CTICasesBabesiosis
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Imaging findings
Initial chest radiograph is clear. A few days later, diffuse lung disease with reticular-nodular opacities and areas of consolidation, particularly in mid-lungs and bases. CT shows extensive ground-glass opacities, predominantly upper lung distribution, with some central and basal involvement. Areas resembling organizing pneumonia and diffuse alveolar damage are seen, with peribronchial/perilobular consolidation and interstitial edema signs like septal lines, peribronchial cuffs, subpleural edema, and small pleural effusions. Blood smear shows Babesia parasites within red blood cells.
Key takeaways
Babesiosis is an opportunistic infection in immunocompromised patients (e.g., stem cell transplant recipients), caused by a tick-borne parasite (or transfusion-acquired). It presents with hemolytic anemia and rapidly progressive pulmonary edema (acute lung injury). Clinically, it can mimic pneumocystis or other viral pneumonias. It is treatable with antibiotics and is endemic in some regions.
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