Individuals with a weakened immune system are more susceptible to developing infections, such as COVID-19. A review study has also found that people with compromised immune systems are at a greater risk of developing disseminated Lyme disease. The authors of “Erythema Migrans: Course and Outcome in Patients Treated With Rituximab” investigated patients diagnosed with Lyme disease, who were also taking Rituximab, a medication known to impair immunity. 
In a recent editorial, Dr. Allen Steere describes the clinical features and proposed mechanisms triggering what he believes are 4 distinct post-treatment Lyme disease syndromes (PTLDS) in patients who fail antibiotic treatment for Lyme disease. 
Patients with Lyme disease are typically treated with a standard antibiotic, which may include doxycycline, amoxicillin, or cefuroxime, for a 2 to 4 week period. However, studies have shown that between 36-63% of treated patients continue to suffer with persistent symptoms. 
Chronic pain, debilitating fatigue, and heightened sensory disturbances are common in Lyme disease patients. In their article, “Post-Treatment Lyme Syndrome and Central Sensitization,” Batheja and colleagues suggest that, in some cases, such symptoms may be due to central sensitization syndrome (CSS). 
Atrial fibrillation, the most common type of arrhythmia (irregular heartbeat), can increase your risk of strokes, heart disease or other heart-related complications. In many cases, atrial fibrillation is associated with a history of cardiac inflammation, writes Szymanska et al. in their article “History of Lyme Disease as a Predictor of Atrial Fibrillation.”
A study by Stanford Medicine indicates that a drug called azlocillin “completely kills off the disease-causing bacteria Borrelia burgdorferi at the onset of the illness.”  In addition, the authors say, azlocillin “could be effective for treating [Lyme disease] patients infected with drug-tolerant bacteria that may cause lingering symptoms.”
Babesiosis, caused most commonly by the tick-borne parasite Babesia microti, was first identified in the northeastern U.S. But its presence has not been recognized within Texas and “the molecular prevalence of these pathogens within the wildlife species is largely unknown,” writes Modarelli and colleagues. 
Attendees at a public workshop, sponsored by the Food and Drug Administration (FDA), discussed emerging tick-borne diseases and the possible threat to blood safety. During the event, Dr. David Leiby made an analogy comparing tick-borne diseases, including Lyme disease and arboviral agents/diseases to The Tortoise and the Hare, an Aesop Fable. 
Over the past two decades, there have been reports of the tick-borne infection Babesia microti being imported into foreign countries from the United States. International travelers are unknowingly carrying the disease into countries, which may be unfamiliar with diagnosing tick-borne illnesses.
“The threat to blood safety by tick-borne agents is ever-increasing and requires constant surveillance,” state the authors of a review article, which describes the risks of contracting a tick-borne illness, including a Babesia infection, through the blood supply. 
Dr. Daniel Cameron, MD, MPH, is a nationally recognized leader for his expertise in the diagnosis and treatment of Lyme disease and other tick-borne illnesses. For more than 30 years, he has been treating adolescents and adults suffering from Lyme disease.