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Facts About Lyme Disease Co-Infections

According to MyLymeData Organization[1], more than 95 percent of Lyme disease patients are co-infected with other bacteria or parasites. Co-infections directly complicate both Lyme disease diagnosis and treatment.

Diseases transmitted by ticks are pathogenic, animals pass the infections to humans . Vectors transfer pathogens from animals such as rodents, rats, and squirrels to humans, including ticks. Ticks carry bacteria, viruses, fungi, and protozoans, and humans can have infection with a one bite.

Anaplasmosis, ehrlichiosis, tularemia, and Rocky Mountain spotted fever (RMSF). These common diseases are co-infections of Lyme disease.

In general, patients with a co-infection experience more serious illness and a longer recovery. An evidence of the Centers for Disease Control and Prevention (CDC)[2] advises that whenever patients with Lyme disease have more serious symptoms, doctors should consider potential co-infection with babesia or anaplasma. 

About Lyme Disease

The first identification of Lyme disease was in 1981, with scientists discovering over 15 tick-borne microorganisms which are not identified before. In the U.s, significantly in New York, the CDC defined and recognized that Borrelia burgdorferi and miyamotoi are the main cause of Lyme Disease. Commercial tests weren’t accessible to many tick borne diseases, including Borrelia miyamotoi infection.

Co infections could be hard to diagnose as symptoms often overlap with most of the other tick-borne infections. The importance of human diagnosis and treatment of polymicrobial infections, is indeed significant.

When the symptoms of patients become serious, recurrent, and resistant to antibiotic therapy, practitioners should include co-infections in the diagnosis. Physicians have found that Lyme disease symptoms are often made acute by co-infections.

Lyme disease can be quickly treated with antibiotics[3] . However, the delayed diagnosis will make it more difficult for treatment and recovery. 

The CDC reports that every year, at least 300,000 people are went down with with Lyme disease in the United States. That number is ten times higher than what the CDC had reported previously. Field experts believe that the actual number is even higher.

What is Lyme Disease?

Lyme disease is a vector-borne zoonotic infection that is caused by multiple Borrelia genospecies and spread by the bite of an infected tick, according to The Pharmaceutical Journal[4]. The discovery of Ticks is throughout the United States, but most of them do not carry the pathogen responsibility for Lyme disease. Lyme disease may evolve into late manifestations without any treatment.

Lyme disease is the most common vector-borne disease in the United States. The bacteria Borrelia burgdorferi[5], and occasionally Borrelia mayonii, are responsible for the diseases. This particular bacterium is a parasite. Erythema migrans[6] such as fever, headache, weakness, and a characteristic skin problem are typical symptoms. Infection by a certain bacteria can spread to our joints, heart, and nervous system if left untreated.

The Diagnosis of Lyme disease based on signs, physical observations (e.g., rash), and the potential of exposure to contaminated ticks. Laboratory testing is beneficial with correct usage and the conduction of validated methods. With a few weeks of antibiotics, most cases of Lyme disease co-infections treatment came out successful. Prevention of Lyme disease includes the use of insect repellent, timely elimination of ticks, pesticide application, and habitat reduction for ticks. 

What causes Lyme disease?

According to The Pharmaceutical Journal[7] study, erythema migrans (EM), as known as is a slowly spreading annular skin rash, is a significant early indication of Lyme disease, observation of about two-thirds of cases. This can happen after a tick bite for 1-4 weeks (with a range of 3 days to 3 months) and can last for several weeks after that. There is often an area of central clearing that gives the rash a “bull’s eye” appearance, while bruise-like or homogeneously red atypical rashes also occur.

An infected deer tick needs to bite you to transmit Lyme disease. Via the bite, the parasite, other bacteria, and viruses penetrate your skin and ultimately find their way into your bloodstream. 

In most cases according to studies of the American Journal for Nursing[8], the attachment of a deer tick must be for 36 to 48 hours to spread Lyme disease. It might have bitten long enough to spread bacteria if you encounter a swollen bite from a tick. It is possible to prevent this infectious disease by removing the tick as soon as possible.   

There are also risk factors that can easily expose people to these ticks like spending time in grassy or wooded areas while having exposed skin and not cleaning frequently and properly. 

Tick-borne disease symptoms

The most common symptoms[8] of diseases linked to ticks are: 

  • Fever – In all tick-borne diseases, patients will experience a tick borne relapsing fever at varying degrees and periods of occurrence.
  • Aches and pains – Signs of the tick-borne diseases include headache, fatigue, and aches in the muscles. You may feel joint pain due to Lyme disease. The severity and time of onset of these symptoms will depend on the degree of personal tolerance to the disease and the patient. 
  • Rashes – Lyme disease may lead to distinctive rashes include southern tick-associated rash disease (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, and tularemia.

There are home treatments for tick-borne diseases that have mild symptoms, but you should see a doctor be sure that it’s not more serious. These diseases can be difficult for physicians to identify, even though antibiotics can treat them easily. However, early detection and treatment of the infection minimize the risk of severe complications.

During diagnosis, except for checking the symptoms, you will be subjected to a particular diagnostic test. You will also be asked from which geographic region[9] you were bitten. Certain geographic areas are abundant with ticks, which is why knowing your location is crucial for medical practitioners to know. It would be helpful for you to check the geographic areas where human-biting ticks are common.

How does Lyme disease affect blood pressure?

When the Lyme virus and bacteria enters your heart tissue,  it can cause Lyme carditis[10], which affects the electrical system of your heart. 

Another disorder is heart block, which occurs when the heart beats too slowly and results in Lyme carditis. Three forms of heart block exist: 

  • First-degree heart block[10] is when electrical impulses conduct from the atria to the ventricles through the atrioventricular node more slowly than normal
  • Second-degree heart block[10]: when either the electrical signals fail to completely conduct to the ventricles or some of the signals are unable to get there at all. 
  • Heart block of the third degree: when none of the electrical signals will make it to your ventricles. 

According to evidence of a research in 2015[11]. people with cardiac Lyme borreliosis developed cardiac problems, most forms of heart block coinfection definition

Co-infection involves living simultaneously with two or more pathogens. Co-infections with Lyme disease may be normal, at least among those with chronic Lyme disease, and it’s important to note that the treatment for them may be more difficult.

Lyme co-infections chart

Lyme disease co-infections

A recently MyLymeData[12] survey of over 3,000 chronic Lyme disease patients found that over 50 percent had coinfections, with two or more co-infections registered by 30 percent. Babesia Microti (32%), Bartonella (28%), Ehrlichia (15%), Mycoplasma (15%), Rocky Mountain Spotted Fever (6%), Anaplasma (5%), and Tularemia (1%) were the most common co-infections.

Common co-infections of Lyme disease


According to a discovery of species of mycoplasma[13] in ticks, they attack human cells smaller than bacteria and damage the immune system, causing fatigue, musculoskeletal symptoms, and cognitive issues. It is possible to treat mycoplasmas with antibiotics

Powassan Virus 

Powassan virus[14] is the main cause of Tick-borne encephalitis . Patients may be asymptomatic, or they may undergo serious neurological compromise and death. Fever, fatigue, vomiting, exhaustion, confusion, convulsions, and loss of memory can be common symptoms of the Powassan virus.

There could be long-term neurologic concerns. There are no commercial screening tests for this virus, nor is there any particular cure for the disorder. However, in order to obtain care to minimize swelling in the brain or for respiratory support, patients may need to be hospitalized for powassan virus.

Tick Paralysis

A toxin that induces progressive paralysis, which is reversed when the tick is removed, is secreted by some ticks. 

Tickborne Relapsing Fever 

Soft ticks from the western United States bear the agent of tick-borne relapsing fever[15] BorreliaOrnithodoros. The symptoms are high fevers, headaches, nausea, vomiting, joint pain, and shortness of breath. The treatment for this relapsing fever might be antibiotics. 


Across the United States, fever tularemia, or cat fever is caused by the Francisella tularensis bacterium[16], a study found. Skin ulcers, swollen eyes, sore throat, mouth sores, pneumonia, diarrhea, swollen and painful lymphatic glands, and vomiting may be signs of tick-borne fever. Therapy with fluoroquinolones is the most effective.

Q Fever 

Coxiella burnetii, a kind of bacteria that is borne by cattle, sheep, and goats, induces Q fever. There are similar signs to those of Lyme disease. It is likely that Q fever will start with a high fever. Q fever also indicates pneumonia and abnormal liver function. The therapy of choice is Doxycycline[17]

Rocky Mountain Spotted Fever

Bacteria spread by the bite of a tick called Rickettsia rickettsii is the reason for Rocky Mountain spotted. Patients develop a high degree of fever, rash, headache, and problems with bleeding. Thirty percent of patients die without timely treatment. Antibiotics, mostly doxycycline, are treatable. 

Colorado Tick Fever

A virus borne by Rocky Mountain wood ticks is responsible for Colorado tick fever. Acute high fever, extreme headache, chills, exhaustion, and muscle pain are the common symptoms of Colorado tick fever.


Avoiding regions where deer ticks live, especially wooded, bushy areas with long grass, is the best way to prevent Lyme disease. With some basic precautions including covering up when near wooded or grassy areas, using insect repellents, clearing bush and leaves near your house, and also inspecting yourself, others around you, and your animals for potential lurking ticks, you may reduce your risk of having Lyme disease.

Lastly, we continue to recommend that you follow through with the classic medical suggestion of keeping your body robust enough to fight off infections. Improve your antibacterial system by having a healthy diet. Your antibodies will help protect you as long as you devote time and effort to enhancing your immune system.

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  1. Johnson, Lorraine. (2019). MyLymeData 2019 Chart Book. Available from: 
  2. the Centers for Disease Control and Prevention (CDC). (2020). Lyme disease. Available from:
  3. Mayo Clinic Staff. (2020). Lyme disease. Available from:
  4. The Pharmaceutical Journal. (2018). Sandra Pearson Lyme disease: awareness, diagnosis and management. Available from:
  5. Kit Tilly, Patricia A. Rosa, & Philip E. Stewart. (2008). Biology of Infection with Borrelia burgdorferi. Available from:
  6. Wilson, Thomas, Legler, Allison, Madison, Kathi, Fairley, Janet & Swick, Brian. (2012). Erythema Migrans A Spectrum of Histopathologic Changes/The American Journal of Dermatopathology. Available from:
  7. The Pharmaceutical Journal. (2018). Sandra Pearson.Lyme disease: awareness, diagnosis and management. Available from:
  8. Patton, Susan Kane & Phillips, Bailey. (2018). American Journal of Nursing: April 2018, 118(4), 38-45. CE: Lyme Disease: Diagnosis, Treatment, and Prevention. Available from:
  9. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD). (2020). Regions where ticks live. Available from:
  10. Mohit Naik, Danny Kim, Francis O’Brien, Leon Axel, & Monvadi B. Srichai. (2008). Lyme Carditis. Available from:
  11. Jarne M. van Hattem, Jan T. Keijer & Robin Nijveldt. (2016). A man with cardiac Lyme borreliosis. Available from:
  12. Johnson, Lorraine. (2019). MyLymeData 2019 Chart Book. figshare. Available from:
  13. Walter Berghoff.  (2012). Chronic Lyme Disease and Co-infections: Differential Diagnosis, from The Open Neurology Journal. Available from:
  14. Gábor Kemenesi, Krisztián Bányai .(2020). Tick-Borne Flaviviruses, with a Focus on Powassan Virus. Available from:
  15. Saar Hashavya, Itai Gross , Matan Gross, Noa Hurvitz, Giora Weiser, Violeta Temper, and Orli Megged. (2020). Tick Borne Relapsing Fever, Jerusalem, Israel, 2004–2018. Available from:,and%20joint%20pain%20(3).
  16. Marilynn A. Larson,Paul D. Fey, Steven H. Hinrichs, and Peter C. Iwen. (2014). Francisella tularensis Bacteria Associated with Feline Tularemia in the United States. Available from:
  17. Cerner Multum, Inc. (2020). Doxycycline. Medically reviewed by Kaci Durbin. Available from:


Written by:
Healthcanal Staff

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