What does Borrelia miyamotoi cause? The Borrelia miyamotoi symptoms vary depending on the patient’s immune status. The authors explain, “Immunocompetent, and otherwise healthy, patients present with milder, flu-like symptoms: fever, fatigue, sleepiness, chills, muscle and joint stiffness, aches and pains, and nausea.” And, “While uncommon, relapses of febrile episodes can occur.”

In fact, the Borrelia miyamotoi symptoms may be mild enough that an individual with Borrelia miyamotoi disease may not seek medical care.

However, immunocompromised individuals may experience not only flu-like symptoms but reduced cognition, disturbed gait, memory deficits, confusion, and other neurological deficiencies resultant of meningoencephalitis, wrote Cleveland and colleagues.

“Additionally, hearing loss, weight loss, uveitis, iritis, neck stiffness, and photophobia have been reported,” the authors wrote.

The Borrelia miyamotoi symptoms can be severe enough in some patients that they require hospitalization.

Who is immunocompromised?

Although the designation of ‘immunocompromised’ is broad, the authors point out, there are several cases which fit into this category. “Hospitalization reports of severe BMD are frequently seen in patients prescribed B-cell depletion therapies, such as rituximab, other cancer immunotherapeutics, or immunosuppressants for rheumatoid arthritis.”

Treatment for Borrelia miyamotoi symptoms

There are several proposed treatments for BMD. Doxycycline and ceftriaxone have been prescribed given their use in relapsing fever. “Ampicillin, azithromycin, and vancomycin, or a combination thereof, have also been used to treat BMD,” wrote Cleveland and colleagues.

However, the jury is still out. “Research has confirmed in vitro that both clinical and tick isolates of B. miyamotoi are susceptible to doxycycline, ceftriaxone, and azithromycin, but show resistance to amoxicillin.”

Herxheimer reaction

“Albeit rarely, Jarisch-Herxheimer reactions have occurred with antibiotic treatment of BMD,” the authors point out. This reaction occurs when large quantities of toxins are released into the body as bacteria die during antibiotic treatment.

Importance of early recognition

Recognizing Borrelia miyamotoi symptoms early is important for prompt treatment. Unlike Lyme disease, B. miyamotoi rarely causes an erythema migrans rash, making clinical diagnosis more challenging. Clinicians in tick-endemic areas should consider B. miyamotoi in patients presenting with relapsing fever and flu-like illness.