Babesiosis-associated Splenic Rupture: Case Series From a Hyperendemic Region

Abstract

Background: Spontaneous splenic rupture is an increasingly reported complication of babesiosis and has been described as a severe complication.

Methods: We performed a retrospective chart review in a high-prevalence area to identify 7 cases of babesiosis-related splenic rupture between 2014 and 2016.

Results: Splenic rupture occurred in approximately 1% of babesiosis cases. Compared to cases without splenic rupture, these patients were younger (by >10 years), healthier (most with ≤1 comorbidity), had a lower degree of parasitemia (<10%), and were less likely to have end-organ dysfunction other than their splenic involvement.

Conclusions: Younger, healthier patients may be more prone to develop splenic rupture, as splenic histiocytes engage in more robust erythrophagocytosis, leading to pathological mechanical strain and rupture.

Keywords: babesiosis; splenic rupture; tick-borne disease.