | MA, USA | None | Nausea, chills, malaise, fever, AP (2) | No | No | No | 10.2 | 26 | No | 3 | Yes | R (PTA) | Yes (platelet) | No | AZ + ATQ (10) | No |
| 9 [25] | 2011 (Abbas) | 23 | M | CT, USA | None | Fever, chills, weight loss, malaise LDN (0.5) | Yes | Yes | No | 6.8 | 78 | No | 30 | Yes | R (PTA) | Yes (4) | No | CLIN + QI (10) | No |
| 10 [26] | 2011 (Reis) | 70 | M | NY, USA | NR | Fever, nausea, vomiting (3) | No | No | No | 8.5 | 90 | No | NR | Yes | R (PTA) | Yes (2) | No | AZ + ATQ (14) | No, SA embolization |
| 11 [27] | 2011 (El Khouri) | 70 | M | NY, USA | None | Fever, chills, malaise (4) | No | NR | No | 10.1 | 77 | No | 8 | Yes | R (PTA) | Yes (3) | No | CLIN + QI AZ + ATQ (16) | No, SA embolization |
| 12 [27] | 2011 (El Khouri) | 36 | M | NY, USA | None | Fever, headache, chills, cough (14) | No | NR | No | 8.5 | 133 | No | 3.5 | Yes | R (AA) | No | No | AZ + ATQ (21) | No |
| 13 [28] | 2011 (Wormser) | 55 | M | RI, USA | Diverticulosis | Fever, rash, AP (10) | Yes | NR | Yes | 13.4 | 99 | NR | 0.1 | NR | R (PTA) | NR | No | AZ + ATQ (42) relapse after 10-day course | Yes |
| 14 [29] | 2013 (Seible) | 83 | M | MA, USA | NR | Fever, nausea, AP (2) | No | NR | NR | NR | 66 | No | 14 | NR | R (PTA) | Yes exchange | No | CLIN + QI (30) | No |
| 15 [30] | 2013 (Leinwan d) | 48 | M | CT, USA | None | Headache, AP, malaise (7) | No | No (camping) | No | 10.5 | 137 | No | 10 | Yes | R (PTA) | NR | No | AZ + ATQ (NS) | No observation |
| 16 [31] | 2014 (Usatti) | 54 | M | CT, USA | None | Fever, headache, AP (2) | Yes | NR | Yes | 10.6 | 123 | No | NR | Yes | R (PTA) | Yes (2) | No | AZ + ATQ (10) | No |
| 17 [32] | 2015 (Farber) | 59 | F | CT, USA | HLP depression | Fever, chills, syncope, fatigue, AP (14) | No | No (gardening) | Yes | 8.2 | 127 | No | 1 | Yes | R (PTA) | Yes (2) | No | CLIN + AZ + ATQ (14) | Yes |
| 18 [33] | 2016 (Al Zoubi) | 72 | M | Ecuador | HTN | Fever, chills, weight loss, AP (NR) | Yes | NR | No | 7.8 | 55 | No | 0.5 | Yes | I | NR | No | ATQ + PRG (NR) | No |
| 19 [34] | 2016 (Wong) | 56 | M | NY, USA | Diabetes | Fever, malaise, night sweats (6) | Yes | No (landscaping) | No | 10.7 | 163 | Yes (LD) | 1.5 | No | I | No | NO | AZ + ATQ (10) | No SA embolization |
| 20 [35] | 2017 (Permpalu ng) | 59 | M | MA USA | MVP | Headache, fever, AP (14) | Yes | NR | NR | 10.4 | 156 | No | NR | Yes | I | No | No | AZ + ATQ (10) | No SA embolization |
| 21 [36] | 2018 (Dumic) | 79 | F | WI, USA | HTN atrial fibrillation CAD | Chest pain, dizziness (1) | Yes | Yes | Yes | 6.5 | 6.5 | Yes (LD) | 1.3 | No | R (PTA) | Yes (4) | No | AZ + ATQ (10) Doxy (21) | Yes |
| 22 [37] | 2018 (Blackwo od) | 51 | M | RI, USA | HTN atrial fibrillation | Fever, chills, malaise, AP (5) | No | Yes | Yes | 9.3 | 25 | NR | 0.25 | Yes | R (PTA) | Yes (4) | No | AZ + ATQ (14) | Yes |
| 23 [37] | 2018 (Blackwo od) | 61 | M | RI, USA | HTN, HLP | Fever, chills, malaise, AP (3) | Yes | No (gardening) | Yes | 12.4 | 89 | NR | 0.44 | Yes | I | No | No | AZ + ATQ (NR) | No |
| 24 [38] | 2018 (Li) | 48 | M | RI, USA | Asthma | Fever, chills, night sweats, AP (7) | NR | NR | No | 8.8 | 68 | NR | 0.22 | YES | R (NR) | NR | No | NR | No SA embolization |
| 25 [13] | 2018 (Patel) | 48 | M | RI, USA | Asthma | Fever, chills, night sweats, AP (7) | NR | NR | No | 8.8 | 68 | NR | 0.22 | Yes | R (NR) | NR | No | NR | No SA embolization |
| 26 [13] | 2018 (Patel) | 83 | M | RI, USA | CKD COPD | AP (1) | NR | NR | Yes | 11.3 | 94 | NR | 0.30 | NR | R (NR) | NR | No | NR | No |
| 27 [13] | 2018 (Patel) | 40 | M | RI USA | Diabetes | Fever, malaise, night sweats (5) | NR | NR | No | 7.8 | 74 | NR | 0.07 | NR | R (NR) | NR | No | NR | No |
| 28 [13] | 2018 (Patel) | 51 | M | RI, USA | HTN atrial fibrillation | Night sweats, headache, malaise, AP (3) | NR | NR | Yes | 8.7 | 25 | NR | 0.25 | 18.2 | R (NR) | NR | No | NR | Yes |
| 29 [13] | 2018 (Patel) | 48 | M | RI, USA | None | Fatigue, AP (5) | NR | NR | Yes | 7.9 | 59 | NR | 0.26 | 16 | R (NR) | NR | No | NR | Yes |
| 30 [13] | 2018 (Patel) | 36 | M | RI, USA | None | Fever, AP (4) | NR | NR | No | 10.6 | 80 | NR | 0.35 | NR | R (NR) | NR | No | NR | No |
| 31 [13] | 2018 (Patel) | 68 | M | RI, USA | HTN | Malaise, AP (NR) | NR | NR | No | 6.6 | NR | NR | 5 | NR | R (NR) | NR | No | NR | No |
| 32 [39] | 2018 (Kwon) | 50 | F | South Korea (imported from NJ, USA) | None | Headache, fever, AP, chills (NR) | Yes | NR (gardening) | No | 11.2 | 53 | NR | NR | NR | I | NR | No | ATQ/+AZ (NR) | No |
| 33 [40] | 2019 (Alvi) | 60 | M | CT, USA | HTN, diabetes, HLP | Fever, chills, rigors, AP (7–10) | Yes | No | Yes | 10.2 | 36 | No | 11 | Yes | I | Yes | No | NS AZ + ATQ (14) | No observation |
| 34 [41] | 2019 (Gupta) | 53 | M | NY, USA | None | Fever, chills, weakness (7) | No | No (hiking) | NR | 11.2 | 90 | NR | 1.5 | NR | I | No | No | AZ + ATQ (NS) | No observation |
A: azithromycin; AA: after admission; AP: abdominal pain; APG: Anaplasma phagocytophilum; ATQ: atovaquone; CKD: chronic kidney disease; CLIN: clindamycin; CT: Connecticut; Dx: diagnosis; E. ch: Ehrlichia chaffeensis; F: female; HA: headache; HD: hemodynamic; Hgb: hemoglobin, HLP: hyperlipidemia; HTN: hypertension; I: infarction; ICS immunocompromised state; LD: Lyme disease; LDN: lymphadenopathy; M: male; MA: Massachusetts; MN: Minnesota; MVP mitral valve prolapse; NJ: New Jersey; NR: not reported; NS: not specified; NY: New York; PRG: proguanil; PTA: prior to admission; PTP: prior to presentation; QI: quinine; R: rupture; Ref: reference; SA: splenic artery; TCV: ticarcillin-clavulanic acid “SIRS: systemic inflammatory response syndrome”.