There is evidence that chronic infections and the immune reactions associated with them may contribute to causing autism spectrum disorders.  These infections include Babesia, Bartonella, Borrelia burgdorferi, Ehrlichia, HHV-6, Chlamydia pneumoniae and Mycoplasma (in particular Mycoplasma fermentans).  Maternal immune reactions to infections appear to adversely affect fetal brain development and possible pathophysiological mechanisms include both inflammatory cytokines, such as IL-6, and maternal autoantibodies to fetal neural tissue of the same kilodalton mass as those seen with B. burgdorferi and some other chronic infections.  The timing of the infection and immune response is critical in determining the pathophysiology.  It is advisable to evaluate women who are pregnant or planning on becoming pregnant for chronic infections, especially if they demonstrate symptoms of an infection or a systemic illness with persistent inflammatory symptoms.  The mother and the newborn should be treated when indicated.

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