A 26 year old woman recently sought my opinion regarding her chronic daily headache syndrome. She had been to multiple neurologists, tried nerve blocks and been treated with every migraine/headache medicine under the sun. Nothing has ever helped. The headaches have decimated her quality of life. She had a remote history of Lyme disease more than two decades before, first presenting as a toxic synovitis of a hip in a toddler. A course of antibiotics helped to some extent, but other "mystery" symptoms persisted. The headaches started in earnest 4 years ago and have only been getting worse. By chance, she came across my episode of (Monsters Inside Me) and came to see me for a recent consultation.
Lyme serology is positive. From Quest the WA1(B. duncani) titer is positive, 1:256.
The Giemsa stain confirms the presence of active babesiosis: a potential cause of chronic daily headache syndrome.
Smearing and fixing must be done immediately. These procedures and staining require a great deal of expertise. These parasites degrade quickly in blood tubes and will not be found by outside labs because of this delay.