Babesia microti causes most cases in the United States. It is transmitted by hard ticks (the same Ixodes ticks that carry the bacteria responsible for
Lyme disease).
Babesia invades human red blood cells and replicates within the RBCs. In histopathology, we can look for distinctive trophozoite tetrad form in blood smears.
Infected red blood cells rupture and release the parasites.
Subsequent parasitemia produces clinical symptoms, such as fever, headache, chills, and fatigue.
Serious infection can ultimately produce
hemolytic anemia and renal failure.
Released parasites invade new red blood cells, and repeat the cycle of replication and cell rupture.