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Lyme Disease Co-Infections Confuse Diagnosis

lyme disease co infections tickborne diseaseLyme disease co-infections occur when the tick transmitting Borrelia burgdorferi is also infected with babesiosis, ehrlichiosis, rickettsia, bartonella or other bacteria or pathogen.

Not all those who become infected with Lyme disease bacteria will have one or more co-infections but for many the long-lasting symptoms of Lyme disease can actually be blamed on the remaining pathogenic co-infection rather than chronic Lyme disease after treatment.

How Lyme Co-Infections Occur

Another possibility with Lyme disease co-infections is that the bacteria was not transmitted at the same time, from the same tick bite(s) as the Borrelia but was the result of a later bite from a mosquito, tick, or fly. The compromised immunity of the patient already suffering from Lyme disease may then make it easier for the second, third, or even fourth bacterium to take hold. Additionally, patients with undiagnosed Lyme disease being treated for suspected rheumatoid arthritis or other autoimmune condition with steroids is also more susceptible to infection. Some Lyme disease co-infection rates are estimated at 20% of Lyme patients as also being infected with Babesia. There are over a hundred species of Babesia although in the US most are attributed to Babesia microti, with B. divergens and B. bovis to blame in Europe.

Is it Lyme Disease?

Controversially, some patients who consider themselves to be infected with Lyme disease may actually be suffering from one of the other infections often found alongside Borreliosis. This could explain why many Lyme disease tests return negative and why symptoms persist even after treatment with Lyme disease antibiotics. In many cases the treatment for Lyme disease does not eradicate Babesia, Bartonella, or other potential co-infections of Lyme. More recent research suggests that a newly uncovered virus may actually account for some cases of chronic Lyme disease, offering a possible explanation for the persistent symptoms experienced by those testing negative for Lyme disease itself.

What Co-Infections Should You Watch Out For?

Ticks in Europe and Asia are known to transmit encephalitis viruses in some cases. In the US the tick population is yet to be infected with these viruses. Reviews in the medical literature have found that 2-5% of young nymphal ticks (Ixodes scapularis) were co-infected with more than one pathogen. Adult tick rates of Borrelia burgdorferi infection ranged from 1-28% however, but humans are more likely to be bitten by smaller nymphal ticks and these are more likely to stay attached to the host unseen for longer.

lyme disease co infections babesiosis life cycle

The Lifecycle of Babesiosis - A common Lyme Disease Co-Infection.

Diagnosing Co-Infections with Lyme Disease

Luckily there are some specific signs and symptoms of Lyme disease co-infections which can help determine the presence of these bacteria, presuming physicians are aware of them. Babesia causes red dots on the abdomen (known as cherry angiomas) and breathing difficulties, and Bartonella causes what look like scratches on the abdomen and enlarged lymph nodes in the neck.

Monitoring for Co-Infections

Human granulocytic ehrlichiosis (now known as anaplasmosis) is harder to differentiate from Lyme disease but is sometimes marked by sharp pain behind the eyes; it also exacerbates the symptoms of Lyme disease. Incurring any co-infection alongside Lyme disease can affect the way the immune system responds to the pathogen and thus alter the symptom profile, making a delayed or incorrect diagnosis increasingly likely. Those already suffering from an autoimmune disease being treated with immunosuppressants, as well as those with compromised immunity should be particularly wary of the potential for Lyme disease co-infections.

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