Lyme isn’t all you can get from a tick bite

You have tested negative for Lyme disease with ELISA, Western Blot and iSpot Lyme. However, you still have symptoms synonymous with Lyme disease like muscle and headaches, fatigue, chills and fever. Testing negative for Lyme disease, doesn’t always mean that you are in the clear, there is a chance that you could have a co-infection.

Figure 1. Incidence of reported cases of ehrilichiosis. Image from: http://www.cdc.gov/ehrlichiosis/stats/index.html

Figure 1. Incidence of reported cases of ehrilichiosis. Image from: http://www.cdc.gov/ehrlichiosis/stats/index.html

There are more than 12 tick-borne diseases is the United States alone, and more are being identified on a regular basis. Ehrilichiosis, Anaplasmosis, Bartonella and Babesiosis are considered to be the most common Lyme disease co-infections. All co-infections are transmitted by tick bites and some can be transmitted other ways as well.

Common Lyme Disease Co-infections

Ehrlichiosis: Ehrlichiosis can be caused by Ehrlichia chaffeensisEhrlichia ewingii, and Ehrlichia species. Symptoms include fever, headache, fatigue, and muscle aches, typically occuring within 1-2 weeks of the tick bite. Diagnosis of ehrlichios is based on symptoms and can later be confirmed by detection of antibodies.

Figure 2. Incidence of reported cases of anaplasmosis. Image from: http://www.cdc.gov/anaplasmosis/stats/

Figure 2. Incidence of reported cases of anaplasmosis. Image from: http://www.cdc.gov/anaplasmosis/stats/

Anaplasmosis: Lxodes scapularis (the black-legged tick) and Ixodes pacificus (the western black-legged tick) commonly cause Anaplasmosis. Symptoms of this disease occur 1-2 weeks post-tick bite and may include: fever, headache, chills, and muscle aches. Physicians may initially diagnose Anaplasmosis based solely on symptoms and then confirm the diagnosis with PCR, blood smears, indirect immunofluorescence assays or enzyme immunoassays.

Bartonella: Three different Bartonella species cause cat scratch disease, trench fever and Carrión’s disease. Symptoms of these three may include: fever, headache, rash, bone pain and nodular lesions under the skin. A Bartonella infection is diagnosed by serology, PCR or bacterial culture depending on the specific disease.

Figure 3. Incidence of reported cases of babesiosis. Image from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6127a2.htm

Figure 3. Incidence of reported cases of babesiosis. Image from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6127a2.htm

Babesiosis: Lxodes scapularis tickstransmit Babesia microti. Many people infected with Babesia do not have symptoms of an infection. However, infected patients with symptoms, often experience  fever, chills, sweats, headache, body aches, loss of appetite, nausea and fatigue. Patients with symptoms of a Babesia infection can have a confirmed diagnosis by microscopy.

If you’ve been treated for Lyme disease or have tested negative, but still have persistent symptoms, you may consider talking to your primary care physician about the possibility of a co-infection. There are tests your health care practitioner can run to rule out co-infections.

References:
http://www.cdc.gov/parasites/babesiosis/
http://www.cdc.gov/parasites/babesiosis/disease.html
http://www.cdc.gov/parasites/babesiosis/diagnosis.html
http://www.cdc.gov/ehrlichiosis/
http://www.cdc.gov/ehrlichiosis/symptoms/index.html
http://www.cdc.gov/anaplasmosis/
http://www.cdc.gov/anaplasmosis/symptoms/index.html
http://www.cdc.gov/bartonella/
http://www.cdc.gov/bartonella/clinicians/index.html
http://www.niaid.nih.gov/topics/lymedisease/research/pages/co-infection.aspx
http://www.lymedisease.org/lyme101/coinfections/coinfection.html
http://www.lymedisease.org/lyme101/coinfections/babesia.html
http://www.lymedisease.org/lyme101/coinfections/ehrlichia.html
http://www.lymedisease.org/lyme101/coinfections/bartonella.html
http://www.lymedisease.org/lyme101/coinfections/other_tick_diseases.html
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