NYMC Faculty Publications

Chronic Coinfections in Patients Diagnosed With Chronic Lyme Disease: A Systematic Review

Author Type(s)

Faculty

DOI

10.1016/j.amjmed.2014.05.036

Journal Title

The American Journal of Medicine

First Page

1105

Last Page

1110

Document Type

Article

Publication Date

11-1-2014

Department

Pathology, Microbiology and Immunology

Second Department

Pharmacology

Keywords

Anaplasmosis, Animals, Babesiosis, Bartonella Infections, Chronic Disease, Humans, Immunocompromised Host, Lyme Disease

Disciplines

Medicine and Health Sciences

Abstract

PURPOSE: Often, the controversial diagnosis of chronic Lyme disease is given to patients with prolonged, medically unexplained physical symptoms. Many such patients also are treated for chronic coinfections with Babesia, Anaplasma, or Bartonella in the absence of typical presentations, objective clinical findings, or laboratory confirmation of active infection. We have undertaken a systematic review of the literature to evaluate several aspects of this practice.

METHODS: Five systematic literature searches were performed using Boolean operators and the PubMed search engine.

RESULTS: The literature searches did not demonstrate convincing evidence of: 1) chronic anaplasmosis infection; 2) treatment-responsive symptomatic chronic babesiosis in immunocompetent persons in the absence of fever, laboratory abnormalities, and detectable parasitemia; 3) either geographically widespread or treatment-responsive symptomatic chronic infection with Babesia duncani in the absence of fever, laboratory abnormalities, and detectable parasitemia; 4) tick-borne transmission of Bartonella species; or 5) simultaneous Lyme disease and Bartonella infection.

CONCLUSIONS: The medical literature does not support the diagnosis of chronic, atypical tick-borne coinfections in patients with chronic, nonspecific illnesses.

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