Ticks carry other infections.



Borrelia is not the only tick-borne organism to cause musculoskeletal symptoms. Mycoplasma, the smallest known free-living organisms, also produces these symptoms. Unlike viruses, mycoplasma can reproduce outside of living cells; but they do not have the rigid cell wall of bacteria. In April 2003, doctors at Hunterdon Medical Center (Flemington, New Jersey) found Mycoplasma in seven New Jersey residents suspected to have Lyme disease. None of these patients exhibited the characteristic rash of Lyme disease or had positive test results; but all developed fatigue, musculoskeletal symptoms, and cognitive problems after a tick bite. The doctors obtained Mycoplasma fermentans-specific DNA from patients' peripheral blood lymphocytes. After treatment for the infection, the patients' symptoms resolved; and M. fermentans DNA could not be found.

In 2007, Eva Sapi, an assistant professor of cellular and molecular biology and environmental science at the University of New Haven, reported the presence of Mycoplasma organisms in over 84% of 150 local deer ticks that she and several graduate students had examined. "'More comprehensive studies on the transmission of Mycoplasma from ticks to humans need to be carried out to prove whether they are, in fact, transmitted from the ticks to humans,' says Sapi. 'But, in the meantime, more doctors should consider testing suspected Lyme disease patients who are not responding well to treatment for Mycoplamsa.'"

Borrelia and Mycoplasma are just two pathogens that can be transmitted by ticks. Ehrlichiosis, caused by small spherical-to-ellipsoidal gram-negative bacteria, has symptoms that are very similar to Lyme disease but more severe. Ehrlichia and Borrelia do not respond to the same antibiotics. Babesiosis, caused by Babesia protozoa, infects red blood cells. Symptoms include enlarged liver and spleen and hemolytic anemia (premature breakdown of red blood cells) in addition to headache, fever, chills, vomiting myalgia, and fatigue. Rickettsia rickettsii, which causes Rocky Mountain spotted fever, produces chills, fever, severe headache, myalgia, mental confusion, and rash. Southern tick-associated rash illness (STARI), like Lyme, can manifest a bull's-eye rash; but the organism that causes this infection has not yet been identified. Most tick-borne diseases are not localized in one region; they occur throughout the continental US.

Eskow E, Adelson ME, Rao RV, Mordechai E. Evidence for disseminated Mycoplasma fermentans in New Jersey residents with antecedent tick attachment and subsequent musculoskeletal symptoms (abstract). J Clin Rheumatol. April 2003;9(2):77-87. Available at: www.pubmed.gov. Accessed April 24, 2009.

Lasker JS. Mycoplasma infections. HealthLine. Available at www.healthline.com/galecontent/mycoplasma-infections. Accessed April 14, 2009.

National Institute of Allergy and Infectious Diseases. Tickborne diseases. Available at www3.niaid.nih.gov/topics/Tickborne. Accessed April 14, 2009.

University of New Haven. What if it's not Lyme disease? - Groundbreaking research may provide answers to why many chronic sufferers don't respond to treatment [press release]. Available at www.medicalnewstoday.com/articles/73982.php. Accessed April 4, 2009

briefed by Jule Klotter

jule@townsendletter.com

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