Clinical research studyChronic Coinfections in Patients Diagnosed with Chronic Lyme Disease: A Systematic Review
Section snippets
Methods
In order to identify relevant articles, we performed the following Boolean searches of the indexed medical literature using the PubMed search engine.
Search 1: Persistent, Chronic, or Recurrent Human Granulocytic Anaplasmosis
This search yielded 252 articles. The vast majority of scientific articles yielded by these search terms were animal studies. Many addressed microorganisms other than A. phagocytophilum. Ultimately, only 2 studies were appropriate for further review based on our inclusion criteria. In the first, 2 febrile asplenic patients were diagnosed with HGA based on blood smear examination.2 One developed neurologic symptoms including left-sided weakness, left hemi-neglect, and delirium within 12 days of
Discussion
There is no debate in the scientific community that Ixodes spp. ticks transmit a number of important human pathogens, and sometimes in combination. In addition to B. burgdorferi, the causative agent of Lyme disease, Ixodes ticks may transmit B. microti and other human Babesia species, A. phagocytophilum, tick-borne encephalitis virus, Powassan virus, and emerging pathogens such as Borrelia miyamotoi. These infections may occur in isolation or in various combinations, and it is well established
Conclusion
The Ixodes spp. ticks that transmit B. burgdorferi are capable vectors of several human pathogens. In all cases, however, these infections produce defined clinical syndromes that are corroborated by objective clinical and laboratory findings. This is true for well-established Babesia-Lyme and Anaplasma-Lyme coinfections. Treatment and diagnosis of chronic coinfections, however, is clearly not justifiable in the absence of convincing objective evidence that these infections are present and
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Cited by (43)
Bartonellosis in Dogs and Cats, an Update
2022, Veterinary Clinics of North America - Small Animal PracticeCitation Excerpt :Although there are no studies evaluating the role of fleas in transmission of B. henselae to dogs, because dogs and humans are both incidental hosts, it is assumed they can become infected in the same flea-dependent manner.7,8 Tick-borne transmission of Bartonella spp is more controversial, and reviews remain skeptical of tick transmission in humans, dogs, and cats.56,57 However, evidence exists to support ticks as a vector for several Bartonella spp.5,7,8,58 Multiple tick species found on cats and dogs in the United States, including certain Ixodes spp, Rhipicephalus sanguineus, and Dermacentor spp have all been shown to harbor Bartonella spp DNA.7,58,59
Persistent Symptoms After Treatment of Lyme Disease
2022, Infectious Disease Clinics of North AmericaCitation Excerpt :All these studies demonstrate substantial (some more than 20%) background prevalence of nonspecific symptoms in the general population. Coinfection with other tick-borne pathogens is rare in patients with PTLDs.82–84 Patients with concurrent Lyme disease and untreated Babesia infection had increased symptoms in one study85 but another study showed no difference in symptoms between patients with and without Babesia coinfection.86
The Role of the Infectious Disease Consultation in Lyme Disease
2022, Infectious Disease Clinics of North AmericaCitation Excerpt :Often the stated evidence for co-infection is based on serologic studies with low specificity or simply a patient symptom checklist. With very specific exceptions (in particular babesiosis), relapsed or chronic infection due to these agents following appropriate antibiotic therapy has not been documented.9 That said, it is expected that infectious disease physicians will have a working knowledge of the potential array of pathogens in addition to B burgdorferi that might be transmitted by black-legged ticks to allay any patient concerns regarding co-infection.
Should Patients Infected with Borrelia burgdorferi No Longer Be Referred to as Having Lyme Disease?
2019, American Journal of MedicineLyme Disease
2018, Integrative Medicine: Fourth Edition
Funding: PML was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2TR001115. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Conflicts of Interest: GPW received research grants from the Centers for Disease Control and Prevention, National Institutes of Health, Immunetics, Inc., Bio-Rad, DiaSorin, Inc., and BioMerieux holds equity in Abbott. GPW was he was an expert witness in malpractice cases involving Lyme disease; an unpaid board member of the American Lyme Disease Foundation; expert witness regarding Lyme disease in a disciplinary action for the Missouri Board of Registration for the Healing Arts; and a consultant to Baxter for Lyme vaccine development. PML has no potential conflicts of interest to report.
Authorship: Both authors had access to all data and took part in writing this manuscript.