Archive for the ‘Bartonella’ Category

Parinaud’s Oculoglandular Syndrome & Bartonella

https://www.ncbi.nlm.nih.gov/m/pubmed/29982178/

Atypical presentation of cat scratch disease: Parinaud’s oculoglandular syndrome with facial nerve paresis.

Valor C, et al. BMJ Case Rep. 2018.

Abstract

A 28-year-old man presented to our clinic over the course of 3 weeks with symptoms that progressed from mild headaches to fever, fatigue, myalgia and an enlarged right preauricular lymph node with ipsilateral (same side) conjunctivitis and upper eyelid weakness. Our differential included Epstein Barr Virus/Cytomegalovirus mononucleosis, bacterial conjunctivitis and lymphoma. We evaluated with CBC, EBV IgM Ab, lactate dehydrogenase level and a CMV IgG Ab which were all within normal limits. During his third visit, we discovered our patient had been scratched by two stray kittens he had adopted 2 months prior. We confirmed the diagnosis with a positive Bartonella henselae IgG level and diagnosed him with cat scratch disease presenting as Parinaud’s oculoglandular syndrome. He was treated with a 5-day course of Azithromycin 250 mg with definitive improvement.

________________

**Comment**

The pre auricular lymph node is #5 in the diagram.  So this is a swollen nodule in front of the ear with conjunctivitis (pink-eye) on the same side as the nodule with upper eye-lid weakness.    

 

Illu_lymph_chain01

Public Domain, https://commons.wikimedia.org/w/index.php?curid=1471974

I would also like to point out it’s on record that people can have Bart without cat-scratch:  https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/  In conclusion, even though there may be a lack of systemic signs and symptoms of CSD in a patient with neuroretinitis, B henselae infection should be considered. 

While authorities argue about whether ticks transmit Bart or not, please see:  https://www.sciencedirect.com/topics/medicine-and-dentistry/parinauds-oculoglandular-syndrome  Finally, tick-borne B. henselae infection has been described, including scalp eschar and neck lymphadenopathy after tick bites in three patients during the colder months in France. B. henselae was detected using molecular tools both in skin biopsy (cervical and occipital) and in a Dermacentor marginatus tick removed from the scalp of one patient. All three patients had asthenia (weakness), but none had alopecia.

That same Science Direct link above also states that a common ocular manifestation is Parinaud’s oculoglandular syndrome……

I predict we are going to see a lot more on Bartonella in the future and it’s going to blow this whole “atypical” and “rare” thing out of the water.

For more on Bart:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2018/06/12/osteomyelitis-in-cat-scratch-disease-a-never-ending-dilemma-a-case-report-literature-review/

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

https://madisonarealymesupportgroup.com/2016/08/09/a-bartonella-story/

https://madisonarealymesupportgroup.com/2017/09/13/dr-fox-cat-scratch-fever-warning/

 

 

Category:

Bartonella, research, Treatment

This Family Learned Tick Bites Can Transmit More Than Lyme Disease

https://www.healthline.com/health-news/family-learned-tick-bites-transmit-more-than-lyme-disease#7

This Family Learned Tick Bites Can Transmit More Than Lyme Disease

Written by Cathy Cassata on June 12, 2018

Screenshot_2018-07-16 Tick Bites More Than Lyme Disease
How one mother’s persistence and perseverance helped doctors properly treat her son’s complicated Lyme disease diagnosis.

Last summer, 11-year-old Gus was beyond excited to attend his first Boy Scout campout without his parents.

“Me and my husband believed he’d be fine on the trip because he’s super independent, but I remember telling my husband I was worried about ticks because how often does an 11-year-old reapply spray?” Gus’s mom, Lesley, explained.

Nevertheless, she and her husband let their son venture off from Illinois to upper Wisconsin for a week away over the Fourth of July holiday.

When Gus returned, Lesley said they did a “tick check from head to toe” but found nothing and figured he was “in the clear.”

However, near the end of July, Gus came down with a high fever and a migraine that wouldn’t go away. After checking in with his pediatrician, Lesley chalked it up to a virus. But when his headache persisted after a week and a half, they went back to the doctor, who suggested giving it another day before sending Gus for an MRI to rule out a tumor.

To Lesley’s relief, her son’s headache was gone the next day. Since the family was heading to Michigan for vacation, Gus’s pediatrician suggested he get the MRI when they return. Yet, as soon as the family arrived in Michigan, things took a turn for the worse.

“I looked across the table at Gus and I noticed he tried to take a drink and he couldn’t get his mouth to work. It was hanging low. He said one side of his face felt weird,” Lesley said.

She rushed him to the nearest emergency room. By the time they arrived, Gus couldn’t blink or close his left eye. His condition was diagnosed as Bell’s palsy.

Over the course of the week, he continued to deteriorate.

“By the time we got home from Michigan, he almost couldn’t walk. His hips, knees, ankles, and lower back were in so much pain that he said it felt like someone had a vice on all his joints,” Lesley said.

On their first night back home, Gus couldn’t sleep and woke his mom, so she took him downstairs to watch TV.

That’s when Lesley noticed her son’s legs, chest, and back were covered with a bull’s-eye rash — a common symptom of Lyme disease that can occur from 3 to 30 days after an infected tick bite and usually doesn’t itch or cause pain.

In the morning, Lesley took Gus back to his doctor. By the time they arrived, the rash was gone. Thankfully, Lesley thought to take pictures of the rash the night before and the images prompted Gus’s pediatrician to test him for Lyme disease right away.

Complex journey to diagnosis and treatment

Gus’s pediatrician gave him two tests: the enzyme-linked immunosorbent assay (ELISA) test, which is commonly used to detect Lyme disease, and the Western blot test, which is often given to confirm Lyme if the ELISA test is positive.

A few days later, Gus received a diagnosis of Lyme disease. Lesley said the family was happy to finally have identified the problem, and she believed her son would soon be on the road to recovery.

Gus’s pediatrician collaborated with a children’s hospital in Chicago to determine he needed 30 days of doxycycline, an antibiotic commonly prescribed to treat Lyme.

“He started feeling better immediately but did have some lingering pain in his hip and he wasn’t totally himself. He tossed and turned all night long and his energy was pretty low,” Lesley said. “I told myself these were all happening because he was growing. I just wanted to [believe] we beat the Lyme.”

However, when Gus’s symptoms persisted after he finished the antibiotics, Lesley started to advocate and research for her son. A friend who had been given a Lyme diagnosis referred her to a Lyme Literate doctor (LLMD) who specializes in the disease.

“From that point on, I got hungry for knowledge. I trusted our doctors but wanted to make sure we were doing the best we could for Gus,” said Lesley.

She learned that the Lyme bacteria replicates in the body every 14 days, which is why many doctors prescribe 30 days of antibiotics. However, she also learned that for some people that’s not enough.

Dr. Daniel Cameron, an expert in Lyme disease, says that many people with Lyme only need 30 days of antibiotics, but 1 out of 3 people treated early for the disease will still have complications.

“I’m most concerned about that one out of three who remains ill,” Cameron told Healthline. “For some, it can last up to 10 years and when you’re at school, it can mess up your ability to concentrate in the classroom or participate in sports or have a life with friends.”

Those were the fears Lesley had for Gus. Since he became ill over summer break, he didn’t miss school, but as an active child, he missed out on sports and hanging out with his friends.

“Sports are his life, but he lost 12 pounds and we had to cancel sports camps last summer. He [started wondering if] he’d ever [get to] play again,” Lesley said. “I’d constantly remind him that’d I’d do everything I could to keep it from stopping him.”

Approximately one month after Gus finished his 30-day supply of antibiotics, he was still struggling with symptoms and Lesley took him to see the LLMD. Because ticks that carry Lyme can also carry other infectious organisms through the same bite, the doctor tested Gus for coinfections. Turns out, Gus was positive for two types of Bartonella bacteria.

“I had never heard of coinfections and learned so much from this doctor,” Lesley said. “She confirmed that 30 days of antibiotics wasn’t enough for Gus. She was optimistic that we caught it early, but she made it clear that everyone’s body fights it differently.”

It’s because of this difference that Cameron says screening for coinfections is so important. “Many patients aren’t aware that coinfections exist. Many doctors are and will order tests for them, but often the tests aren’t reliable. That’s why carefully monitoring patients over time is important.”

Gus’s doctor began a regimen of three antibiotics, as well as probiotics, herbs, and supplements last November.

Advocating to calm controversy

Today, Gus is still taking antibiotics but Lesley said his health has greatly improved and he should be done soon.

“He just competed in track on the state level which is amazing. As I watched him run, I looked like a racoon because I was blubbering,” she said. “He’s overcome a lot since July. As a parent, those first few months were the darkest days. We didn’t know what he had and then we didn’t know if he’d be alright.”

Screenshot_2018-07-16 Tick Bites More Than Lyme Disease(1)
Over the past year, Lesley says she’s grown a lot as well and hopes sharing her family’s struggle will help others who find themselves in the same situation.

“Not much is known about this disease, so as a parent you have to keep asking questions and finding information and advocating for your child,” she said, noting the frustrations they encountered while trying to treat Gus.

Part of the frustrations Lesley felt were due to a divide within the medical community.

“Some doctors don’t believe that children have chronic issues from Lyme, no matter what the published literature says,” Cameron explained. “Some physicians disagree on what to call [complications]. I use the term chronic Lyme disease, whether there’s a coinfection or not. Some people use other terms.”

Cameron also points out that while early leaders in Lyme disease were thorough in their understanding and managing early Lyme, they lacked knowledge of the chronic complications that can accompany the disease.

“Today, the published literature is very descriptive on all the problems that happen. It’s just that doctors are divided and it’s not clear why there’s disagreement on something that’s so common,” he said.

He added that the understanding of what infections ticks carry is another barrier.

“There are so many strains of Lyme and other infections in a tick. Some infections like Babesia can’t be treated with doxycycline and need to be treated with a parasite medicine. So much of the complexity and difficulty is knowing what’s in the tick without even looking at the child that was bit,” he explained.

Another complication of Lyme disease treatment is the worry many in the medical community have surrounding antibiotic overuse. Doctors can lose their license for overprescribing antibiotics and it’s a fear that can contribute to less-effective treatment for patients.

“We understand that we’re trying to cut back on antibiotic use, but if you have a child that’s sick, and with so many complexities of infection in a tick and plenty of published literature that supports how complicated this disease is, you’d like to have the freedom as a doctor to treat your patients and not be limited,” Cameron said. “If doctors who treat Lyme had more freedom, we wouldn’t have so much frustration in the medical community.”

Lesley is doing her part to help change this.

“I know this is a big issue and that I’m just one mom. But my kid’s in a good place, and I felt a calling to spread the word about this disease. I’m ready to say I knew nothing about Lyme. It’s not something I wanted to know about but if sharing Gus’s story can help even one other person, it’s worth it,” she said.

Most of all, she hopes other parents learn that they can seek out doctors who specialize in Lyme disease.

“It can be an isolating disease if your child isn’t getting the treatment they need and if your doctors don’t know enough about it,” Lesley said.

While Cameron says that a pediatrician can effectively treat many children with Lyme, he points out that for the one out of three kids who are still ill after initial treatment, it’s a good idea to see a doctor who is familiar with complications of the disease.

Additional defense

What else can parents do to protect their children?

The Centers for Disease Control and Prevention has a list of preventive measures to avoid a tick bite but nothing is foolproof.

Cameron says the most important thing is to perform a tick check after your child is outdoors, and to remove a tick as soon as you see one.

“Kids still get bit and get the infection even with these recommendations,” Cameron said.

He notes Lesley did the smartest thing she could for Gus: become familiar with Lyme disease.

He encourages other parents whose children get a Lyme disease diagnosis to do the same.

“Learn everything you can] so if your child doesn’t do well, you know about other complications and symptoms of Lyme to look out for so you can be the advocate for your child.”

**Comment**
Fantastic article.  So thankful for those doctors who are concerned about the one in three that remain ill. 
Please note the treatment Gus received was 3 different antibiotics, supplements, probiotics, and herbs.  This is quite common – but most general pracitioners are clueless and continue to give the extremely limited monotherapy of doxycycline, which is often sufficient for an acute case but will not cure a person with coinfections or even often Lyme (borrelia) that has gotten into the central nervous system, which can happen quickly.
If you suspect Lyme/MSIDS and have only been treated with doxy, but have remaining symptoms, learn from Gus’s case and get to a Lyme literate doctor (LLMD).  The best place to start is with your state’s local Lyme support group as they are the most familiar with locally trained doctors and can save you a lot of time, money, and heartache.

 

Category:

Activism, Bartonella, Lyme, Testing, Ticks, Treatment

We Have No Idea How Bad the US Tick Problem Is

https://www.wired.com/story/we-have-no-idea-how-bad-the-us-tick-problem-is/
AUTHOR: MEGAN MOLTENIMEGAN MOLTENI
SCIENCE
7.04.18

WE HAVE NO IDEA HOW BAD THE US TICK PROBLEM IS

WHEN RICK OSTFELD gets bitten by a tick, he knows right away. After decades studying tick-borne diseases as an ecologist at the Cary Institute of Ecosystem Studies in Millbrook, New York, Ostfeld has been bitten more than 100 times, and his body now reacts to tick saliva with an intense burning sensation. He’s an exception. Most people don’t even notice that they’ve been bitten until after the pest has had time to suck up a blood meal and transfer any infections it has circulating in its spit.

Around the world, diseases spread by ticks are on the rise. Reported cases of Lyme, the most common US tick-borne illness, have quadrupled since the 1990s. Other life-threatening infections like anaplasmosis, babesiosis, and Rocky Mountain spotted fever are increasing in incidence even more quickly than Lyme. Meat allergies caused by tick bites have skyrocketed from a few dozen a decade ago to more than 5,000 in the US alone, according to experts. And new tick-borne pathogens are emerging at a troubling clip; since 2004, seven new viruses and bugs transmitted through tick bite have shown up in humans in the US.

Scientists don’t know exactly which combination of factors—shifting climate patterns, human sprawl, deforestation—is leading to more ticks in more places. But there’s no denying the recent population explosion, especially of the species that carries Lyme disease: the black-legged tick.

“Whole new communities are being engulfed by this tick every year,” says Ostfeld. “And that means more people getting sick.”

Tick science, surveillance, and management efforts have so far not kept pace. But the country’s increasingly dire tick-borne disease burden has begun to galvanize a groundswell of research interest and funding.

In 1942, Congress established the CDC specifically to prevent malaria, a public health crisis spreading through mosquitoes. Which is why many US states and counties today still have active surveillance programs for skeeters. The Centers for Disease Control and Prevention uses data from these government entities to regularly update distribution maps, track emerging threats (like Zika), and coordinate control efforts. No such system exists for ticks.

Public health departments are required to report back to the CDC on Lyme and six other tick-borne infections. Those cases combined with county-level surveys and some published academic studies make up the bulk of what the agency knows about national tick distribution. But this data, patchy and stuck in time, doesn’t do a lot to help public health officials on the ground.

“We’ve got national maps, but we don’t have detailed local information about where the worst areas for ticks are located,” says Ben Beard, chief of the CDC’s bacterial diseases branch in the division of vector-borne diseases. “The reason for that is there has never been public funding to support systematic tick surveillance efforts.”

That’s something Beard is trying to change. He says the CDC is currently in the process of organizing a nationwide surveillance program, which could launch within the year. It will pull data collected by state health departments and the CDC’s five regional centers about tick prevalence and the pathogens they’re carrying to build a better picture of where outbreaks and hot spots are developing, especially on the expanding edge of tick populations.

The CDC is also a few years into a massive nationwide study it’s conducting with the Mayo Clinic, which will eventually enroll 30,000 people who’ve been bitten by ticks. Each one will be tested for known tick diseases, and next-generation sequencing conducted at CDC will screen for any other pathogens that might be present. Together with patient data, it should provide a more detailed picture of exactly what’s out there.

Together, these efforts are helping to change the way people and government agencies think about ticks as a public health threat.

“Responsibility for tick control has always fallen to individuals and homeowners,” says Beard. “It’s not been seen as an official civic duty, but we think it’s time whole communities got engaged. And getting better tick surveillance data will help us define risk for these communities in areas where people aren’t used to looking for tick-borne diseases.”

The trouble is that scientists also know very little about which interventions actually reduce those risks.

“There’s no shortage of products to control ticks,” says Ostfeld. “But it’s never been demonstrated that they do a good enough job, deployed in the right places, to prevent any cases of tick-borne disease.”

In a double-blind trial published in 2016, CDC researchers treated some yards with insecticides and others with a placebo. The treated yards knocked back tick numbers by 63 percent, but families living in the treated homes were still just as likely to be diagnosed with Lyme.

Ostfeld and his wife and research partner Felicia Keesing are in the middle of a four-year study to evaluate the efficacy of two tick-control methods in their home territory of Dutchess County, an area with one of the country’s highest rates of Lyme disease. It’s a private-public partnership between their academic institutions, the CDC, and the Steven and Alexandra Cohen Foundation, which provided a $5 million grant.

Ostfeld and Keesing are blanketing entire neighborhoods in either a natural fungus-based spray or tick boxes, or both. The tick boxes attract small mammal hosts, which get a splash of tick-killing chemicals when they venture inside. They check with all the human participants every two weeks for 10 months of the year to see if anyone’s gotten sick. By the end of 2020 the study should be able to tell them how well these methods, used together or separately on a neighborhood-wide scale, can reduce the risk of Lyme.

“If we get a definitive answer that these work the next task would be to figure out how to make such a program more broadly available. Who’s going to pay for it, who’s going to coordinate it?” says Ostfeld. “If it doesn’t work then perhaps the conclusion is maybe environmental control just can’t be done.”

In that case, people would be stuck with pretty much the same options they have today: protective clothing, repellants, and daily partner tick-checks. It’s better than nothing. But with more and more people getting sick, the US will need better solutions soon.

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**Comment**

Great article pointing out the scary fact that only 6 pathogens transmitted by ticks are being reported on.  There are currently 18 pathogens and counting…..so the numbers are woefully inadequate.

Here’s the list so far:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

Babesiosis
Bartonellosis
Borrelia miyamotoi
Bourbon Virus
Colorado Tick Fever
Crimean-Congo hemorrhagic Fever
Ehrlichiosis/Anaplasmosis
Heartland Virus
Meat Allergy/Alpha Gal
Pacific Coast Tick Fever: Richettsia philipii
Powassan Encephalitis
Q Fever
Rickettsia parkeri Richettsiosis
Rocky Mountain Spotted Fever
STARI: Southern Tick-Associated Rash Illness
Tickborne meningoencephalitis
Tick Paralysis
Tularemia

And the number keeps growing…..but nobody’s keeping score.

Category:

Activism, Alpha Gal Meat Allergy, Anaplasmosis, Babesia, Bartonella, Borrelia Miyamotoi (Relapsing Fever Group), Ehrlichiosis, Lyme, mosquitoes, research, Rickettsia, Rocky Mountain Spotted Fever, Testing, Ticks, Transmission, Viruses

Bartonella henselae Neuroretinitis in Patients Without Cat Scratch

https://www.ncbi.nlm.nih.gov/m/pubmed/29962482/

Bartonella henselae neuroretinitis in patients without cat scratch.

Celiker H, et al. Jpn J Infect Dis. 2018.

Abstract
Cat-scratch disease (CSD) is a syndrome which is characterized by lymphadenopathy, fever, and skin lesions in association with a cat scratch or bite. Bartonella henselae is the primary bacterial agent responsible for CSD. Here we report serologically proven atypical presentation cases of B henselae neuroretinitis. In this study, three neuroretinitis patients were evaluated. Animal contact histories, ocular examinations, systemic work-up, clinical findings, and treatment compliance of the patients were assessed. All the patients denied a history of a cat or any animal contact, or of having CSD findings. Serologic testing with indirect immunofluorescence assay (IFA) was used for diagnosis of Bartonella neuroretinitis. IFA test results were positive for all patients. Two of the patients were treated with antibiotics. Optic disc edema and macular exudates resolved gradually, and at their last follow-up visits, all the signs had disappeared. There was no disease recurrence after finishing treatment. Serious complications were seen in the untreated patient. In conclusion, even though there may be a lack of systemic signs and symptoms of CSD in a patient with neuroretinitis, B henselae infection should be considered.

______________

**Comment**

This article points out an extremely important point – Bartonella is spreading without a history of cat or animal contact, which begs the question:

HOW DID THEY GET IT?

I just posted this today and commented that many Lyme/MSIDS patients have Bartonella yet authorities are denying tick involvement:  https://madisonarealymesupportgroup.com/2018/07/10/infective-endocarditis-associated-with-bartonella-henselae-a-case-series/

https://madisonarealymesupportgroup.com/?s=Bartonella+Treatment  Here we see far more than ticks carry Bart:

Arthropod vectors including fleas and flea feces, biting flies such as sand flies and horn flies, the human body louse, mosquitoes, and ticks; through bites and scratches of reservoir hosts; and potentially from needles and syringes in the drug addicted. Needle stick transmission to veterinarians has been reported. There is documentation that cats have received it through blood transfusion. 3.2% of blood donors in Brazil were found to carry Bartonella in their blood. Bartonella DNA has been found in dust mites. Those with arthropod exposure have an increased risk, as well as those working and living with pets that have arthropod exposure. 28% of veterinarians tested positively for Bartonella compared with 0% of controls. About half of all cats may be infected with Bartonella – as high as 80% in feral cats and near 40% of domestic cats. In various studies dogs have close to a 50% rate as well. Evidence now suggests it may be transmitted congenitally from mother to child – potentially leading to birth defects.

Is this getting any media coverage?  Nope.  Yet we STILL hear about Zika…..despite the fact mosquitoes here in Wisconsin can’t even carry it!  And according to 2017 CDC data, only SEVEN cases were reported through “presumed” local mosquito transmission in Florida and Texas:  https://www.cdc.gov/zika/reporting/2017-case-counts.html

So the question begs to be asked, why are my tax dollars going toward a disease that can’t even be acquired in the state of Wisconsin, yet no work is being done on Bartonella, yet nearly every Wisconsin patient I work with has it?  

Oh, and it can kill you…..

 

Category:

Bartonella, research, Testing, Treatment

Infective Endocarditis Associated with Bartonella henselae: A Case Series

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010976/

Infective endocarditis associated with Bartonella henselae: A case series

Akio Nakasu,⁎ Tohru Ishimine, Hiroshi Yasumoto, Toshiho Tengan, and Hidemistu Mototake

Abstract
Organisms in the genus Bartonella are cause of blood culture-negative endocarditis. Bartonella infective endocarditis is being increasingly reported worldwide; however, reports from Japan are limited. Here, we report five cases of infective endocarditis associated with Bartonella henselae. All patients had a history of contact with cats or fleas; this information helped achieve an appropriate diagnosis.

________________

**Comment**

The word on Bart is finally getting around.  It is not some benign pathogen to shrug off but can actually kill you.  

While this article discusses cats and fleas, too many people with Lyme/MSIDS are infected with Bart to deny either the direct transmission by a tick, the involvement of other vectors, or the ability for a tick bite to activate a latent infection, or all of the above.  

You will find some claiming tick transmission, while others deny it.  Research must be done to settle the issue once and for all as most doctors are not even considering Bartonella with Lyme/MSIDS patients and for many it’s a big player.

For more on Bartonella:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

More on tick borne illness and heart issues:  https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/  (Please know viruses, bacteria, and parasites can cause heart issues and many are transmitted by a tick or reactivate latent infections within the body)

Category:

Bartonella, Heart Issues, research