American Board of Internal Medicine (ABIM) Certification Practice Exam

How should asymptomatic patients with babesiosis be managed?

1. They should receive immediate treatment with antibiotics.

2. They need follow-up with polymerase chain reaction assay.

3. They require hospitalization for observation.

4. They should have a repeat blood transfusion.

The correct answer is: They need follow-up with polymerase chain reaction assay.

Managing asymptomatic patients with babesiosis typically involves monitoring rather than immediate intervention. In asymptomatic individuals, the infection may be self-limiting and does not always warrant aggressive treatment. Therefore, follow-up with polymerase chain reaction (PCR) assay is an appropriate approach to ensure that the infection is being adequately addressed and to rule out progression or complications that may arise. Using PCR helps to confirm the presence of Babesia microti or other species causing the infection. This method allows for precise monitoring of the patient's status without the need for unnecessary treatments that could lead to side effects or complications. Furthermore, testing can guide decisions about treatment if the patient later becomes symptomatic or exhibits any signs of severe illness. Immediate treatment with antibiotics is generally reserved for symptomatic cases or individuals at high risk for severe illness, such as those with compromised immune systems or other underlying health conditions. Hospitalization for observation is typically not necessary in asymptomatic cases, as many individuals may clear the infection on their own without significant clinical concerns. Lastly, repeat blood transfusion is irrelevant in asymptomatic patients without evidence of severe anemia or other complications related to the infection. In summary, regular follow-up with PCR assays allows for safe management of asymptomatic babesiosis while keeping the potential for treatment available