ArticleASM case reports2026
Babesiosis at ultra-low parasitemia presenting as secondary hemophagocytic lymphohistiocytosis in a patient on B cell-depleting therapy.
Article in ASM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Case Summary: We report a case of babesiosis manifesting in a subacute fashion with secondary HLH in a 51-year-old female on B cell-depleting therapy. She presented in December with generalized weakness and fever and was found to have pancytopenia, transaminitis, and hyperinflammatory markers consistent with HLH. A microbial cell-free DNA next-generation sequencing test detected Conclusion: This case highlights the heterogeneity of babesiosis and its potential to present with minimal parasitemia, yet severe systemic inflammation in immunocompromised hosts. Additionally, this case underscores the importance of maintaining a broad differential in patients on B cell-depleting agents who present with new pancytopenia and systemic inflammatory symptoms. Early utilization of microbial cell-free DNA next-generation sequencing tests may aid in timely diagnosis and treatment.
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