Babesiosis in the Immediate Postoperative Period after Splenectomy for Trauma

Background: In an immunocompetent host, Babesia microti has not been reported as a cause of postoperative fever. Methods: Case report and literature review. Results: A 52-year-old woman living on Martha's Vineyard developed postoperative fever after splenectomy for trauma. The patient's mechanism of injury was a fall from a stationary bicycle. Intraoperatively, the patient was noted to have splenomegaly. Postoperatively, she developed fever and was found to have Babesia microti on blood smear with an otherwise negative fever evaluation. She was treated with atovaquone and azithromycin and made a full recovery. Conclusions: For individuals who have lived or traveled in endemic areas, babesiosis should be considered as a possible cause of postoperative fever when other sources have been excluded. Patients undergoing splenectomy in an endemic area should be screened for babesiosis to prevent postoperative recrudescence of symptoms.