Babesia Herxheimer reactions?

I haven't seen anything written about this phenomenon. When I learned about the Jarish Herxheimer reaction the literature indicated that it was limited to an exclusive club of microbes. It was associated with syphilis, leptospirosis, relapsing fever, rate bite fever, Lyme disease, anthrax and very few other infections. The reaction was related to two things: 1) the infection was disseminated and 2) the germ antigens, released when the germ was killed, caused an exaggerated immunological response associated with an unusually exuberant cytokine response.

Now the term Herxheimer reaction seems to be associated with a whole host of other infections. My clinical experience confirms that when patients are placed on anti-Babesia therapy they experience massive Herxheimer reactions. The sweating increases. Pain and fatigue increase. Even cognitive dysfunction- brain fog and memory loss increases substantially. These reactions can be much more intense than those associated with initial anti-Borrelia (Lyme) therapies.

Let's take a look. We are told that Babesia is associated with specific symptoms. These include: recurrent chills and sweats- the sweats are frequently drenching, neck pain and air hunger. We are told that it is a clinical diagnosis and that lab tests are inaccurate and cannot be relied upon. Babesia is a malaria like parasite, and resides in red blood cells. Malaria is associated with a parasitic infection of the red blood cells associated with hemolysis, rupture of the red blood cells. The afflicted individuals experience sever chills, sweats and fevers and are frequently very ill. It is diagnosed when the parasites are observed in the red cells under the microscope. The blood smears for Babesia are generally negative. We are told it is because the parasites infest a very small percent of red blood cells.

PCR tests, antibody tests and a wide variety of special diagnostic assays searching out confirmation of Babesia are usually negative. There is no evidence of ruptured red blood cells. Occasionally antibodies for a Babesia strain may be present. This indicates exposure to the organism- not active infection. If IgM antibodies are present active infection is more likely. For the most part there is no confirmation whatsoever. The standard wisdom (mainstream medicine) is that Babesia is generally a self limited infection which is cleared by the immune system.

Let me play Devil's advocate. Lyme can cause sweats, flu symptoms, breathing problems and pains of all sorts. The same symptoms frequently clear when only Lyme therapy is given. Is Babesia really present at all? Or is a case of the emperor without any clothes. If we have invisible "Bartonella like organisms," perhaps we should have "Babesia like organisms." or Babesia syndrome associated with Lyme disease. Perhaps the anti-Babesia therapy is really killing a form of Lyme via some unsuspected mechanism. If the Babesia organisms are rare and hard to find then why does killing them cause a Herx reaction? Is there any precedent for the treatment of parasitic (piroplastic) infection associated with a described Herxheimer response?
I believe it is important to question all the assumptions of what has now become the new orthodoxy of Lyme literate dogma.

Let's put this argument aside. When I treat patients for Babesia they do have dramatic Herx reactions. The reactions can be disabling and cause serious setbacks.
Patients may Herx with a single dose of Artemesia or Malarone. Frequently Mepron cannot be tolerated due to excessive Herxing. The dose of anti-Babesia therapy must be gradually ramped up based on individual tolerances. One can start with Artemesia/Artemesin or Malarone/Mepron. When the second agent is added it must be done gradually. The clinical response is that the sweating and associated symptoms increase for a period of time and then gradually wane and disappear. It works.

For now I do believe in chronic, persistent Babesiosis, despite the lack of supporting evidence, as part of the Lyme disease complex; but my mind is open to other possibilities.