A Breathtaking Discovery

A 76-year-old man presented with exertional dyspnea and fatigue, progressing over one month. Despite normal cardiopulmonary findings, his condition revealed anemia, thrombocytopenia, elevated liver enzymes, and splenomegaly. Extensive evaluation, including imaging and blood smears, ultimately confirmed babesiosis caused by Babesia microti. The patient responded well to azithromycin and atovaquone, with resolution of symptoms and normalization of hematologic values. The case emphasizes diagnostic bias challenges and the importance of recognizing atypical presentations of endemic tickborne infections.

A 76-year-old man presented with exertional dyspnea and fatigue, progressing over one month. Despite normal cardiopulmonary findings, his condition revealed anemia, thrombocytopenia, elevated liver enzymes, and splenomegaly. Extensive evaluation, including imaging and blood smears, ultimately confirmed babesiosis caused by Babesia microti. The patient responded well to azithromycin and atovaquone, with resolution of symptoms and normalization of hematologic values. The case emphasizes diagnostic bias challenges and the importance of recognizing atypical presentations of endemic tickborne infections.