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Babesiosis is an anthropo-zoonotic tick-borne disease. Babesia microti, B. divergens, B. duncani , B. venatorum and a B. crassa like pathogen are known to cause human disease [1-3]. Ixodes scapularis is the principal vector in Eastern United States [2]. The intraerythrocytic parasite causes an infection ranging from asymptomatic to life threatening [4,5]. More severe cases are in asplenic, elderly or immunocompromised individuals [1,4,6]. Some cases have been acquired from blood transfusions [5,7] and organ transplants [8] or transmission from mother to the fetus [9,10]. Here we report the unusual presentations of 2 patients, presenting with left upper quadrant pain in Warren County, New Jersey, USA, initially misdiagnosed and treated for pyelonephritis.

Unusual presentation of babesiosis with delayed diagnosis in 2 patients with intact spleens and mixed infections