Background: Previously reported cases of babesiosis in New York State emphasize the endemic areas of
Long Island, particularly the more wooded, suburban regions of Suffolk County. Cases have also been described in patients from Upstate New York, and New Jersey, areas further deemed more rural. Our literature search failed to reveal any reported cases of babesiosis in New York City, and only one study described a low incidence of the disease in this geographic region.
Case Report: We present the case of a patient who was admitted with a severe hemolytic anemia to our
urban community hospital in South Brooklyn, New York USA. After a thorough history and physical examination, a peripheral blood smear was performed. The initial results coupled with the patient’s clinical presentation yielded a diagnosis of falciparum malaria; however the fact that this patient had not traveled outside of the United States in nine years prompted further investigation. Definitive testing with Polymerase Chain Reaction (PCR) then ruled out malaria and identified babesiosis.
Conclusions: Our case demonstrates two concerns: the need to consider babesiosis in all cases of hemolysis,
including cases in non endemic areas; and the diagnostic complexities of distinguishing babesiosis
from falciparum malaria as well as associated treatments.

Keywords: Babesiosis, New York City, Brooklyn, Falciparum, Malaria, Hemolysis