Chronic Lyme disease is an intimidating enough prospect by itself. Unfortunately, a large number of cases are compounded by Lyme co-infections – additional diseases that are transferred simultaneously with the Lyme-causative Borrelia burgdorferi bacteria. Ticks are responsible for all these transmitted infections; they carry the strains that are passed on to their human hosts. Unfortunately, many patients don’t realise that co-infections even exist, and more crucially, many doctors don’t either. It’s extremely important to test for co-infections at the same time as Lyme disease diagnosis, as they can compound or revitalise the primary debilitating symptoms of the umbrella infection. This makes simultaneous diagnosis an important area of study for Lyme-literate doctors.
The majority of co-infections will exacerbate the symptoms of chronic Lyme itself. They modulate and stymy the immune system, as well as providing resistance to therapy. Chronic Lyme disease diagnosis in itself is a controversial topic, whose waters do not need muddying further. Acute Lyme is relatively straightforward to diagnose, if the distinctive bullseye rash is present. This rash – a red circle surrounded by a larger red circle, forming the shape of a bullseye – will be noticeable in the majority of cases, although it can be easily missed. Once the infection develops to chronic Lyme, however, the process of diagnosis becomes much more difficult, as Lyme is not usually considered among potential diseases.
Lyme is sometimes nicknamed ‘the Great Imitator’, due to its symptoms mimicking the symptoms of other significant diseases. The symptoms themselves bear very little resemblance to the initial ones presented by acute Lyme, instead differing in severity from patient to patient. Broadly, they encompass everything from fatigue, joint pain and muscle pain to depression, neurological issues, headaches and sleep disturbances. These symptoms are so broad that it’s easy to see why under-educated doctors will often reach for something more common, like multiple sclerosis or fibromyalgia. When it comes to Lyme, misdiagnosis rates are estimated to be extremely high, with the full extent unknown. Co-infections can cloud diagnosis by adding more symptoms, presenting new ones, or making others more pronounced. To fully benefit Lyme disease treatment, the full spectrum of issues must be investigated and laid out before the process begins.
BCA-lab, who are Lyme specialists based in Augsburg, Germany, understand co-infections very well. They will run a full gamut of tests early on in the treatment process in an effort to understand exactly what the patient is suffering from, and how precisely they’re suffering from it. Some of the main diseases they test for can severely change the way Lyme develops within the body, and how it should be treated. Some co-infections can even revitalise the Lyme disease symptoms after the primary Borrelia infection has been dealt with, leading patients to believe that either they are not fully cured, or that they were never suffering from Lyme in the first place.
One of the most common Lyme co-infections is Bartonellosis. If this co-infection is present in the initial tick bite, and is allowed to run amok within the system, it can be expected to have substantial significance to the overarching Lyme infection. The clinical manifestations of both diseases contain numerous overlaps, and the symptoms presented by both are undeniably broad. Bartonellosis is still not well understood by the medical community at large; it was initially thought to be relatively benign. However, the long-term effects and symptoms of the disease are intimidating, especially if paired with Lyme. They include fever, fatigue, joint pain, muscle ache and brain fog. More alarmingly, the disease can have a range of neurological effects, resulting in symptoms such as panic attacks, seizures, depression, epilepsy and psychosis. Many of these symptoms are extremely similar to the ones presented by chronic Lyme, which makes differentiating them at the diagnostic stage a critical first step.
Another common co-infection is Chlamydophila pneumoniae, the primary manifestation of which is the well-known and well-understood pneumoniae. However, left over a long period of time, Chlamydophila pneumonia can severely compromise the body’s immune system by placing it under extreme stress. Upper respiratory infections can be a huge drain on the immune response, especially if they are recurring. Given the fact that chronic Lyme already sends the immune system haywire, Chlamydophila pneumoniae is a very dangerous co-infection, if left to its own devices. To compound this, the infection is quite hard to both detect and treat, as chlamydia are much smaller than other pathogens. Mixed in with Lyme disease and possible other co-infections, it can often go undetected.
Bartonellosis and Chlamydophila pneumoniae are just two examples of co-infections that can cause severe problems for Lyme patients if they are not dealt with adequately. Currently, the answer to the question posed by this article, ‘what role do co-infections play in Lyme disease diagnosis’, is simply ‘not enough’. There needs to be a combined and concerted effort on the part of medical health professionals everywhere to engage with co-infections and recognise the danger they pose to Lyme patients. Diagnosis is often the hardest part of the Lyme battle; it’s the stage where we should strive to get everything right the first time. Correct diagnosis across the Lyme disease spectrum lays a strong foundation for successful patient treatment and subsequent recovery.