Clinical, Laboratory, Imaging and Electrocardiographic Differences between Patients with Lyme Disease and Patients with Lyme Disease and B. divergens Antibodies

Abstract

Clinical and diagnostic tests differences between adult patients monoinfected with Borrelia burgdorferi sensu lato (s.l.) and patients infected with B. burgdorferi s.l. who also had IgG antigens against Babesia divergens have not been reported so far. Both Lyme disease caused by B. burgdorferi and babesiosis caused by B. divergens, endemic in Northwestern Spain, are transmitted by Ixodes tick bites.
 
 Clinical, laboratory and other diagnostic tests characteristics (imaging, electrocardiographic-ECG) of 120 residents of Northwestern Spain with B. burgdorferi s.l. infection, diagnosed during 2015-2017, of whom 47 (39.2%) had B. divergens IgG antibodies, were retrospectively compared.
 
 Cardiorespiratory symptoms were reported in 9/47 (19.2%) patients with Lyme disease and B. divergens IgG antibodies compared to 4/73 (5.5%) patients with B. burgdorferi s.l. monoinfection (P=0.02). Dyspnea was recorded in 4/47 (8.5%) patients with Lyme disease and B. divergens IgG antibodies compared to 1/73 (1.4%) monoinfected patients (P=0.07). In addition ECG atrioventricular (AV) block was detected in 5/47 (15.6%) patients with Lyme disease and B. divergens IgG antibodies compared to 1/73 (2.6%) monoinfected individuals (P=0.09). No other clinical, laboratory or other tests differences were observed between doubly infected and monoinfected patients.
 
 We conclude that patients with Lyme disease and B. divergens IgG antibodies had more frequently cardiorespiratory symptoms, mostly dyspnea, compared to monoinfected individuals. These symptoms were unrelated to anemia. ECG AV block perhaps induced by summative myocardial damage due to both infections might play some role in the cardiorespiratory dysfunction.