Co-infections Babesiosis and Lyme disease, missed diagnosis can have “dire consequences”

Woman being examined for co-infections with Babesiosis and Lyme disease

In a recently published article, “A Case of Tick Bite Induced Babesiosis With Lyme Disease,” Bhesania and colleagues [1] describe a 72-year-old woman with atypical symptoms, who was found to have co-infections with Lyme disease and Babesiosis.


The woman had a three-week history of a fever (maximum temperature, 104 F], chills, nausea, and productive cough of yellow sputum.

Six weeks prior to her onset of symptoms, the woman had been vacationing in Connecticut, an area endemic for Lyme disease. She reported having 2 tick bites during the previous year.

Her examination and tests were normal, except for pancytopenia and manual peripheral blood smear showed Babesia microti in her red blood cells. Initially, 1.7% red blood cells were infected with Babesia microti.

“The unique feature of our case was the atypical presentation with no rash and no joint pain, but the patient had only constitutional symptoms like weakness and occasional fever…”

“The patient was started on azithromycin, atovaquone for Babesiosis, and doxycycline to treat Lyme disease with initial suspicion of co-infection and a plan to deescalate once the Lyme disease was ruled out,” the authors state.

She was discharged home with the combination of the three oral treatments.

Dire consequences with delayed treatment

“Cases with severe hemolytic anemia, disseminated intravascular coagulation, respiratory failure, renal failure erythrocyte apheresis should be considered,” they suggest.

And, “Clinicians should consider co-infection when suspecting tick-borne disease which can lead to fatal consequences if not addressed promptly.”

“If there is delayed initiation of therapy in these kinds of patients, there may be dire consequences that may require aggressive therapy.”

The authors cited another case report to highlight the importance of a timely diagnosis.

A 67-year-old woman was treated for Lyme disease. But her fever, rash, and myalgias persisted despite a 21-day course of amoxicillin. The patient was also found to have pancytopenia and evidence of Babesia. Once she began treatment for Babesia, her symptoms improved.

  1. Bhesania S, Arora KS, Tokarski M, et al. A Case of Tick Bite Induced Babesiosis With Lyme Disease. Cureus. Aug 2021;13(8):e17401. doi:10.7759/cureus.17401
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6 Replies to "Co-infections Babesiosis and Lyme disease, missed diagnosis can have "dire consequences""

  • Diane Ostrander
    01/11/2022 (6:14 am)

    Robert-Send your blood to IGENEX in California. Contact them. I too am in PA, and that was the way I found out for myself. Take care.

  • Patrice Vogel
    01/10/2022 (5:33 pm)

    Keep looking for lymes literate physician
    Even if you have to go out of state. It will save your life. I’m from Wisconsin and have received care there it saved my life. 2 years into this deal there is light at the end of the tunnel.
    I was a nurse working 12 hrs a day, it shocks me that drs have so little training especially infectious disease. Worked in medicine for 40 years never saw such treatment of people. The long term effects of no treatment for people will bring heavy consequences to the healthcare system.

    • Al Nagle
      01/16/2022 (3:07 pm)

      We are in MN, what specialist did you go see? I too am in healthcare and many health professionals don’t believe in chronic Lyme’s disease.

  • Kate Wood
    01/10/2022 (2:43 pm)

    I believe you. People come literally from all over the world for treatment in Pgh. Hospitals. But to find a Lyme Specialist, is almost impossible. Anyone have any recommendation of a great knowledgeable doctor in the tri-state area? My husband had undiagnosed Lyme for 2 years. It went to his nervous system. It not only affected his body but also affected his brain, mind and mental stability. He took his own life. Chronic Lyme DOES exist and suicide is a very common way of treating yourself. Come on people! Get the facts. Get the word out there that 2 days of Doxycycline doesn’t cure everyone! Doctors, get educated! If you are suffering and nobody knows what’s wrong with you, demand a Lyme test. Demand treatment. You could be saving your own life.

  • Robert Satterfield
    01/10/2022 (1:17 pm)

    I had two video appointments with 2 different so called specialists at a Pittsburgh infectious disease center who said chronic Lyme doesn’t exist and that 3 months of doxycycline was more than sufficient. I’m suffering horribly. I have no choice but to try herbs. No doctors in western Pennsylvania has a clue as how to treat Lyme disease. I was told I do not have bartonella but was only tested for 3/4 strains. There are about 15. I have all the symptoms of babesia, but they won’t test me for that. They say people in western Pennsylvania don’t get that. They need to be sued.

    • Peggy
      01/10/2022 (5:08 pm)

      Call Dr Joseph in Hermitage. He is a Lyme expert and has helped numerous people I know.

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