Archive for the ‘Babesia’ Category

Is Babesia Blocking Your Recovery From Lyme Disease?

https://www.lymedisease.org/is-babesia-blocking-your-recovery-from-lyme-disease/

Is Babesia blocking your recovery from Lyme disease?

By Dorothy Kupcha Leland
Sept. 15, 2025

Lyme disease is increasingly being recognized as a complex chronic illness, often tangled up with co-infections and overlapping conditions that make it difficult to pinpoint what’s really going on.

One of the trickiest players in this mix is Babesia. Even though it can come from the same tick bite as Lyme, it’s a separate infection, and it needs its own testing and treatment. Left unaddressed, Babesia can derail recovery, leaving patients with persistent symptoms and few answers.

Dr. Alexis Chesney, a naturopathic physician and Lyme specialist, has just published an article in NDNR (Naturopathic Doctor News & Review) titled “The Diagnosis and Treatment of Babesiosis: A Naturopathic Approach to an Emerging Tick-Borne Disease.”

As she explains, Babesia is a malaria-like parasite that infects red blood cells. It can cause symptoms ranging from crushing fatigue and night sweats to shortness of breath and heart palpitations. And although it often accompanies Lyme disease, it doesn’t respond to the same treatment. That means that if Babesia isn’t identified and treated properly, you are missing an essential step in your quest to get better.

Dr. Chesney’s article offers:

  • A clear explanation of how babesiosis is diagnosed, including which tests are most reliable.
  • A look at naturopathic treatment options, including herbs, supplements, and detox strategies.
  • A balanced approach that integrates conventional and natural medicine.

You can read the full article here. And if you’re navigating tick-borne illness, consider sharing it with your provider. It might just change the course of your treatment.

TOUCHED BY LYME is written by Dorothy Kupcha Leland, President of LymeDisease.org. She is co-author of Finding Resilience: A Teen’s Journey Through Lyme Disease and of When Your Child Has Lyme Disease: A Parent’s Survival Guide. Contact her at dleland@lymedisease.org.

For more:

Category:

Babesia, Lyme

Babesia Treatment: Dr. Cameron’s Clinical Tips

https://danielcameronmd.com/babesiosis-treatment/

Babesiosis Treatment: My Go To Clinical Tips

Posted By: Dr. Daniel Cameron
7/22/25

Babesiosis treatment is often overlooked—especially in patients who also have Lyme disease. Babesiosis is a malaria-like illness caused by microscopic parasites that infect red blood cells. It’s frequently found alongside Lyme, but just as often, it’s missed.

Unlike Lyme, which is caused by the bacterium Borrelia burgdorferi, babesiosis is caused by parasites (Babesia microti or Babesia duncani) and does not respond to doxycycline. Yet I continue to see Lyme patients who are only treated with doxycycline—even when symptoms strongly suggest babesiosis may be present.

So what do I use when babesiosis testing is negative but suspicion is high?

Let’s walk through my approach.

Why Testing for Babesiosis Falls Short

Babesiosis tests often fail—especially in patients with chronic or relapsing symptoms. Here’s why:

    1. Parasites are visible on blood smear only in early infection

    2. PCR (detects DNA) may miss low-level infections

    3. Antibody tests may remain negative for months—or fade over time

In my practice, I increasingly see positive Babesia antibodies after months of symptoms, even when earlier testing was negative. This tells me two things:

    1. Symptoms often precede test positivity.
    2. Waiting for test confirmation may delay needed treatment.

Babesiosis Treatment: Key Symptoms That Warrant Empiric Therapy

When testing fails but the clinical picture fits, I move forward with treatment.

Common babesiosis symptoms in my patients include:

    1. Night sweats (often drenching)

    2. Shortness of breath or “air hunger”

    3. Fatigue that worsens with activity

    4. Lightheadedness, POTS-like symptoms

    5. Temperature dysregulation

    6. Anxiety or depression out of proportion

These symptoms are sometimes dismissed as menopause, anxiety, or long COVID—but in a patient with a history of Lyme disease or tick exposure, they raise concern for babesiosis.

First-Line Babesiosis Treatment

When babesiosis is suspected, the first-line treatment I use is: Atovaquone + Azithromycin

This combination remains the most commonly prescribed regimen, with proven effectiveness.

    1. Atovaquone is an anti-parasitic that targets the Babesia organism in red blood cells.

    2. Azithromycin is an antibiotic that complements atovaquone’s activity.

Practical Note:

Many clinicians prescribe Mepron® (atovaquone 750 mg/5 mL oral suspension), but I’ve had success using Malarone® (atovaquone 250 mg + proguanil 100 mg tablets), which:

    1. Is better tolerated by many patients

    2. Is easier to obtain in outpatient practice

    3. Comes in pediatric-sized tablets (62.5 mg/25 mg) useful for dose titration

This flexibility allows me to individualize babesiosis treatment—especially for sensitive patients who cannot tolerate full adult dosing at first.

Newer Option: Tafenoquine

For resistant or relapsing babesiosis, I’ve also begun using: Tafenoquine (Krintafel®)

    1. Originally approved for malaria

    2. May be effective in difficult Babesia cases

    3. Requires screening for G6PD deficiency before use

    4. Still considered off-label in many outpatient Lyme protocols

Tafenoquine is not a first-line therapy, but it may have a role when patients relapse despite standard babesiosis treatment. I’m following the research closely.

Why I Don’t Use Clindamycin or Quinine

While clindamycin and quinine are sometimes recommended for severe babesiosis (especially hospitalized cases), I have not been using them in outpatient care. In my experience:

    1. Clindamycin + quinine causes significant nausea, tinnitus, and other side effects

    2. Not well tolerated in chronic or relapsing Lyme patients

    3. Alternative regimens (like atovaquone-based therapies) are typically sufficient

If a patient does not respond to first-line babesiosis treatment, I evaluate for possible co-infections (like Bartonella or Ehrlichia), medication tolerance, and drug absorption before moving to more aggressive regimens.

What I Watch for During Treatment

When treating babesiosis, I monitor:

    1. Liver enzymes (especially with Mepron)

    2. Hemoglobin and hematocrit (to assess for hemolysis)

    3. Symptom patterns (including Herxheimer reactions)

    4. Drug tolerance and adherence

Improvement can take time. But when patients begin to regain energy, lose their night sweats, and tolerate light exertion again, it’s a sign that treatment for babesiosis is working.

Final Thoughts on Babesiosis Treatment

Babesiosis doesn’t always show up on a lab test—but it can still cause profound illness, especially in those with Lyme disease or immune dysfunction.

If you’ve been treated for Lyme disease but still suffer from:

    1. Fatigue

    2. Night sweats

    3. Breathlessness

    4. POTS-like symptoms

… don’t assume it’s “just Lyme.” Babesiosis treatment may be the missing piece.

 References

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**Comment**

Fantastically practical article.

For more:

I believe Dr. Horowitz states that when you start treatment for Babesia, you need to keep going until it’s gone.  Stopping and starting makes it harder to treat in the long run.

Category:

Babesia, Treatment

Lyme Treatment Explained: Co-infections & Complex Cases

https://imahealth.substack.com/p/lyme-treatment-explained-co-infections

Lyme Treatment Explained: Co-infections and Complex Cases

IMA Senior Fellow Dr. Yusuf (JP) Saleeby hosts Part 3 in a series of Weekly Webinars on diagnosing and treating Lyme Disease.
Independent Medical Alliance's avatar
Independent Medical Alliance
Jun 28, 2025

Speakers: Dr. Yusuf (JP) Saleeby, Dr. Tom Moorcroft, Chris Jackman, FNP

Lyme disease is notoriously difficult to treat, but it’s even more complex than most realize. That’s because Lyme doesn’t always travel alone. Associated tick-borne co-infections like Bartonella and Babesia can mimic or mask Lyme symptoms, requiring different treatments to resolve. This reality turns Lyme treatment into a winding, uncertain road for patients and providers alike.

Luckily, we’ve enlisted some of the world’s top experts in Lyme and chronic disease to help demystify this debilitating condition. Join IMA Senior Fellow Dr. JP Saleeby as he hosts a practical conversation with Lyme specialist Dr. Tom Moorcroft and integrative nurse practitioner Chris Jackman. Together, they’ll break down what makes Lyme so persistent, how co-infections complicate recovery, and what successful treatment protocols can look like in the real world.

This is the third installment in IMA’s Lyme Disease series—an essential session for patients, practitioners, and anyone trying to make sense of this often-misunderstood chronic condition. Catch up with the previous episodes here:  (See link for article and video seminars)

More from IMA on Lyme:

Check out our ever-expanding Lyme Library for more:

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One things for sure: a multi-drug combination is required for this.  Doctors who still prescribe ONE drug for this are hopelessly in the dark.  I would even add that ONE drug for an acute case isn’t enough and that tinidazole should be pulsed along with daily doxycycyline or minocycline until symptoms are completely gone.  I would also recommend blood ozone – the stronger the better – EBOO preferably.  If other coinfection symptoms arise – then the drugs that are effective for them should be layered in.  This is no joke, and the days of treating this passively are long gone.  Wake up doctors and do the right thing!

Category:

Babesia, Bartonella, Lyme, Treatment

Bartonella and Babesia Detected in Patients With Chronic Illness

https://news.ncsu.edu/2024/07/bartonella-and-babesia-co-infection-detected-in-patients-with-chronic-illness/

Bartonella and Babesia Co-Infection Detected in Patients with Chronic Illness

July 16, 2024  
For Immediate Release
Tracey Peake
Edward Breitschwerdt

A small pilot study has found evidence of human co-infections from Bartonella and Babesia odocoilei, a protozoal tick-borne infection primarily found in deer, moose and other cervids. The co-infections were detected in six of seven patients suffering from chronic, non-specific illness, who were enrolled in a Bartonella study at North Carolina State University. The work presents some of the first definitive DNA evidence of this strain of Babesia infection in humans, and could impact treatments for patients with Bartonella, Borrelia or Babesia infections.

Bartonella are a group of vector-borne bacteria transmitted primarily via arthropods like fleas, lice and potentially ticks, but also by the animals that harbor them. There are at least 45 different known Bartonella species, of which 18 have been found to infect humans. Improved methods for detecting Bartonella infection in animals and humans have led to the diagnosis of bartonelloses in patients with a host of chronic illnesses, as well as in some patients with psychiatric symptoms.

In the U.S., the main Babesia species that infect humans are B. microti, B. duncani and B. divergens-like. Transmission occurs mainly by tick bite, but there are reports of transmission by transfusion of contaminated blood, organ transplantation and transplacental transmission. In addition to asymptomatic infection, babesiosis can be associated with non-specific symptoms such as fever, chills and night sweats, or with severe, life-threatening hemolytic anemia.

Babesia and Bartonella are often suspected as co-infections with Lyme disease, caused by the bacterium Borrelia burgdorferi.

“Doctors who work with Lyme patients often suspect co-infection with Babesia most often based on serology data and symptoms,” says Edward Breitschwerdt, Melanie S. Steele Distinguished Professor of Internal Medicine at NC State’s College of Veterinary Medicine and corresponding author of a paper describing the work. “So we decided to test for potential co-infections with this subset of our Bartonella study participants.”

The seven patients in the pilot study were already enrolled in a larger study aimed at detecting Bartonella in the blood of people with chronic illness and extensive animal contact. The participants’ ages ranged from two-and-a-half to 62 years old. Four were veterinary workers, one was a student and veterinary technician, one was a veterinarian’s daughter and one was a pre-school aged child. All submitted blood and tissue samples for testing.

Using digital droplet PCR testing, which identifies pathogens by their DNA sequences, the researchers discovered that all seven participants were infected with Babesia odocoilei, and that six of the seven were co-infected with at least one, and sometimes two or more, species of Bartonella.

“We were surprised by these findings for several reasons,” Breitschwerdt says. “First, this strain of Babesia – B. odocoilei – isn’t currently considered a cause of human infection. Second, these patients reside in locations around the U.S. and in Mexico, so the distribution may be geographically widespread. Finally, we were able to identify these seven infected individuals within a one-year time period, suggesting that this may be a more prevalent infection than currently appreciated.”

The findings could have implications for how patients with symptoms of vector-borne illnesses such as Lyme, babesiosis, or bartonellosis are tested and treated.

“The main symptom associated with babesiosis is acute, severe hemolytic anemia. None of these patients reported any such illness, a factor that could limit a doctor’s decision to test for Babesia infection,” Breitschwerdt says.

“This study primarily focused on patients with chronic illnesses and suspected bartonelloses. Most often, doctors don’t look for Babesia in these patients, but we now have good evidence that people can be infected by this organism, evidence that should be pursued in larger studies. Physicians who treat Lyme disease have often suspected co-infections with these pathogens, and it looks like their suspicions are correct, at least in a subset of patients.”

“We are committed to providing the best vector borne infectious disease testing results possible,” says Ricardo Maggi, research professor at NC State and first author of the study. “The cases presented in this manuscript reflect our team’s efforts to develop better approaches and diagnostic tools that can give answers to both patients and their doctors.”

The study appears in Parasites and Vectors and was supported by NC State’s Bartonella/Vector-Borne Diseases Research Fund and the Steven & Alexandra Cohen Foundation. NC State Ph.D. student Charlotte Moore, São Paulo State University Ph.D. student Ana Cláudia Calchi, and NC State research specialist Emily Kingston also contributed to the work.

For more:

Category:

Babesia, Bartonella, research

One Unit of Blood Led to Babesia Infection

https://danielcameronmd.com/blood-transfusion-babesia/

One Unit of Blood Led to a Babesia Infection

April 22, 2025

Posted By: Dr. Daniel Cameron

When we think of tick-borne illnesses like Babesia, we often picture outdoor exposure in wooded, high-risk areas. But what happens when Babesia shows up in someone who hasn’t been outdoors—and hasn’t been bitten by a tick? One recent case reminds us that Babesia can travel silently through the bloodstream, sometimes delivered unintentionally through a blood transfusion.

A 30-year-old man with sickle cell disease (SCD) required regular red blood cell exchanges—about 10 units every 3 to 4 weeks since childhood. Two months after a routine blood transfusion, he developed symptoms that initially seemed vague: fever, neck pain, and photophobia.

But within days, his condition worsened. He experienced:

  1. Persistent fever and chills
  2. Headache
  3. Fatigue
  4. Loss of appetite

It was clear something serious was unfolding.

A Surprising Diagnosis – Babesia via a blood transfusion

Lab work confirmed the presence of Babesia parasites in his red blood cells, and serologic testing came back positive. He was also borderline positive for Anaplasma phagocytophilum and Ehrlichia chaffeensis, though not treated for those due to a lack of supportive symptoms.

Babesia is a malaria-like parasite typically spread by ticks, but this patient hadn’t been outdoors or hiking recently. So, where had it come from?

Tracing the Source: A Lookback Investigation

A donor lookback investigation revealed the answer. Over six months, the patient had received blood transfusions including 65 units of blood—58 of which were screened for Babesia. One of the 7 unscreened units came from a donor who tested positive for Babesia microti.

This donor lived in Ohio, a state not considered endemic for Babesia and thus not required to screen blood donors for the parasite. The donor reported no symptoms and had been active outdoors, hiking and camping in Ohio, Tennessee, and North Carolina—states with potential but under-recognized risk for tick exposure.

Why This Matters: A Vulnerable Blood Supply

This case, published by Costa and colleagues,¹ highlights a critical issue: transfusion-transmitted babesiosis (TTB) remains a real and preventable risk—especially in patients with chronic blood transfusion needs, like those with sickle cell disease.

“Prior to laboratory-based blood donor screening for Babesia, TTB was a leading infectious risk to the blood supply in the United States,” the authors note.

In 2019, the FDA implemented Babesia screening requirements for blood donors in 14 high-incidence states, including Connecticut, Massachusetts, New York, and Minnesota. But states like Ohio—where this case originated—are not yet on that list.

A Simple Treatment, a Critical Delay

Fortunately, this patient was promptly treated with a 10-day course of azithromycin and atovaquone, and his symptoms resolved. But in many cases, particularly in non-endemic states, the delay in diagnosis can lead to more severe disease, especially in vulnerable populations.

Lessons for Clinicians and Policymakers

This case reminds us of a few important lessons:

🩸 1. Babesia Isn’t Just Tick-Borne

Yes, it’s a tick-borne disease—but it’s also transmissible via blood transfusions. That means even patients without outdoor exposure can be at risk.

🌎 2. “Non-Endemic” Doesn’t Mean No Risk

Donors may travel, camp, or hike in high-risk areas—even if their home state isn’t considered endemic. Geographic assumptions can lead to blind spots in our screening systems.

⏳ 3. Delays in Diagnosis Can Be Deadly

In places where clinicians aren’t used to seeing Babesia, diagnosis can be delayed. For immunocompromised or chronically transfused patients, that delay can be critical.

📋 4. Screening Policies May Need Expansion

We must reconsider whether the current state-specific Babesia screening recommendations are sufficient. This case suggests a broader approach may be warranted.

Final Thoughts

For patients like this young man with sickle cell disease, a single unscreened unit of blood changed everything. His case is a powerful reminder that Babesia is no longer just a disease of the woods—it’s also a disease of the blood bank.

As we continue to evolve our understanding of blood transfusion safety, infectious disease spread, and vector-borne illnesses, we must remain open to adjusting our protocols and awareness—even in states not currently labeled “high risk.”

Because in medicine, what we don’t test for can still hurt our patients.

Related Articles:

Podcast: Two mothers transmit Babesia to their babies

Geriatric cases of Babesia are rising and may require longer treatment

Reference:

Costa B, et al. Transfusion-transmitted babesiosis in a patient with sickle cell disease undergoing chronic red cell exchange. International Medical Case Reports Journal, 2020.

Category:

Babesia, Uncategorized