Response of Babesiosis to Pentamidine Therapy

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Abstract
Three nonsplenectomized patients were infected with B. microti. One had fever, abdominal pain suggesting gallbladder disease and evidence of disseminated intravascular coagulation; another was considered to have lymphoma, partly because 2 smears for Babesia before admission were negative. All 3 patients were treated with pentamidine isethionate and improved clinically. Parasites were no longer seen on smears after 5 days of therapy, but Babesia could still be recovered by hamster inoculation 5 wk after therapy in 1 of the patients tested, underscoring the need for this test to properly evaluate eradication of the organism. In 1 patient, pentamidine was stopped after 7 days because of increased creatinine concentration and this amount of drug appeared adequate to control the parasitemia. Pain at drug injection sites was a major side effect in all 3 patients. Pentamidine appears to be useful in controlling clinical manifestations of babesiosis and decreasing parasitemia, but it does not eradicate the organism.