Lyme Disease Co-infections

Ticks can carry more than just Lyme disease. When people are infected with Lyme, they can also be infected with other nasty organisms from the same tick bite. We call these guys Lyme co-infections. Diagnosing Lyme disease should include checking for co-infections. Lyme co-infections further complicate an already complex condition. Each co-infection can alter the symptom picture, and can make primary Lyme symptoms much worse. Treatment programs have to be tailored to also target the co-infections, and recovery can take much longer. But without treating the co-infections, the patient cannot regain full health. Common co-infections include Babesia, Bartonella, Rickettsia, and Erlichia.


Babesia is a parasite similar to the one that causes malaria. As in malaria, Babesia parasites infect the red blood cells and cause similar symptoms. Babesia infection can often have mild, nonspecific symptoms. It can also be severe and life threatening, especially in the elderly and in people who are immunocompromised. 

Acute infection involves fever, chills and haemolytic anaemia. Less severe cases may experience a more gradual onset of headaches, fatigue, loss of appetite, muscle and joint pain, high fever and shaking chills, nausea, and vomiting.

Lyme patients with Babesia co-infection also often experience blurry vision, ringing in the ears, dizziness and lightheadedness, shortness of breath and a feeling of pressure on the chest, night sweats, nausea, and sometimes Bell’s palsy. There is also a cycle of flare-ups every 4-6 days. Lyme patients who fail to respond to treatment can often have an untreated Babesia co-infection.


Bartonella are aerobic bacteria that like to live inside cells. As with Babesia, Bartonella infection can range from mild to severe. With Bartonella the onset of illness is slow. Signs and symptoms include swollen lymph glands, fever, fatigue, headaches, an unusual streaked rash, enlarged spleen, raised liver enzymes, and aches and pains in joints, muscles and bones.

Lyme patients with Bartonella co-infection can also experience light sensitivity, neurological symptoms including tremors and muscle twitching, racing heart, headaches, anxiety, agitation, new stretch marks, and tender nodules under the skin, usually on the shin, outer thigh and back of the arm. There can be rapid improvement following treatment, but the symptoms can return if treatment is stopped too soon.


Rickettsia are a group or organisms that lie somewhere between bacteria and viruses. Rickettsial diseases range from mild illnesses to severe life-threatening infections. Common symptoms include headache, fever, chills, and aching muscles. Depending on the type of Rickettsia, there may also be a rash, cough, chest pain, runny nose, sore throat, nausea and vomiting, and abdominal pain.


Erlichia comes with a rapid onset of symptoms. These include muscle pain (but not necessarily joint pain), headaches, and neurological symptoms such as shooting pains and seizures. Tests may show a low white blood cell count and raised liver enzymes. We also usually see fast improvement with treatment.

Testing for co-infections

Testing for Rickettsia can be done by your GP and is covered by Medicare. Unfortunately, Australia is behind on the testing for Babesia, Bartonella, and Erlichia. For the most reliable co-infections testing we use IGeneX, a specialist Lyme lab in the US.