Babesia and Bartonella Species DNA in Blood and Enrichment Blood Cultures from People with Chronic Fatigue and Concurrent Neurological Symptoms

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a medical condition characterized by extreme fatigue lasting at least 6 months. Based upon case reports, patients infected with <i>Babesia</i> or <i>Bartonella</i> spp. have reported a history of chronic fatigue and concurrent neurological symptoms. In this study, 50 study participants reporting fatigue lasting from six months to 19 years and one or more neurological symptoms were selected. PCR assays were used to amplify <i>Babesia</i> and <i>Bartonella</i> spp. DNA from blood and enrichment blood cultures. Using targeted qPCR amplification and DNA sequencing, infection with <i>Babesia</i> spp., <i>Bartonella</i> spp. or both genera was confirmed in 10, 11, and 2 individuals, respectively. Of 50 participants, 12 (24%, 95% CI: 12-36%) were infected with a <i>Babesia</i> species, while <i>Bartonella</i> species infection was documented in 13/50 individuals (26%, 95% CI: 13.8-38.2%). This study provides documentation supporting a potential role for <i>Babesia</i> and <i>Bartonella</i> infection in patients with presentations consistent with ME/CFS. Prospective case-control studies, using highly sensitive direct pathogen detection techniques, are needed to determine whether or the extent to which infection with members of these two genera contributes to or causes ME/CFS.