Background: Babesiosis is an emerging infectious disease caused by a tick-borne parasite that infects red blood cells. Pregnancy is a relatively immunocompromised state that can underlie severe manifestations of parasitic disease.
Case: A healthy primiparous patient in the second trimester developed nonspecific symptoms after a tick bite. Evaluation by obstetrics, primary care, and neurology over 4 weeks yielded diagnoses of Lyme disease, upper respiratory infection, migraine, and medication overuse headache. Babesiosis was diagnosed only after she became acutely ill with hemolysis. She was treated with standard antibiotics and had an uncomplicated pregnancy and healthy newborn.
Conclusion: Diagnosis of babesiosis in pregnancy requires a high index of suspicion to ensure early treatment and optimal pregnancy outcomes.