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Transfusion-Associated Babesiosis with an Atypical Time Course after Nonmyeloablative Transplantation for Sickle Cell Disease

Christopher M. Cirino, DO; Susan F. Leitman, MD; Esther Williams; Daniel Fedorko, PhD; Tara N. Palmore, MD; Amy Klion, MD; Christian Ockenhouse, MD, PhD; Courtney Fitzhugh, MD; John F. Tisdale, MD; and Matthew M. Hsieh, MD
[+] Article and Author Information

From St. Vincent Health Center, Erie, PA 16544; National Institute of Diabetes and Digestive and Kidney Diseases, Warren Grant Magnuson Clinical Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and Walter Reed Army Institute of Research, Silver Spring, MD 20910.


Acknowledgment: The authors would like to thank the Reference Diagnostic Laboratory, Division of Parasitic Diseases, Centers for Disease Control and Prevention.

Grant Support: This research was supported by the intramural research programs of the National Institute of Diabetes and Digestive and Kidney Diseases, and National Institute of Allergy and Infectious Diseases, and the Warren Grant Magnuson Clinical Center of the National Institutes of Health.

Potential Financial Conflicts of Interest: None disclosed.


Ann Intern Med. 2008;148(10):794-795. doi:10.7326/0003-4819-148-10-200805200-00018
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Figure.
Intraerythrocytic ring forms on a Wright–Giemsa-stained smear of peripheral blood from a patient with transfusion-associated babesiosis.

Morphologic differentiation of Babesia microti and Plasmodium falciparum can be difficult, particularly if the parasitemia level is low and only ring forms are found. The presence of vacuolated, pleomorphic rings, without pigment or gametocytes, is characteristic of Babesia infection. Tetrad (Maltese cross) forms are pathognomonic but uncommonly seen.

Grahic Jump Location

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