Lyme 101: Co-infections


It is rare that a Lyme tick is not infected with co-infections, yet testing for co-infections can be less sensitive than even the test for Lyme disease. In addition, some of the symptoms can overlap. This is why it is imperative to have a good LLMD who can diagnose you clinically.

Lyme Info does a good job of explaining the various co-infections, which I’ve included below.


Babesiosis: A malaria-like protozoa illness that invades, infects, and kills the red blood cells. Symptoms include fatigue, night sweats, chills, fever, shortness of breath, heart palpitations, headache, dark urine, muscle pain, joint pain, nausea, and jaundice. Treatment is an anti-malarial combined with an antibiotic–often Mepron or Malarone with Zithromax or Biaxin w/Artemisinin. Septra/Bactrim has shown in some cases to be effective.


Ehrlichiosis: A bacterial infection that invades and infects the white blood cells. There are two types of Ehrlichiosis: Human Monocytic Ehrlichiosis (HME) and Human Granulocytic Ehrlichiosis (HGE). Symptoms include malaise, fever, sweating, nausea, dry cough, headache, anemia, muscle aches and pain. First line treatment is most often Doxycycline, Minocycline and/or Rifampin. Cipro, Levaquin, Biaxin and Azithromycin have shown in some cases to be effective.


Bartonella or cat-scratch fever: A bacterial infection. Symptoms include swollen, painful lymph nodes, muscle and/or joint pain, nausea, vomiting, chills, anxiety, insomnia, red rashes that resemble stretch marks. Treatment is often Levaquin or Rifampin, Biaxin or Azithromycin. Septra/Bactrim has shown in some cases to be effective.

Mycoplasma: A bacterial infection. Symptoms include fatigue, breathing problems, headache, muscle pain and soreness, nausea, lymph node pain, and cognitive problems. Treatment is usually Doxycycline, Minocycline, Azithromycin, Clarithromycin, or Ciprofloxacin.

Lyme Disease: There are 300 strains worldwide – 100 of which are in the United States. In addition there are 3 bacterial forms of LD that must be addressed before treatment ends.

The bacterial forms include: Spirochete, Cyst, Cell Wall Deficient
To learn more on the 3 forms please click here.

Lyme-Symptoms provides a wonderful comparison chart.  Click here to read it.

Courtesy of Melanie Reber and Lyme Info as well as Lyme-Symptoms.

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