Borrelia burgdorferi are gram-negative spirochete bacteria that cause Lyme disease. Spirochetes are a group of phylogenetically distinct bacteria that have a unique mode of motility by means of axial filaments (endoflagella).

Borrelia are divided into “genospecies” including B. burgdorferi sensu strict, B. garinii and B. afzelii. The term used to collectively describe all these genospecies is B. burgdorferi sensu lato. B. burgdorferi invades the blood and tissues of various infected mammals and birds via the bite of ticks of genus Ixodes. The natural reservoir for B. burgdorferi is thought to be the white-footed mouse. Ticks transfer the spirochetes to deer, humans, and other warm-blooded animals after a blood meal from an infected animal. In most mammals, including humans, infection by B. burgdorferi can result in Lyme disease.

Lyme disease exhibits a variety of symptoms that may be confused with immune and inflammatory disorders. Inflammation around the tick bite causes skin lesions. Erythema (chronicum) migrans (ECM), a unique expanding skin lesion with central clearing that has a ring-like appearance, is typically the first stage of the disease. Arthritis, neurological disease, and cardiac disease may be later stage manifestations.


In Lyme disease concurrent infections frequently occur. The clinical and pathological impact of co-infections was first recognized in the 1990th. Their pathological synergism can exacerbate Lyme disease or induce similar disease manifestations. Co-infecting agents can be transmitted together with Borrelia burgdorferi by tick bite resulting in multiple infections but a fraction of co-infections occur independently of tick bite.

Clinically relevant co-infections are caused by Babesia, Bartonella species, Yersinia enterocolitica, Chlamydophila pneumoniae, Chlamydia trachomatis and Mycoplasma pneumoniae. Infections caused by these pathogens in patients not infected by Borrelia burgdorferi can result in clinical symptoms similar to those occurring in Lyme disease. This applies particularly to infections caused by Bartonella henselae, Yersinia enterocolitica, and Mycoplasma pneumoniae.

Chlamydia trachomatis primarily causes polyarthritis. Chlamydophila pneumoniae not only causes arthritis but also affects the nervous system and the heart, which renders the differential diagnosis difficult. The diagnosis is even more complex when co-infections occur in association with Lyme disease. (from Berghoff W. Open Neurol J. 2012;6:158-78.)

Tick Borne Disease-related testing

Summarizing TBI-related testing is a huge enterprise. Many articles, books, websites, blogs, etc are available today and multiple conferences are held each year. The goal of the present contribution was to put some of this information together as a convenient resource for patients in order to promote an understanding of the usefulness but also the limitations of available tests and the underlying reasons of failure.

The final aim was also to further emphasize the need for a global, integrative approach for a better management of TBIs.

Initial Integrative Chronic Lyme Panel

In order to offer better management of patients with chronic and/or persistent infections that are very difficult to uncover, it is important to focus both on direct pathogen detection as well as on indirect supportive tests, including tests for gastrointestinal issues. Following many discussions with specialists in chronic infections management, we at R.E.D. Labs are launching the Initial Integrative Chronic Lyme panel.

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