A patient with babesiosis may not respond to therapy as expected. Failure to respond to therapy should prompt a review of the diagnosis and the therapeutic regimen.
Reasons why the patient with babesiosis may not respond to therapy as expected:
(1) error in diagnosis:
(1a) misdiagnosis of malaria
(1b) based on serology
(2) severe babesiosis or one of its complication such as splenic rupture
(3) concurrent infection with Lyme disease or anaplasmosis
(4) inappropriate antibiotic therapy
(5) noncompliance with the drug regimen
(6) onset of an unrelated disorder
where:
• Ixodes scapularis ticks may be infected with multiple pathogens and can transmit these during a blood meal.
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