Can Babesia and Bartonella Cause Psychiatric Symptoms in Children?
Babesia and Bartonella may affect the nervous system.
Some children develop severe psychiatric, behavioral, and autonomic symptoms.
Advanced molecular testing has identified multiple tick-borne co-infections in selected patients.
Can Babesia and Bartonella cause psychiatric symptoms in children? In some children, yes. Small observational studies and case reports have described anxiety, rage, depression, hallucinations, developmental regression, sleep disturbances, and behavioral deterioration in children with Babesia and Bartonella co-infections. However, these studies do not prove that the infections directly caused the psychiatric symptoms.
Babesia infection and Bartonella co-infections have been associated with severe psychiatric, neurologic, cognitive, and autonomic symptoms in selected patients. Reported manifestations include anxiety, rage, hallucinations, developmental regression, sleep disturbances, cognitive impairment, depression, and behavioral deterioration.
Although these findings come primarily from small observational studies and case reports, they raise important questions about whether tick-borne infections may occasionally contribute to complex neuropsychiatric presentations that remain unexplained after standard medical evaluations.
One species receiving increasing attention is Babesia odocoilei, which may not be detected by conventional Babesia testing. When combined with Bartonella co-infection, diagnosis may be delayed for months or even years.
For a broader overview, see tick-borne co-infections.
Advanced Testing Detected Babesia and Bartonella Co-Infections
In a 2024 study, Maggi and colleagues from the College of Veterinary Medicine at North Carolina State University used highly sensitive droplet digital PCR (ddPCR) assays to improve detection of Babesia, Bartonella, and Borrelia DNA.
According to the investigators, digital PCR identified Babesia odocoilei DNA in seven research participants, six of whom were also infected with one or more Bartonella species.
The participants lived in the United States and Mexico and had experienced illness ranging from several days to 14 years.
The authors reported that “Fatigue was the most frequently reported symptom, followed by memory loss, headache, irritability/rage/aggression and poor appetite.”
These findings suggest an association between Babesia odocoilei and Bartonella co-infections and a broad spectrum of neurologic and psychiatric symptoms, including anxiety, irritability, cognitive impairment, depression, behavioral deterioration, rage, aggression, and memory problems.
Because Babesia odocoilei is not routinely detected by standard Babesia testing, diagnosis may be delayed despite persistent symptoms.
Interestingly, the symptom questionnaire used in the study did not include night sweats or air hunger, two symptoms commonly associated with Babesia infection.
A Four-Year-Old Boy With Progressive Neuropsychiatric Decline
At four years of age, a previously healthy, high-functioning boy suddenly developed symptoms consistent with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS).
He experienced rapid regression of both receptive and expressive language together with anxiety, sleep disturbance, impaired memory, irritability, rage, aggression, poor appetite, and muscle weakness.
Over the next 5½ years, the child was evaluated by at least 12 specialists and treated with clonazepam and clonidine.
Despite extensive neurologic and psychiatric evaluations, no unifying diagnosis was established.
According to the investigators, “undiagnosed brain disease of 5 years and 10 months duration” remained the working diagnosis at study entry. By that time, the boy had deteriorated to the point that he was almost entirely non-verbal.
His father described progressive physical weakness, severe anxiety, and profound functional impairment.
Advanced molecular testing later identified DNA consistent with infection with both Babesia odocoilei and Bartonella henselae.
A Nine-Year-Old Girl With Severe Psychiatric Symptoms
A 9-year-old girl developed severe neuropsychiatric illness accompanied by symptoms suggesting autonomic nervous system dysfunction.
She experienced anxiety, severe depression, nightmares, hallucinations, headaches, tachycardia, recurrent urinary tract infections, suicidal thoughts, homicidal thoughts, and marked behavioral instability.
She had previously been diagnosed with oppositional defiant disorder (ODD).
The authors reported that she later attempted suicide and subsequently developed persistent tachycardia, recurrent urinary tract infections, homicidal thoughts, and cutaneous stretch marks.
The patient also reported cat and dog bites during the same year her psychiatric symptoms began. Although this exposure raised suspicion for Bartonella infection, advanced molecular testing later identified multiple pathogens.
Advanced molecular testing identified DNA consistent with infection with Babesia odocoilei, Bartonella henselae, and Bartonella quintana.
A Toddler With Night Sweats, Knee Pain, and Sleep Problems
A 2½-year-old girl developed a bull’s-eye rash after playing in her parents’ backyard in Oklahoma.
During the following months she developed night sweats, knee pain, nightmares, and symptoms suggestive of sleep apnea.
Although she received antibiotic therapy, several symptoms reportedly persisted for years.
According to her father, she continued to experience significant night sweats, knee pain, nightmares, and abnormal nighttime breathing.
Advanced molecular testing later identified DNA consistent with infection with Babesia odocoilei, Bartonella henselae, and Bartonella quintana.
The investigators did not report detailed treatment outcomes for these patients.
Why Babesia and Bartonella Co-Infections May Be Missed
Babesia and Bartonella infections can produce symptoms that overlap with psychiatric, neurologic, developmental, autoimmune, and autonomic disorders.
Children may undergo years of neurologic, psychiatric, developmental, or behavioral evaluations before tick-borne infections are considered. In addition, conventional laboratory testing may fail to detect less common species such as Babesia odocoilei, contributing to delayed diagnosis.
This overlap is one reason some patients experience Lyme disease misdiagnosis before the underlying infection is recognized.
Can Babesia and Bartonella Cause Psychiatric Symptoms?
This study cannot prove that Babesia odocoilei or Bartonella directly caused the psychiatric symptoms observed in these children. However, it raises important questions about whether tick-borne infections may contribute to complex neuropsychiatric illness in selected patients.
The investigators concluded:
- “Using a combination of different molecular diagnostic approaches, infection with Babesia odocoilei was confirmed in seven people suffering chronic non-specific symptoms, of whom six were co-infected with one or more Bartonella species.”
- “We conclude that infection with Babesia odocoilei is more frequent than previously documented and can occur in association with co-infection with Bartonella spp.”
Research involving Babesia odocoilei remains limited, and additional studies are needed to determine how frequently these infections contribute to psychiatric, neurologic, developmental, or autonomic symptoms.
Frequently Asked Questions
Can Babesia and Bartonella cause psychiatric symptoms in children?
Yes. In this study, some children with Babesia and Bartonella co-infections experienced anxiety, rage, depression, hallucinations, developmental regression, and suicidal thoughts. Larger studies are needed to determine how commonly these associations occur.
Can Babesia odocoilei and Bartonella cause irritability or rage?
Irritability, rage, and aggression were among the reported symptoms in several children described in this study. However, the study cannot establish that these infections directly caused those symptoms.
What is Babesia odocoilei?
Babesia odocoilei is a lesser-known Babesia species that may not be detected by standard Babesia testing, potentially delaying diagnosis.
Why are these infections difficult to diagnose?
The symptoms overlap with psychiatric, neurologic, developmental, autoimmune, and autonomic disorders, while conventional laboratory testing may miss some Babesia species.
Can tick-borne infections mimic psychiatric illness?
Yes. Some patients with tick-borne infections have presented with behavioral, cognitive, autonomic, or psychiatric symptoms that initially led clinicians to pursue other diagnoses.
Did the study report treatment outcomes?
No. The investigators focused primarily on diagnosis and did not provide detailed treatment outcomes for the patients described.
Important Study Limitations
This report describes only a small number of patients and cannot establish that Babesia odocoilei or Bartonella directly caused the psychiatric, behavioral, cognitive, developmental, or autonomic symptoms.
The findings should therefore be interpreted as hypothesis-generating rather than proof of causation.
Additional prospective studies are needed to determine how frequently these associations occur, clarify the underlying biologic mechanisms, and identify which patients may benefit from further evaluation.
Clinical Takeaway
Babesia and Bartonella co-infections may contribute to severe neuropsychiatric, neurologic, and autonomic symptoms in some children.
Some children with persistent behavioral, cognitive, developmental, or psychiatric symptoms undergo years of neurologic and psychiatric evaluation before tick-borne infections are considered.
I have evaluated children with persistent behavioral, cognitive, autonomic, and sleep-related symptoms whose tick-borne infections were not initially recognized.
Although additional research is needed, clinicians should consider Babesia, Bartonella, and other tick-borne co-infections in children with unexplained psychiatric, behavioral, cognitive, developmental, or autonomic symptoms—particularly when standard evaluations fail to identify an underlying cause.
Related Articles
These articles explore pediatric Lyme disease, Babesia, Bartonella, and other neurologic complications of tick-borne infections.
Bartonella Associated With Psychiatric Symptoms
Babesia Infection
Bartonella Infection
Tick-Borne Co-Infections
Pediatric Lyme Disease
References
- Maggi RG, Calchi AC, Moore CO, Kingston E, Breitschwerdt EB. Human Babesia odocoilei and Bartonella spp. co-infections in the Americas. Parasit Vectors. 2024;17(1):302.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I am suffering from what is called PTLDS. My left knee cartilage has designigrated to the point of needing a knee replacement. My right eye is quite irritated and have had frequent eye appointments for uveitis, irritation, etc…I had been dx with having ehrlichiosis and treated, Now what can been done for the residual issues? I am afraid of further deteriation.
I have patients who degenerative joint disease and a persistent tick borne infection no responding to treatment for Ehrlichia. I have had to have them work with an orthopedist and be retreated for Lyme. The knee is still challenging
Hello, dr. Cameron,
I would like to ask do you know if these children improved with treatment? I have two children 7 and 10 years old with Babesia and Lyme probably for a long time, withsome neuro-psychiatric symptoms, starting now treatment Malarone+Azithromycine now. Soon we will start treating also the Lyme. What do you think in your experience do children can recover with prolonged treatment? Do they have the chance to have normal life?
Thank you!
I have seen children improve, sometimes significantly. Recovery is often gradual, but many return to school, activities, and a full life over time.