患者，女，58岁，江西省宜春市袁州区人，农民。2023年6月4日因胆管癌在宜春市第二人民医院行根治性胰十二指肠切除术，术后腹腔内出血，经输血等治疗后仍有活动性出血。6月9日行剖腹探查术，术后反复出现腹部隐痛，7月中下旬出现呕吐、发热，最高体温40 ℃。8月13日拟“腹腔感染”转入南昌大学第二附属医院，实验室检查：红细胞计数1.75 × 10¹²/L，血红蛋白49 g/L，重度贫血；总蛋白60.5 g/L，白蛋白31.4 g/L，低蛋白血症；总胆红素、直接胆红素、间接胆红素轻度增高；腹部CT检查显示脾大，脾多发梗死灶；颅脑弥散成像检查见双侧半卵圆中心、侧脑室旁多发梗死灶。8月15日血涂片吉氏染色镜检查见部分红细胞内可见环状体，考虑寄生虫感染。患者长期生活在袁州区农村，无国内外旅居史，起病前否认明确的蜱叮咬史。取8月17日和8月18日患者血样，经巴贝虫属特异性引物PCR扩增18S rRNA基因片段后测序，所获序列与田鼠巴贝虫（GenBank：JX962781.1）的序列一致性高达99.57%。确诊该患者为田鼠巴贝虫感染。给予克林霉素（0.45 g/次，3次/d）口服治疗，连续治疗5 d，症状缓解。9月30日复查血涂片仍查见巴贝虫，给予盐酸多西环素静脉滴注（0.1 g/次，1次/d），连续3 d；后继续予盐酸多西环素片（0.1 g/次，2次/d）口服治疗15 d。10月30日随访仅有轻微的上肢震颤。

The 58-year-old female patient was a farmer from Yuanzhou District, Yichun City, Jiangxi Province. The patient underwent radical pancreaticoduodenectomy for cholangiocarcinoma in the Second People’s Hospital of Yichun City on June 4, 2023 due to postoperative intra-abdominal hemorrhage. After blood transfusion and other treatments, the active hemorrhage remained. She underwent cesarean section on June 9, with recurrent abdominal pains after the operation. She had symptoms of vomiting and fever with the highest temperature of 40 ℃ in the middle and late July. The patient was transferred to the Second Affiliated Hospital of Nanchang University with “abdominal infection” diagnosis on August 13. Laboratory tests showed the red blood cell count was 1.75 × 10¹²/L and the hemoglobin was 49 g/L, which suggested severe anemia. The total protein was 60.5 g/L and the albumin was 31.4 g/L, which suggested hypoproteinemia. The patient also had mildly elevated total, direct and indirect bilirubin. Abdominal CT examination showed splenomegaly, splenic multiple infarct foci. Cranial diffusion imaging examination showed multiple infarct foci in the center of the bilateral semiovals and the lateral paraventricular region. Giemsa stained blood smear on August 15 showed ring-form parasites in some red blood cells, and parasitic infections were considered. The patient has been living in the rural area of Yuanzhou District for a long time without domestic or overseas-traveling history, and no clear history of tick bites before the onset of the disease. The DNA extracted from blood samples of August 17 and 18 was amplificated uesd Babesia spp. specific primer by PCR and sequenced to identify 18S rRNA gene fragment. The PCR product identified with 99.57% homology to B. microti (GenBank: JX962781.1). The diagnosis of Babesia microti infection was confirmed. The patient was treated with oral clindamycin 0.45 g, 3 times per day for 5 days, and the symptoms were relieved. On September 30, parasites were still detected on microscopic examination. The patient was treated with doxycycline hydrochloride injection 0.1 g per day for 3 days, followed by doxycycline hydrochloride tablets 0.1 g, 2 times per day for 15 days. At follow-up on October 30, the patient had only a slight tremor in the upper limb.