Did you know that just one tick bite could transmit to you a number of infections? That’s right, according to a Lyme Science blog post from Dr. Daniel Cameron, MD, MPH, an elderly woman who was bitten by a tick was later diagnosed with a triple infection: babesiosis, anaplasmosis, and Lyme disease. This highlights that a tick bite may transmit multiple parasites or bacteria to a person, and that co-infection is possible. Thus, patients – and doctors – should remain vigilant and perform testing to ensure that all infections are being taken care of, even if treatment has already been administered. Learn more about the findings here.

Identifying a Tick Bite

Now, before we move into the story, let me quickly go over how to identify a tick bite. This way, if you see a bite, or feel symptoms, you are able to pursue earlier medical attention. According to IGeneX, some characteristics of a tick bite include:

• A distinctive bullseye rash. This typically appears as a red, circular rash, with another red, circular ring positioned outside of the rash (much like a bullseye). In addition to highlighting the tick bite, this rash also appears in around 1/3 of all Lyme disease diagnoses.
• Location. Unlike other insects, ticks often bite the legs, groin, scalp, or back of the neck.
• Appearance. If you get bitten by ants or other insects, pus-filled bites or bumps may appear. Alternately, a tick bite is not filled with any sort of fluid.
• Bite count. Other insects (like mosquitos) may bite multiple times, leaving you with many different, itchy bites. For ticks, they often bite once.
• Symptoms. Some symptoms associated with a tick bite include reddened skin, fever, mild itching, and either the distinctive bullseye rash (for Lyme disease) or another rash (for other bites).

Diagnosing a Tick Bite

In this particular case, the female patient came to the hospital without knowing that she had been bitten by a tick. In fact, she had not presented with any sort of rash. However, she did enjoy working in the garden, which is most likely where she was exposed to the tick. When she first appeared at the hospital, her symptoms included:

• Difficulty breathing
• Fatigue
• Pale skin
• Swelling of the hands and lower legs
• Bibasilar crackles (a bubbling or crackling sound originating from the lungs, often due to excess fluid)
• Altered mental status
• A cough, which produced yellow mucus

Initially, the woman was diagnosed with pneumonia. But later testing revealed that she actually had a triple infection of tick-borne illnesses: anaplasmosis, babesiosis, and Lyme disease. Due to her extremely high parasitic load (regarding babesiosis), she required multiple rounds of antimicrobials, antibiotics, and erythrocytapheresis. Doctors now say that this should be a warning to physicians: if someone is presenting with atypical symptoms, specifically for a certain pathogen, or isn’t improving on treatment, more testing is needed to determine if co-infections exist.

Lyme Disease

A tick bite from an infected tick transmits Lyme disease, an illness caused by Borrelia burgdorferi (B. burgdorferi) infection. On the West Coast, the western blacklegged tick often spreads the infection; in the rest of the country, infected deer ticks are the transmitters. While around 30,000 Lyme disease cases are reported each year, many believe that this number is actually much higher. Symptoms appear 3-30 days following infection. In early stages, symptoms include:

• Muscle and joint pain
• Headache
• Fatigue
• Fever and chills
• Swollen lymph nodes
• Bullseye rash

However, symptoms may worsen and progress within days or months following the bite. These symptoms include:

• Severe headaches
• Neck stiffness
• Facial palsy
• Arthritis
• Severe joint pain and swelling
• Muscle, tendon, and bone pain
• Irregular heartbeat
• Dizziness
• Shortness of breath
• Brain and spinal cord inflammation

Patients diagnosed and treated in early stages of Lyme disease often recover fairly easily and quickly. However, those not treated until later stages often require weeks of antibiotic treatment.

Learn more about Lyme disease.

Babesiosis

Babesiosis, a rare disease caused by the Babesia parasite, is often spread through the bite of an infected deer tick. In rarer cases, this infection may also be spread through blood transfusions or from mother to child. This infection is most common in the Northeast and upper Midwest U.S. states. Severity varies, with many people being asymptomatic. However, patients who do show symptoms may experience:

• Fever and chills
• Muscle, hip, and chest pain
• Fatigue
• Excessive sweating
• Shortness of breath

Learn more about babesiosis.