Clinical, analytical, imaging and ECG differences in adult patients infected by Borrelia burgdorferi and doubly-infected by Babesia divergens-Borrelia burgdorferi

Abstract Differences between double infection by Borrelia burgdorferi - Babesia divergens and Borrelia burgdorferi monoinfection in adult patients have not been reported so far. Both zoonosis, endemic in Northwestern Spain, are transmitted by Ixodes tick bites. Clinical, analytical and other tests (imaging, ECG) characteristics of 120 adult patients with B.burgdorferi infection, of which 47 (39.2%) had B.burgdorferi-B.divergens double infection, diagnosed between 2014–2017, were retrospectively compared. Cardiorespiratory symptoms were reported in 9/47 (19.2%) patients with B.burgdorferi-B.divergens double infection compared to 4/73 (5.5%) patients with B.burgdorferi monoinfection (P = 0.02). Dyspnea was recorded in 4/47 (8.5%) doubly infected compared to 1/73 (1.4%) monoinfected patients (P = 0.07). In addition ECG atrioventricular (AV) block was detected in 5/47 (15.6%) doubly infected 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 doubly infected 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.