Acute Babesiosis in Pregnancy: A Novel Imitator of Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome.

Abstract

Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is a serious complication of pregnancy associated with significant maternal and fetal morbidity and mortality. Several medical conditions have been described as imitators of this syndrome, presenting with similar signs and symptoms. A term, multiparous woman with a history of prior pregnancy complicated by preeclampsia developed symptoms and laboratory abnormalities suggestive of HELLP syndrome. After an uncomplicated repeat caesarean delivery of a healthy newborn, infection with Babesia species was diagnosed incidentally on a peripheral blood smear. She was treated with antibiotics postpartum without sequelae for her or her newborn. The laboratory abnormalities normalized by postoperative day 4. Babesiosis complicating pregnancy may be a novel imitator of HELLP syndrome and should be considered in the differential diagnosis, especially where geographically prevalent infection exists.