Osteomyelitis: Types, complications and imaging studies
During the discussion, Dr Gompf explains what the three basic types of osteomyelitis are, the different complications of the infection and what imaging studies are most useful in the diagnosis of osteomyelitis.
Patients with Lyme/MSIDS can develop osteomyelitis.
https://www.columbia-lyme.org/bartonellosis In immunocompetent people, the systemic symptoms of cat scratch disease (Bartonella) are usually limited to regional adenopathy, though it can also cause fever and, more rarely, eye disorders, hepatosplenic infection, osteomyelitis, and encephalopathy.
Here is a literature review of bone infections associated with Bart (Cat Scratch Disease): https://www.prohealth.com/library/bone-infections-associated-bartonella-cat-scratch-disease-82357. 51 cases identified. Fever (84.3%), often with a prolonged course (64.7%), and osteoarticular pain (88.2%) were the most common clinical findings. Lymphadenopathy was present in 64.7% of patients. Vertebral body was mainly involved (51.9%). MRI (50%) and bone scintigraphy (48.1%) were favored to confirm osteomyelitis, while serology was the preferred microbiological diagnostic. Various antibiotics were prescribed in combined or sequential regimens, with median duration of therapy of 23 days.
(While around 12% didn’t receive any treatment but still completely recovered, if other tick borne infections are involved, please remember that these pathogens work synergistically together to mess up the immune system. Most of us out here are infected with numerous pathogens. Bart is often just one of many.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC165354/ A 62-year-old woman presented with a 2-week history of cervical column tumefaction (swelling due to excess fluid). She complained of severe pain in the cervical column with radiation of the pain and paresthesia (burning or pins & needles sensation) in both arms. She had intermittent fevers and night sweats. Histological examination showed necrotizing granulomatous inflammation indicative of cat scratch disease (CSD). (She owned 20 cats)
https://www.ncbi.nlm.nih.gov/pubmed/19303175 (This was in 2009. Hopefully, now that Bartonella is beginning to be recognized, more cases will start showing up in the literature so they will refrain from using the word, “rare” when it comes to osteomyelitis and Bart).
We report an immunocompetent 61-year-old woman who presented with a systemic cat scratch disease including a multifocal osteomyelitis. Diagnosis was confirmed by PCR on the adenopathy. A literature review identified 51 other cases of osteomyelitis associated with cat scratch disease, 14 of those confirmed by PCR.
Here, Lyme caused it: https://www.researchgate.net/publication/15305104_Subacute_Multiple-Site_Osteomyelitis_Caused_by_Borrelia_burgdorferi Before the specific diagnosis was established, the patient received several potent antimicrobial drugs, without a favorable outcome. In contrast, therapy with ceftriaxone led to a rapid cure that persisted thereafter. We conclude that infection due to B. burgdorferi must be considered a possible cause of subacute pediatric osteomyelitis.
Here, Bb infects the bones of mice and induces bone loss: https://iai.asm.org/content/85/2/e00781-16
On page 21 & 26 of Gompf’s ID Pearls, she speaks about Daptomycin for MRSA osteomyelitis, a drug being used by Dr. Horowitz on his toughest Lyme/MSIDS patients with success. She also recommends getting the G6PD Level on any patient being considered for Dapsone as it’s a common mutation which can trigger hemolysis (when red blood cells rupture and release contents into surrounding fluid). Go to page 113 for Osteomyelitis.
She states that Rheumatoid arthritis caused by Staphylococcus aureus as an underlying condition associated with osteomyelitis as well as immunodeficiencies caused by Candida, atypical mycobcteria and Bartonella especially in HIV. Animal exposures such as cat, dog, human, rat, and hoofed animal bites are associated with osteomyelitis.
On page 337 she states that LD, Babesia, and Ehrlichiosis are diseases that can occur concurrently. I’m sure the reason she left out Bartonella is due to the fact the authorities still haven’t gotten the memo that many Lyme/MSIDS patients have Bartonella and it’s been found in ticks. The final nail in the coffin needs to be hammered down showing that it is clearly transmitted by ticks, then Bartonella will make her list. She also states that endocarditis & acute osteomyelitis occur concurrently which is ironic because Bart can cause both endocarditis and osteomyelitis….
More on rheumatoid arthritis: https://madisonarealymesupportgroup.com/2015/08/12/connecting-dots-mycoplasma/ Nicholson’s experience has found Mycoplasma to be the number one Lyme coinfection, and similar to other coinfections can be supposedly cleared for years only to reappear when conditions are right. 90% of evaluated ALS patients had Mycoplasma. 100% of ALS patients with Gulf War Syndrome had Mycoplasma and nearly all of those were specifically the weaponized M. fermentans incognitus.
*One of the hallmark symptoms of Mycoplasma is fatigue*