There are changes in the clinical presentation of the co-infected patient as compared to when each infection is present individually. There may be different symptoms and atypical signs. There may be decreased reliability of standard diagnostic tests, and most importantly, there is recognition that chronic, persistent forms of each of these infections do indeed exist. As time goes by, I am convinced that even more pathogens will be found. Therefore, real, clinical Lyme as we have come to know it, especially the later and more severe presentations, probably represents a mixed infection with many complicating factors. I will.
