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Babesiosis — DTM&H MCQ

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HardProtozoal infectionsBabesiosisDTM&H

An asplenic man with Babesia microti infection has 14% parasitaemia, haemoglobin 62 g/L, rising creatinine and hypoxaemia. What is the most appropriate escalation in addition to active combination antimicrobial therapy?

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Correct answer: A — Urgent expert assessment for red-cell exchange transfusion

The best answer is “Urgent expert assessment for red-cell exchange transfusion”. High-grade parasitaemia above 10%, severe haemolytic anaemia and renal or pulmonary compromise are guideline-supported reasons to consider red-cell exchange with transfusion and infectious-disease expertise. Exchange rapidly reduces infected erythrocytes; it complements rather than replaces antimicrobial treatment.

Reference: IDSA 2020 guideline on diagnosis and management of babesiosis: https://www.idsociety.org/practice-guideline/babesiosis/; Worshipful Society of Apothecaries DTM&H examination guide and syllabus: https://www.apothecaries.org/wp-content/uploads/2025/12/Guide-to-the-Diploma-in-Tropical-Medicine-Hygiene.pdf