A tick bite can deliver Borrelia plus a plethora of other pathogens (hyperlink to definition) referred to as co-infections. This further complicates the clinical picture as they often have similar symptomatology and it is hard to differentiate between them. See Co-Infections table.
Globally common co-infections include Babesia, Bartonella, Ricketsia, Ehrlichia/Anaplasma, Q-fever, tick borne encephalitis virus, West Nile virus, Francisella tularensis and others. Babesia is the most commonly found co-infection in USA and the incidence with Borrelia varies with the endemic area and the reservoir animals. (Diuk-Wasser et al 2014; Pujalte & Chua 2013). B.microti, B.duncani, B.divergens, B.venatorum are infectious to humans to date. See Co-Infections table and Ticks in Australia table. Tick borne encephalitis virus has become a growing health concern in Europe and Asia and a vaccine has been developed.
The opportunistic infections that predominate depend on the patient’s previous pathogen exposure and load. For example Chlamydophyla pneumoniae is believed to be very common. due to air borne transmission. Some go on to develop persistent chronic - pneumonia symptoms which can be controlled after two weeks of treatment but it is not eradicated, and can disseminate within the host (Puolakkainen, 2013).
The main symptoms are pharyngitis, bronchitis, atypical pneumonia, cough, fever, difficulty breathing, whitening of the back of the tongue and nasal congestion (Wang B et al 2013). When C. pneumoniae symptoms surface in the presence of Borrelia and co-infections, it is very hard to differentiate between specific symptoms of each pathogen due to overlap. Fortunately the antibiotics that kill Borrelia are also effective against C. pneumoniae.
For an excellent site about information and help with Chlamydophyla infections and complications visit http://www.cpnhelp.org
Some co-infections and opportunistic infections are known, but there are probably many that have not been characterised.
Prevention of infections is better than trying to find a cure. See how to prevent tick bites.
Growing evidence of an emerging tick-borne disease that causes a Lyme like illness for many Australian patients
On 12 November 2015, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report:
The growing evidence of an emerging tick-borne disease that causes a Lyme‑like illness for many Australian patients.