228 Ch 228. Babesiosis

Tick-borne intra-erythrocytic protozoan; Babesia microti USA NE/Midwest, B. divergens Europe; asplenic + immunocompromise = severe disease; mimics malaria on smear; atovaquone + azithromycin for mild-moderate, clindamycin + quinine + exchange transfusion for severe; co-infection with Lyme + Anaplasma (same Ixodes tick)。