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A 60-year-old man presents with fever, fatigue, headache, and myalgias for the past 4 days. He recently returned from a vacation on Martha™s Vineyard. On examination, his pulse is 110 and his BP is 110/70. His temperature is 39°C. There is some scleral icterus. His blood work reveals the following:
Hemoglobin 8.2 g/dL
Hematocrit 24%
MCV 94 fL
Reticulocytes 9%
Platelets 150 K/μL
Total bilirubin 3.5 mg/dL
Direct bilirubin 1 mg/dL
Lactate dehydrogenase 500 U/dL
A peripheral smear is obtained that reveals intraerythrocytic oval parasites, with some tetrads. What is the most likely vector of this disease?
A. Anopheles mosquito
B. Reduviid bug
C. Brown recluse spider
D. Ixodes tick
E. Tsetse fly

Babesiosis ... ans ... DDD

yes babesiosis...
very nice q
DD

Answer: D. This patient presents with hemolytic anemia due to parasitemia.
He recently returned from Martha™s Vineyard, which is a clue to the diagnosis of
babesiosis. Babesiosis is a parasitic disease that is transmitted by the Ixodes tick.
In the United States, Babesia microti is endemic to areas in the Northeast.
Patients can be asymptomatic or can develop life-threatening hemolytic anemia. It
is often difficult to distinguish babesiosis from malaria (transmitted by the
anopheles mosquito) based on the peripheral smear alone, but epidemiologic
information and serology can be helpful. The reduviid bug is the vector of Chagas™
disease, while the tsetse fly is the vector for African trypanosomiasis.