Answer: Exchange transfusion
There are 2 combination treatments used in babesiosis
- atovaquone and azithromycin
- clindamycin and quinine
But in severe and life-threatening cases, exchange transfusion (ET) is indicated. Babesiosis is generally a subclinical infection in most normal hosts, but it can be life threatening in asplenic patients, older, or immunocompromised individuals progressing to coma, renal failure, or ARDS. ET is recommended to reduce the level of parasitized RBCs, to remove cytokines, and to improve the rheologic properties of the blood.