Thrombocytopenia(decrease in platelet count)
Peripheral blood smear:
The blood is taken from the infected individuals and it is stained with wright stain or giemsa stain. The organisms within the red blood cells shows the ring form with light blue cytoplasm. Maltese cross formations(cross inclusion bodies formed by the 4 merozoites which undergoes asexual reproduction and linked to each other )are the diagnostic features of babesiosis.
Serological test with indirect immunofluorescence antibody test(IFAT) is using and recommended test to detect the antibodies to parasite. IgG antibodies remains declined in the patients with persisitent infection that is the infection that is lasting greater than 3 months.
Molecular diagnostic approach:
With the discovery of PCR (polymerase chain infection) mild infection can also be detected the early stages.Amplification of highly conserved sequence such as amplification in the specific region such as nss-DNA. Patients with detectable babesial DNA in their blood are likely to be parsitemic.
clinically apparent cases may develop high levels of transaminases, alkaline phosphatases, unconjugated bilirubin, and lactic dehydrogenase in serum. Normochromia, normocytic anemia, thrombocytopenia, and, occasionally, leukopenia may also be present. This may be due to TNF-mediated inflammation responses, similar to the pathogenesis of severe malarial infections. However, in light of the recent recognition of coinfection in humans with multiple tick-transmitted agents, it is possible that some of the more variable aspects of the disease could also be associated with coinfection