Case Report

A 67-year-old male with a past medical history of chronic kidneyinsufficiency, splenectomy, and recurrent babesiosis infectionwas transferred to with jaundice and abdominal pain.The patient initially presented to an outside hospital (OSH) withgeneralized weakness, chills, and gastrointestinal symptoms andwas found to have Babesia on peripheral blood smears. The patient received seven days of azithromycin and atovaquone,followed by three days of clindamycin and quinine sulfate.The patient was discharged home with improved symptomsand a negative peripheral blood smear. Less than 24 hourslater he returned to the OSH with worsening myalgias andabdominal pain. Physical exam was significant for jaundiceand hepatomegaly. Laboratory data revealed anemia, elevatedcreatinine, bilirubin of 30 mg/dL, and 1% parasitemia. At this point the patient was transferred for further management.