Acute Babesiosis in Pregnancy: A Novel Imitator of Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome.

BACKGROUND Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is a serious complication of pregnancy associated with significant maternal and fetal morbidity and mortality. Several medical conditions have been described as imitators of this syndrome, presenting with similar signs and symptoms. CASE A term, multiparous woman with a history of prior pregnancy complicated by preeclampsia developed symptoms and laboratory abnormalities suggestive of HELLP syndrome. After an uncomplicated repeat caesarean delivery of a healthy newborn, infection with Babesia species was diagnosed incidentally on a peripheral blood smear. She was treated with antibiotics postpartum without sequelae for her or her newborn. The laboratory abnormalities normalized by postoperative day 4. CONCLUSION Babesiosis complicating pregnancy may be a novel imitator of HELLP syndrome and should be considered in the differential diagnosis, especially where geographically prevalent infection exists.