2019 Nov;98(46):e17977. doi: 10.1097/MD.0000000000017977.

Case report: A patient coinfected by Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae in Urumqi, China.

Jiang Y1,2, Hou X1,2, Zhang L1,2, Tan Y3, Lu C3, Xiao D3, Li H3, Hao Q1,2, Wan K1,2.



Both Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae (SFGR) are pathogens carried by ticks. There is a possibility of co-infection with these tick-borne diseases.


Male patient, 63 years-of-age, admitted to hospital with skin rash presenting for 1 week and fever with cough and expectoration for 3 days before admission.


We diagnosed that the patient was co-infected by B burgdorferi sl and SFGR using laboratory test results and the patient’s clinical manifestations.


The patient started therapy with oral minocycline, then levofloxacin by intravenous injection for SFGR. Meanwhile, he was treated with penicillin G sodium, cefoperazone sulbactam sodium and ceftriaxone by intravenous injection for B burgdorferi sl.


After the patient was in stable condition, he was discharged from hospital.


This case report highlights the possibility of co-infection by 2 tick-borne diseases in Urumqi, Xinjiang Uygur Autonomous Region, China. The antibiotic therapy should be based on the detection of pathogenic bacteria, and the different susceptibilities of co-infecting bacteria should be considered.



Very glad these cases are being reported as mainstream medicine has its head completely in the sand regarding tick-borne infections. In 2018 a fantastic study demonstrated that many patients are coinfected with numerous pathogens.  Patients whom are coinfected have more severe illness for a longer duration of time. The idea that 21 days of the mono therapy of doxycycline is a complete joke.

Going back to 1998, it was known that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, causing greater symptoms, disease severity, and duration of illness:  Great example of a previously healthy 39-year-old male presenting to the emergency department (ED) with generalized severe headaches for eight days and fever for four days. Abdominal examination was normal except for a swollen spleen.

THE NUMBER OF SYMPTOMS AND DURATION OF ILLNESS IN PATIENTS WITH CONCURRENT LYME DISEASE AND BABESIOSIS ARE GREATER THAN IN PATIENTS WITH EITHER INFECTION ALONE  It also suggests a synergistic inflammatory response to both a parasitemia and an increased spirochetemia. In addition, babesial infection enhances Lyme disease myocarditis in mice, which suggests that coinfection might also synergize spirochete-induced lesions in human joints, heart, and nerves.

Telling quote:

Persistent and debilitating fatigue characterized coinfection.

Similar to humans, B. microti coinfection appears to enhance the severity of Lyme disease-like symptoms in mice. Coinfected mice have lower peak B. microti parasitaemia compared to mice infected with B. microti alone, which may reflect attenuation of babesiosis symptoms reported in some human coinfections. These findings suggest that B. burgdorferi coinfection attenuates parasite growth while B. microti presence exacerbates Lyme disease-like symptoms in mice.

 Mainstream medicine hasn’t even factored this into the equation yet.