Case report Severe babesiosis and Borrelia burgdorferi co-infection

primary care physician with a bull’s eye rash in his right arm and fatigue. He traveled to the state of Massachusetts in the week before the lesion’s appear-ance, where he spent most of his time outdoors and had a tick bite in that same arm. He was initially diagnosed with Lyme disease and was given a prescription for amoxicillin. The fatigue persisted, and 3 weeks later, he presented to our hospital with intermittent fever (38.88C), chills and night sweats. His medical historywas remarkable for coronary heart dis-ease and coronary artery bypass graft surgery. On physical examination, the patient was febrile and tachycardic with a normal respiratory rate. The rest of the examination was otherwise unremark-able. No distinctive rashes, jaundice, lymphadenop