The patient: “Tony” a 63 year-old landscape architect in Northwest Connecticut.
Why he came to see me: This robust outdoorsman, contacted me to help evaluate his very unusual situation. Since moving to a very woodsy part of the state and being out in the forests and brush, both for his work and his love of camping and hunting, he had been bitten quite frequently by ticks but he never felt any symptoms of Lyme Disease. Tony was concerned that an infection could be silently brewing inside him.
How I evaluated him: In our preliminary phone call, I told Tony to come in to the Clinic the next time that he found a tick on himself. When he came in, I carefully removed the tick intact. Oddly, although it had definitely burrowed into his skin deeply enough to start extracting blood, there was no evidence of the swelling that characterizes successful “feeding.” The tick appeared to be dead as well, which also was odd. I told him that we would send the critter into the State lab for analysis to see if it indeed was carrying the organism that causes Lyme Disease, Borrelia burgdorferi. We also discussed the testing available for evaluating possible infection and associated diseases that often go along as “co-infections” and sent a blood sample to a specialty laboratory known for extremely thorough evaluation beyond conventionally available screening, asking for evaluation relating to his contracting another tick-borne illness, Rocky Mountain Spotted Fever, as a youngster.
The test results came back from the State lab within a week and the specialty lab two weeks later. The State confirmed that the tick we removed from Tony arrived dead and indeed was carrying the Lyme organism. The specialty lab found no evidence of either current or past Lyme infection and did confirm the past exposure to the other tick-borne illness that he had so many years ago. I spoke to the Lab Director about Tony’s situation and we decided that it was possible, in theory, for a certain “memory cell” that had been developed by his immune system to activate against the Lyme organism, providing actual immunity to the disease and killing the infected tick, but that this was the first time that he had seen any evidence of this.
The patient’s progress: I shared my conversation with Tony and have mentioned his case with other physicians and continue to marvel at the power of the human immune system. Often we see that infections in the past to certain diseases may confer immunity to similar disease that are present in our current environment. This may mean that many of us may not need certain immunizations to remain healthy, as Tony has certainly proved.