The case of an untreated Babesia infection
Babesia can be a severe and life-threatening tick-borne illness. In a recent article, Dr. Gary Wormser described a 61-year-old female with an untreated Babesia microti infection.¹ The woman’s IgM test for Lyme disease was positive, but it was dismissed as a false positive test.
In his article, Wormser discusses the case of a 61-year-old woman who went untreated for a Babesia infection, despite positive test results. The patient, who lives in Westchester, NY, a highly endemic area for Lyme disease, reportedly removed an unidentified tick from her left wrist at the end of March 2020, wrote Wormser.
In June, she developed intermittent fevers, joint pain, anorexia, and fatigue and was evaluated at the Lyme Disease Diagnostic Center (LDDC) in New York State.
Unfortunately, the patient did not have an erythema migrans rash. And, as a result was not treated for a tick-borne infection.
On July 30, 2020, the woman tested positive by PCR for Babesia but was not treated.
Two weeks later, she had a positive Lyme disease EIA and one IgM Western blot band. But she was still not treated for either Lyme disease or Babesia.
On August 26, 2020, her Lyme disease tests were positive by the CDC’s two-tier diagnostic criteria. She had a positive EIA and positive IgM Western blot test. Still, she was not treated for either Lyme disease or Babesia.
On December 11, 2020, the woman’s PCR test for Babesia and IgM Western blot test for Lyme disease were negative. Her Lyme EIA remained positive.
I. scapularis ticks recovered from the environment that are infected with B. microti may be co-infected with B. burgdorferi.
The woman never developed more than two IgM Western blot bands for Lyme disease. And she never exhibited an erythema migrans (or Bull’s-eye) rash. If she had, it would have allowed Dr. Wormser to make the diagnosis of Lyme disease in a patient with Babesia.
As he states, “Diagnosing Lyme disease co-infection in patients with active babesiosis, as in patients with human granulocytic anaplasmosis, is more convincingly accomplished if objective clinical features of Lyme disease are present, such as an erythema migrans skin lesion.”
The woman’s fever resolved without treatment. But Dr. Wormser did not state whether the patient’s joint pains, anorexia, or fatigue had resolved. Neither did Dr. Wormser report whether there were any long-term sequelae from an untreated tick-borne illness.
Editor’s perspective:
I would have been uncomfortable leaving the woman untreated particularly since she had evidence of at least one tick-borne infection – Babesia.
Related Articles:
Case series: Wide range of Babesia symptoms and presentations
Babesia infections and tick-borne agents transmitted through blood supply
References:
- Wormser GP. Documentation of a false positive Lyme disease serologic test in a patient with untreated Babesia microti infection carries implications for accurately determining the frequency of Lyme disease coinfections. Diagn Microbiol Infect Dis. May 16 2021;101(1):115429. doi:10.1016/j.diagmicrobio.2021.115429
Sherry Darrah
10/15/2022 (1:56 pm)
I was exposed to mold at work for 8 years, diagnosed initially with Lyme through Igenex and clinically diagnosed with Babesia and Bartonella. Before being diagnosed with mold I had treated the lyme and co. For almost 2 years and many symptoms resolved but I had still persistent slurred speech and off balance and loss of fine motor skills that led to the testing for mold.
Although I treated with binders for over a year I didn’t have any resolution to these symptoms and then got Covid. All of my balance, slurred speech and motor skills have been exasperated and some new ones added. Could these symptoms be from babesia or from mold still although out of that exposure since I was diagnosed 12/4/20
Dr. Daniel Cameron
10/16/2022 (10:33 am)
I have had success with treating Lyme diseases and Babesia again. Others have reported success with mold treatment.
Amy Morgan
08/30/2022 (10:38 pm)
My mom has been extremely sick since 6 August. She developed the red rash on her arm the morning she went to urgent care (9 Aug) and was notified on 12 Aug that she tested positive for Lyme. The doctor, thankfully, was proactive and started her on doxycycline at the visit on the 9th. However, she continues to be very sick. After her second visit to the ER, we asked for testing for bartonella and Babesia, which both came back negative today. She has a headache (temples and eyes), extreme fatigue, body tremors, nausea, extreme loss of appetite with a weight loss of 16 pounds in the last 10 days, a chronic dry cough, shortness of breath upon exertion, gastrointestinal problems, short-term memory loss, and a CT shows she has some fluid around her heart. She sees her cardiologist tomorrow. My questions are, could she have those co-infections despite the tests being negative? Is it possibly the lyme bacteria has caused carditis which would be the reason for the cough? The doctor who tested for babesia and bartonella put her on a long and high tapered dose of prednisone (50 mg X 3 days, 40 mg X 3 days etc, down to 5 mg X 3 days) for the cough which seemed to make her get worse rather quickly. He agreed she could stop when it didn’t stop the cough after 4 days. We are at a loss and her PCM refuses to refer her anywhere for the lyme. We requested a referral to infectious disease at WVU Medical in Morgantown, WV but again, her said no. Any resources anyone can recommend so we can get mom the help she needs?
Dr. Daniel Cameron
08/31/2022 (7:42 am)
I have worked with patients who remain ill despite standard therapy for a tick borne illness. The tests for co-infections have not been as good as I would like. My patients also see other doctors to rule out other diseases including pulmonary and cardiac disease. Keep working on all fronts until she gets better.