Babesia microti Infection in Pregnancy Mimicking HELLP Syndrome

Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is associated with maternal and fetal complications. HELLP syndrome is diagnosed by laboratory abnormalities; approximately 85% of cases have hypertension and proteinuria. Magnesium sulfate is recommended for seizure prophylaxis, and prompt delivery is recommended. Imitators of HELLP syndrome such as acute fatty liver and thrombocytopenic thrombotic purpura have been described. We report a case of Babesia microti infection in pregnancy presenting similarly to HELLP syndrome.

Babesia microti Infection
Babesia microti Infection

A 34-year-old gravida 3 para 1-0-1-1 at 38 1/7 weeks of gestation was transferred from a community hospital to our tertiary care center for induction of labor for suspected HELLP syndrome. The patient reported a one-week history of malaise, diffuse joint pain, “painful skin” and headaches.


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