2019 Nov 10;12(11). pii: e231645. doi: 10.1136/bcr-2019-231645.

Powassan virus encephalitis, severe babesiosis and lyme carditis in a single patient.


Ixodes scapularis is responsible for transmission of Borrelia burgdorferi, B. miyamotoi, Babesia microti, Anaplasma phagocytophilum and Powassan virus to humans. We present a case of an 87-year-old man who presented with fever and altered mental status. Initial workup revealed haemolytic anaemia, thrombocytopenia, mild hepatitis and acute kidney injury. Patient tested positive for B. burgdorferi and Babesia microti, and was started on doxycycline, atovaquone and azithromycin. He also underwent exchange transfusion twice. After some initial improvement, patient had acute deterioration of mental status and appearance of neurological findings like myoclonus and tremors. Therefore, testing for arboviruses was done and results were positive for Powassan virus. During a protracted course of hospitalisation, patient required intubation for respiratory failure and temporary pacemaker for unstable arrythmias from Lyme carditis. Patient developed permanent neurological deficits even after recovery from the acute illness.



This right here is an example of the polymicrobial aspect of Lyme disease that doctors are not considering. The continued blindness of the medical community on the true nature of tick-borne disease is unbelievable. The only reason this patient made the books is due to the severity of the case. There are many, many patients in Lyme-land who have these exact same pathogens but are flying under the radar of mainstream medicine due to the fact they haven’t been hospitalized yet.


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