Folia Parasitologica 67:031 (2020) | DOI: 10.14411/fp.2020.031

The first human case of babesiosis mimicking Reiter's syndrome

Zuzana Strizova¹, Klara Havlova², Ondrej Patek³, Daniel Smrz¹, Jirina Bartunkova¹

¹ Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;

² Department of Urology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;

³ Department of Internal Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic

Babesiosis is a tick-borne disease that may exhibit a broad range of clinical manifestations. According to the Food and Drug Administration (FDA), Babesia species belong to the most common transfusion-transmitted pathogens (FDA, May 2019), but the awareness of the disease caused by these parasitic protists is still low. In immunocompromised patients, the clinical course of babesiosis may be of extreme severity and may require hospital admission. We demonstrate a case of a young male who experienced severe polytrauma requiring repetitive blood transfusions. Six months later, the patient developed a classic triad of arthritis, conjunctivitis and non-specific urethritis. These symptoms largely mimicked Reiter's syndrome. The patient was later extensively examined by an immunologist, rheumatologist, urologist, and ophthalmologist with no additional medical findings. In the search for the cause of his symptoms, a wide laboratory testing for multiple human pathogens was performed and revealed a babesiosis infection. This was the first case of human babesiosis mimicking Reiter's syndrome. Following proper antimicrobial therapy, the patient fully recovered in four weeks. We aim to highlight that a search for Babesia species should be considered in patients with non-specific symptomatology and a history of blood transfusion or a possible tick exposure in pertinent endemic areas.

Keywords: arthritis, conjunctivitis, urethritis, Babesia microti, transfusion, diagnosis

Received: April 23, 2020; Revised: July 23, 2020; Accepted: August 20, 2020; Published online: October 30, 2020  Show citation