ABC's of TBD's

Overlooked Infections Associated With Lyme Disease

Lucy Barnes

Lyme disease, once considered a rare and easily treated ailment, is actually a complex infectious disease which can progress to a chronic state and seriously affect even the most healthy individuals and their pets. The discovery of multiple strains of Borrelia spirochetes (over 300 to date), coupled with the fact that at least three different forms of spirochetes have been documented (spirochetal, spheroplast, and cystic form), is merely the underlying foundation of the comprehensive infectious soup currently referred to as ‘Lyme disease’.

To complicate the Lyme picture there are a growing number of tick borne infections such as Bartonella (trench fever, cat scratch fever), Babesiosis (WA-1, microti), Ehrlichiosis (HGE, HME), Rocky Mountain Spotted Fever, STARI, Tularemia (rabbit fever), Brucelliosis, Leptospirosis, and Mycoplasmas which have been detected in patients with Lyme disease. All too often these infections are being overlooked or subsequently misdiagnosed and not treated properly. The CDC warns, “early diagnosis and proper antibiotic treatment of Lyme disease are important strategies to avoid the costs and complications of infection and late-stage illness.”

These tick borne infections have the ability to destroy the brain, the peripheral nervous system, and the musculoskeletal system. They may also cause a variety of dermatological, pulmonary, gynecological, endocrinological, and urologicalmanifestations and are known to cause life threatening cardiac abnormalities. Without prompt and aggressive treatment they may lead to a significant degree of immune suppression and/or death.

If you have been diagnosed with, or even suspect you may have Lyme disease, it would be to your advantage to locate a competent practitioner who is extremely familiar with updated testing procedures, clinical diagnoses, and treating Lyme and the associated co-infections. Unfortunately, many of the local university, hospital, and commercial labs are unable to perform the definitive tests required to detect newly discovered strains or forms of bacteria and the variety of co-infections. Many people are, therefore, not being tested or treated.

The CDC states that Lyme disease is, “greatly under reported.” Education and prevention are essential to reduce the growing numbers of cases of tick borne illnesses. Listed below are a few of the co-infections associated with Lyme disease.

Tick borne co-infections associated with Lyme disease


The parasite that causes Babesiosis destroys red blood cells and causes a malaria-like illness which is potentially fatal. It is characterized by fever, chills, sweats, muscle pains, breathing difficulties, headaches, and malaise. Patients may also experience episodes of depression, dizziness, vomiting, bleeding tendencies, dark colored urine, anemia, bruising, pulmonary edema, anorexia, and encephalopathy.

Treatment: A combination of Atovaquone and Zithromax or Baixin is currently being used to treat the disease. This combination has less potential side effects than quinine and clindamyacin. Re-treatment or long term treatment is often needed in long-standing cases.


Bartonella quintana and Bartonella henselae are bacterial infections which can cause fatigue, restlessness, myalgias, encephalopathy, liver or spleen involvement, abdominal pain, hepatitis, seizures (mild to severe), headaches, cognitive dysfunction, red splotches or slightly raised red spots, subcutaneous nodules, softening of bone, radiculitis, transverse myelitis, arthritis, polyneuropathy, endocarditis, cardiomegaly, and an array of eye problems such as conjunctivitis, neuroretinitis, and a loss of vision. If not treated properly it can become chronic and difficult to eradicate.

Treatment: There is no set treatment protocol that works in all patients. Antibiotics, such as Doxycycline, Rifampin, Ciprofloxacin, or a combination of antibiotics have been used with varying degrees of success.


Ehrlichia HME or HGE (rickettsial diseases related to RMSF) may be fatal, however, milder chronic forms do exist. Headaches, fever, chills, myalgias, fatigue, nausea, vomiting, and cough are some of the more prominent symptoms.

Treatment: Doxycycline is often used to treat Ehrlichia infections. Doses may need to be increased or extended due to the severity or duration of the illness and co-infections involved.

Rocky Mountain Spotted Fever:

RMSF is a rickettsial disease normally presenting with a sudden onset of fever, chills, fatigue, muscle pain, headaches, and conjunctivitis. A spotted rash may appear on the hands and feet in about 50% of cases. Delay in treatment may result in death or a chronic illness which can affect the brain, spinal cord, heart, lungs, kidneys, or liver. Chronic cases of RMSF may also cause a loss of bladder or bowel control, blood clotting problems, partial paralysis, hearing loss, congestive heart failure, movement disorders, and respiratory distress syndrome. The fatality rate can reach 20% in untreated cases.

Treatment: The most common treatment for RMSF is Doxycycline which should be started immediately if this disease is suspected.

*Note- Ask your doctor about other tick and vector borne diseases and viruses in Virginia, including STARI, Tularemia, Brucelliosis, Anaplasmas, Leptospirosis, and Mycoplasmas.