ASD symptoms improve following antimicrobial treatment for tick-borne infections

This article describes the case of a 14-year-old boy with autism spectrum disorder, who experienced significant improvement in cognitive (such as learning disabilities, focus, concentration) and neurobehavioral (such as oppositional, defiant, anti-social, disordered mood, immaturity, tics) symptoms following antimicrobial treatment for tick-borne infections, specifically Borrelia and Bartonella pathogens. ¹

Currently, borreliosis and bartonellosis are infections that are rarely considered in the evaluation and treatment of patients with neuropsychiatric presentations, the authors state. However, as this case demonstrates, chronic infections may play a role in the onset or persistence of neurologic and/or psychiatric symptoms.

The patient had been diagnosed with cerebellar hypoplasia (in utero), ADHD at age 5, and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) at age 10. He was diagnosed with autism and autoimmune encephalitis at age 14 and subsequently treated with intravenous immunoglobulin (IVIG), which temporarily improved most of his symptoms.

Serological test results were positive for bartonellosis and borreliosis, along with “the borderline presence of anti-neuronal antibodies, which can occur in association with vector borne and other non-vector borne infections,” the authors state.

“Therefore, a decision was made to treat with antimicrobial agents targeting a potential infectious etiology, with secondary auto-antibody formation.”

Treatment included single or combination antimicrobial agents, such as disulfiram, rifampin, minocycline, rifabutin, clarithromycin, and methylene blue, along with probiotics, antioxidants, and anti-inflammatories.

Antimicrobial treatment led to drastic improvement in the patient’s neuropsychiatric symptoms and in his academic standing. He no longer needed special education services and was eventually accepted into a college program.

“In addition, there was a sudden and noted improvement in his social skills, progress that had not been noted by school officials since kindergarten,” the authors state.