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Common Co-infections of Lyme Disease?

Many people who have Lyme disease focus only on it, but the fact is that there are a number of common co-infections of Lyme disease that can also cause health issues and make Lyme treatment more complicated.

Ticks are parasites that live on the blood of mammals, reptiles and amphibians. They are not choosy about who they bite and feed on. That being the case, they can pick up many different bacteria, viruses, fungi and protozoans all at the same time and pass them all to a human with one single bite.

There are a number of tick borne illnesses in addition to Lyme disease. In about 30% of cases, Lyme patients have been found to be suffering from other infections as well.

The most common tick borne illnesses in the US are:

  • Anaplasmosis/ Ehrlichiosis

  • Babesiosis

  • Bartonella

  • Mycoplasma

  • Rocky Mountain spotted fever (RMSF)

  • Tickborne relapsing fever

Let’s look at each of these in turn.

Anaplasmosis Ehrlichiosis

Anaplasmosis is a form of ehrlichiosis, a family of bacterial diseases. At present, only 2 of these diseases can be tested for. They are commonly carried by the same ticks that carry Lyme.

The symptoms for Lyme may be present, but also:

Sudden high fever, and in severe cases:

  • Low white blood cell count, so the immune system is affected

  • low platelet count, so blood clotting is affected

  • anemia

  • elevated liver enzymes

  • kidney failure

  • breathing issues.


Babesiosis accounts for about one-third of all Lyme coinfections. It is a malarial like illness that appears similar to Lyme, but with some key differences, which include:

  • High fever

  • Chill

  • Drenching sweats

  • Shortness of breath

  • Hip pain

  • Chest pain


Bartonella accounts for about one-third of all Lyme coinfections. It is becoming increasingly common because it can come from many sources, not just ticks, though they are a major vector. It can affect the lining of blood vessels, and can cause serious illness, including endocarditis, which can affect the heart.

Early signs of bartonellosis in addition to Lyme symptoms include:

  • Poor appetite

  • An unusual streaked rash that resembles “stretch marks” from pregnancy

  • Swollen glands in the neck and under the arms

  • Neurological symptoms such as:

  • blurred vision

  • numbness in the hands and feet

  • memory loss

  • balance problems

  • trouble walking and

  • tremors such as with Parkinson’s disease. A course of several antibiotics can usually clear it up.


Mycoplasma are even smaller than bacteria and invade human cells, interfering with the proper function of the immune system. It causes similar symptoms to Lyme, particularly:

  • Fatigue

  • Muscle aches

  • Joint pain

  • Cognitive problems

Rocky Mountain spotted fever (RMSF)

This is carried by a number of ticks and can be contracted anywhere in North or South America, not just in the Rocky Mountains. The symptoms in the early stages are like Lyme. The key difference is the distinctive rash that gives it its name. It used to be referred to as ‘black measles. The tick bite site might look black or encrusted as well.

Tickborne relapsing fever

As the name suggestions, a person may fall ill, recover, and then relapse, or become ill again. This pattern forms in a 3 day ill, 7 days well, 3 days’ ill pattern that can go on for weeks or months if it is not treated. The symptoms are similar to Lyme.

For more information on common co-infections with Lyme, see the chart at:

More information regarding Co-Infections and Lyme disease:

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