Archive for the ‘Heart Issues’ Category

Did Charles Darwin Have Lyme Disease?

https://www.smithsonianmag.com/smart-news/did-charles-darwin-have-lyme-disease-180971189/

Did Charles Darwin Have Lyme Disease?

New study attributes British naturalist’s persistent poor health to tick-borne disease

By Meilan Solly

SMITHSONIAN.COM
JANUARY 8, 2019

Throughout his adult life, Charles Darwin was plagued by bouts of poor health, including “incessant vomiting,” trembling hands, a “swimming” head,” “singing in the ears” (likely linked with tinnitus), and “violent palpitation of the heart.” Historians have long puzzled over the exact nature of Darwin’s ailments, proposing diagnoses like Chagas disease, lactose intolerance and a mitochondrial disorder. But as George Dvorsky reports for Gizmodo, a new study identifies a previously unmentioned culprit: Lyme disease.

The findings, now published in Denisea, the official scientific journal of the Natural History Museum Rotterdam, posit that the naturalist contracted the tick-borne disease in the somewhat surprising locale of his home country, Great Britain. Although Darwin visited numerous tropical regions during his famed voyage on the H.M.S. Beagle and subsequent research expeditions, the researchers argue it’s more likely he encountered an infectious tick while roaming the expanses of England, Wales and Scotland. Despite the fact that Lyme disease wasn’t formally diagnosed until 1976, Dvorsky notes that instances of the tick-borne disease abound in late 19th- and early 20th-century European records.

Lead researcher Erwin Kompanje of Rotterdam’s Erasmus University medical centre tells the Guardian’s Ian Sample that “[Darwin] had a lot of different symptoms: involuntary twitching of muscles, swimming of the head, a shortness of breath, trembling hands.

He adds, “All of them came and went, and that is quite typical of Lyme disease.”

To analyze Darwin’s maladies, Kompanje and study co-author Jelle Reumer of the Natural History Museum Rotterdam sifted through the scientist’s copious body of correspondence and personal writings. These accounts, many of which are available through the University of Cambridge’s online Darwin portal, offer a portrait of a man beset by chronic illness. In a March 28, 1949, letter to a friend named Joseph Hooker, for example, Darwin explains,

“I was not able to do anything one day out of three, [and] was altogether too dispirited to write to you or to do anything but what I was compelled.”

According to the study, Darwin’s symptoms can be divided into three categories: dysautonomic (or related to the autonomic nervous system), neurological and psychiatric; gastrointestinal; and cutaneous (affecting the skin). The first group of ailments closely resembled what we would now call a panic disorder, with key complaints, including fatigue, dizziness and heart palpitations. Some studies have drawn on these symptoms to suggest Darwin suffered from agoraphobia, but the new study points out that his wife, Emma, once wrote “he always tells me how he … never wants to be alone”— a sentiment not likely shared by most true agoraphobics. Indeed, the authors note that recent research has linked the sudden onset of panic attacks with underlying Lyme disease. Upon receiving treatment for Lyme, some patients have reported these symptoms abated. Overall, the researchers attribute this group of symptoms to “atypical panic attacks.”

The second category of gastrointestinal symptoms—amongst others, flatulence, vomiting and nausea—has previously been attributed to Crohn’s disease or lactose intolerance. Adding to the mix, the study proposes yet another disorder: Cyclic Vomiting Syndrome, which is marked by periods of debilitating vomiting triggered by “stress, excitement and fatigue.”

Finally, in reference to Darwin’s recorded battles with rashes and eczema, the authors suggest that such skin inflammations emerged as a side effect of panic disorder, which they in turn identify as “a rare symptom of chronic borreliosis,” or Lyme disease.

As the Guardian’s Sample notes, the popular diagnosis of Chagas disease, an infection spread by insects native to the Americas, originates from Darwin’s mention of being bitten by a “great black bug of the Pampas” during an 1835 trip to Argentina. But Kompanje and Reumer say that the naturalist’s symptoms align more closely with Lyme disease, in part because certain recurring complaints appeared before the South American expedition.

The pair’s final assessment of a “complex condition with multisystem symptoms” pinpoints Lyme as Darwin’s major affliction, but as Dvorsky explains for Gizmodo, the researchers believe another illness, likely lactose intolerance, contributed to the scientist’s poor health. Combined with what the study terms Darwin’s “hypochondriac predisposition,” it’s unsurprising that his litany of illnesses continues to fascinate.

Still, not everyone is convinced: Richard Wall, a tick expert at the University of Bristol, tells the Guardian, “Borreliosis is a particularly difficult infection to diagnose symptomatically even when the patient is available … so retrospective diagnosis at a historical distance of 200 years, while interesting, must be considered as highly speculative.”

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For more:  

Panic Attacks:  https://madisonarealymesupportgroup.com/2018/05/19/panic-attacks-may-be-lyme-msids/  The author describes the histories of three patients with panic-like episodes that turned out to be related to underlying, previously unsuspected tick-borne diseases.

Tinnitus, tingling, numbness, twitching:  https://madisonarealymesupportgroup.com/2015/09/16/bizarre-symptoms-msids/

Hearing Loss:  https://madisonarealymesupportgroup.com/2018/05/19/panic-attacks-may-be-lyme-msids/

Shortness of breath/air hunger:  https://madisonarealymesupportgroup.com/2018/03/22/what-is-air-hunger-anyway/

Brain fog:  https://madisonarealymesupportgroup.com/2018/03/22/what-is-air-hunger-anyway/

Heart issues:  https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/

Rashes:  https://www.sciencedaily.com/releases/2013/04/130422132507.htm?

Clinical diagnosis must consider any skin rash, regardless of its resemblance to the bull’s-eye.  Many people never recall a rash or tick bite. “Researchers note that multiple textbooks and websites prominently feature the bull’s-eye image as a visual representation of Lyme disease.” They write, “This emphasis on target-like lesions may have inadvertently contributed to an underappreciation for atypical skin lesions caused by Lyme disease.”Some Visible Signs of Lyme Disease Are Easily Missed or Mistaken, Science Daily, Apr 22, 2013

“Not everything is Lyme, but Lyme can be anything.”  Dr. Hoffman RIP

 

 

Scientists Weigh-in on the Seriousness of Tick-borne Illness (Video)

  Approx. 48 Min.

Published on Dec 10, 2018

In Stand4Lyme Foundation’s video, scientists tackle the Lyme disease Epidemic. Experts address the serious consequences of Lyme and tick-borne diseases, an increasing source of morbidity and mortality worldwide. Stand4Lyme makes a clear business case for pharmaceutical support and federal research funding to develop reliable diagnostic tools and accessible effective medical treatment. The goal of this video is to help educate all stakeholders from a scientific perspective and garner increased government support and funding.
They discuss:
  1. Heart issues (including Dr. Neil Spector’s case)
  2. Eye issues
  3. Cognitive issues
  4. Borrelia is complex and lurks within the body
  5. Borrelia crosses the blood/brain barrier
  6. The pathogen connection & Alzheimer’s
  7. Neurological complications of Lyme
  8. Psychiatric complications of Lyme
  9. This year, WHO has recognized Lyme can be spread Congenitally
  10. Sexual transmission was broached as well & will be researched
  11. Admission that Lyme has been neglected by the Medical Community
  12. The need for a system approach to Lyme
  13. The admission that borrelia is slow growing & sustain themselves like TB, and the fact current medications only work on cells that are dividing.  Borrelia can lie dormant.
  14. In both mouse and primate studies, doxycycline does not eradicate borrelia in the later stages of infection.
  15. The admission “WE ARE IN THE DARK” on Lyme
  16. Discussion of some current hopeful research  (scroll to 34:39 & listen until 38:30)
  17. Lyme can cause suicide
  18. Families have to sell their house, car, etc. to get help from doctors who do not accept insurance
  19. Funding for Lyme/MSIDS research is coming from private sources not the NIH
  20. 2018 – LD is in ALL 50 states and in 80 countries worldwide by CDC numbers
Want to donate & support LD Research at Stanford University?  https://www.stand4lyme.org/
Stanford Lyme Working Group:
Dr. Laura Roberts
Dr. Mark Davis
Dr. William Robinson
Dr. Irving Weissman
Dr. Frank Longo
Dr. John Aucott
Dr. Brian Fallon
Dr. Nevena Zubcevik
Dr. Monica Embers
Dr. Neil Spector
Dr. Allen Steere
**May be a partial list of SWLG and Collaborators
________________
**Comment**
One of the best videos I’ve personally seen.  Kudos to Taking a Stand 4 Lyme on such a groundbreaking video.  Definitely worth your time to view.

Advanced Heart Block in Children With Lyme Disease

https://link.springer.com/article/10.1007%2Fs00246-018-2003-8

Advanced Heart Block in Children with Lyme Disease

Meena Bolourchi, Eric S. Silver, Leonardo Liberman

 

Abstract

Background

The clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.

Objective

To review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.

Methods

An IRB approved single-center retrospective study was conducted of all patients < 21 years old with confirmed Lyme disease and advanced second or third degree heart block between 2007 and 2017.

Results

Twelve patients (100% male) with a mean age of 15.9 years (range 13.2–18.1) were identified. Six patients (50%) had mild to moderate atrioventricular valve regurgitation and all had normal biventricular function. Five patients had advanced second degree heart block and 7 had complete heart block with an escape rate of 20–57 bpm. Isoproterenol was used in 4 patients for 3–4 days and one patient required transvenous pacing for 2 days. Patients were treated with 21 days (n = 6, 50%) or 28 days (n = 6, 50%) of antibiotics. Three patients received steroids for 3–4 days. Advanced heart block resolved in all patients within 2–5 days, and all had a normal PR interval within 3 days to 16 months from hospital discharge.

Conclusion

Symptomatic children who present with new high-grade heart block from an endemic area should be tested for Lyme disease. Antibiotic therapy provides quick and complete resolution of advanced heart block within 5 days, while steroids did not appear to shorten the time course in this case series. Importantly, no patients required a permanent pacemaker.

_________________

 

**Comment**

Yes, go ahead and test but realize testing misses half of all cases.  

Since 3rd degree heart block can be fatal, this is a big deal.  Don’t let fear of antibiotics keep you from treating these poor kids.  They say 5 days of antibiotics does the trick, but these patients need follow-up.  Coinfections also need to be taken into consideration as certain antibiotics will not work on all pathogens.  If they have Babesia, for instance, they need anti-malarials.

There are many out there giving “natural” protocols and dissing the use of antibiotics.  This study on serious heart issues is a prime example of the fact that Lyme can kill & time is of the essence.  

More on heart issues with Lyme:  https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/

https://madisonarealymesupportgroup.com/2018/10/10/lyme-carditis-presenting-with-atrial-fibrillation/

https://madisonarealymesupportgroup.com/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/

https://madisonarealymesupportgroup.com/2018/08/14/vermont-resident-dies-of-rare-lyme-disease-complication-that-isnt-rare/

https://madisonarealymesupportgroup.com/2018/07/02/new-uva-study-tentatively-links-ticks-to-heart-disease/

 

 

Advanced Heart Block in Children With Lyme Disease

https://link.springer.com/article/10.1007%2Fs00246-018-2003-8

Advanced Heart Block in Children with Lyme Disease

Meena Bolourchi, Eric S. Silver, Leonardo Liberman

 

Original Article

 

Abstract

Background

The clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.

Objective

To review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.

Methods

An IRB approved single-center retrospective study was conducted of all patients < 21 years old with confirmed Lyme disease and advanced second or third degree heart block between 2007 and 2017.

Results

Twelve patients (100% male) with a mean age of 15.9 years (range 13.2–18.1) were identified. Six patients (50%) had mild to moderate atrioventricular valve regurgitation and all had normal biventricular function. Five patients had advanced second degree heart block and 7 had complete heart block with an escape rate of 20–57 bpm. Isoproterenol was used in 4 patients for 3–4 days and one patient required transvenous pacing for 2 days. Patients were treated with 21 days (n = 6, 50%) or 28 days (n = 6, 50%) of antibiotics. Three patients received steroids for 3–4 days. Advanced heart block resolved in all patients within 2–5 days, and all had a normal PR interval within 3 days to 16 months from hospital discharge.

Conclusion

Symptomatic children who present with new high-grade heart block from an endemic area should be tested for Lyme disease. Antibiotic therapy provides quick and complete resolution of advanced heart block within 5 days, while steroids did not appear to shorten the time course in this case series. Importantly, no patients required a permanent pacemaker.

_________________

**Comment**

Two things stick out 1) These are all kids 2) They need to be followed for a much longer period of time.  There is a third thing as well and that’s the ineffectiveness of steroids, which has long been known, as catabolic steroids will suppress the immune system allowing the infection to worsen.  Many a Lyme/MSIDS patient has had to learn that fact the hard way.  The next question begging to be asked is are these kids were infected with other TBI’s (tick borne infections) such as Bartonella, Babesia, Mycoplasma, and numerous viruses?  After all, one tick bite could give you 18 and counting different infections:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/  This link shows the importance of overlapping treatment with many antimicrobials to effectively treat a pleomorphic (shape-shifting), complex bacteria(ish) organism that pretty much defies all convention in the infectious world.  It’s complexity has never been taken seriously by main-stream medicine.

Myopic and limited research such as this worries me greatly.  These kids are young and have full lives ahead of them.  Due to the lack of recognition and acceptance of the complexity of the organisms involved, these children in my mind are in harm’s way and are in great risk of developing serious issues in the not so distant future.  

Please spread the word!

For more on Lyme:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

Key Quote: “Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

And I’ll bet that 65% is still low….

https://madisonarealymesupportgroup.com/2018/10/27/school-related-difficulties-with-lyme-disease/

https://madisonarealymesupportgroup.com/2018/08/23/caring-for-a-child-with-lyme-podcast/

https://madisonarealymesupportgroup.com/2017/08/12/lyme-disease-case-started-with-headaches/

https://madisonarealymesupportgroup.com/2017/10/08/misdiagnosed-how-children-with-treatable-medical-issues-are-mistakenly-labeled-as-mentally-ill/

https://madisonarealymesupportgroup.com/2018/06/04/ld-diagnosis-took-forever-because-of-mental-health-stigma/

https://madisonarealymesupportgroup.com/2017/06/30/child-with-lymemsidspans-told-by-doctors-she-made-it-all-up/

Study Shows Lyme/MSIDS Patients Infected With Many Pathogens and Explains Why We Are So Sick

https://www.nature.com/articles/s41598-018-34393-9?fbclid=IwAR3k-zPy2rJu8OuFl3HHqJ0twLPJvQrxiIUALUs0T-BuuJ50_1VQVwcflIQ (Please see comment at end of article)

Evaluating polymicrobial immune responses in patients suffering from tick-borne diseases

Kunal Garg, Leena Meriläinen, Ole Franz, Heidi Pirttinen, Marco Quevedo-Diaz, Stephen Croucher & Leona Gilbert
Scientific Reportsvolume 8, Article number: 15932 (2018)   https://doi.org/10.1038/s41598-018-34393-9

Abstract
There is insufficient evidence to support screening of various tick-borne diseases (TBD) related microbes alongside Borrelia in patients suffering from TBD. To evaluate the involvement of multiple microbial immune responses in patients experiencing TBD we utilized enzyme-linked immunosorbent assay. Four hundred and thirty-two human serum samples organized into seven categories followed Centers for Disease Control and Prevention two-tier Lyme disease (LD) diagnosis guidelines and Infectious Disease Society of America guidelines for post-treatment Lyme disease syndrome. All patient categories were tested for their immunoglobulin M (IgM) and G (IgG) responses against 20 microbes associated with TBD. Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes. We have established a causal association between TBD patients and TBD associated co-infections and essential opportunistic microbes following Bradford Hill’s criteria. This study indicated an 85% probability that a randomly selected TBD patient will respond to Borrelia and other related TBD microbes rather than to Borrelia alone.

A paradigm shift is required in current healthcare policies to diagnose TBD so that patients can get tested and treated even for opportunistic infections.
Please see link for full article.  Snippets below:

Introduction
Tick-borne diseases (TBDs) have become a global public health challenge and will affect over 35% of the global population by 20501. The most common tick-borne bacteria are from the Borrelia burgdorferi sensu lato (s.l.) group. However, ticks can also transmit co-infections like Babesia spp.2, Bartonella spp.3, Brucella spp.4,5,6,7,8, Ehrlichia spp.9, Rickettsia spp.10,11, and tick-borne encephalitis virus12,13,14. In Europe and North America, 4–60% of patients with Lyme disease (LD) were co-infected with Babesia, Anaplasma, or Rickettsia11,15,16. Evidence from mouse and human studies indicate that pathogenesis by various tick-borne associated microbes15,16,17 may cause immune dysfunction and alter, enhance the severity, or suppress the course of infection due to the increased microbial burden18,19,20,21,22. As a consequence of extensive exposure to tick-borne infections15,16,17, patients may develop a weakened immune system22,23, and present evidence of opportunistic infections such as Chlamydia spp.24,25,26,27, Coxsackievirus28, Cytomegalovirus29, Epstein-Barr virus27,29, Human parvovirus B1924, and Mycoplasma spp.30,31. In addition to tick-borne co-infections and non-tick-borne opportunistic infections, pleomorphic Borrelia persistent forms may induce distinct immune responses in patients by having different antigenic properties compared to typical spirochetes32,33,34,35. Nonetheless, current LD diagnostic tools do not include Borrelia persistent forms, tick-borne co-infections, and non-tick-borne opportunistic infections.

The two-tier guidelines36,37,38 for diagnosing LD by the Centers for Disease Control and Prevention (CDC) have been challenged due to the omission of co-infections and non-tick-borne opportunistic infections crucial for comprehensive diagnosis and treatment39,40. Emerging diagnostic solutions have demonstrated the usefulness of multiplex assays to test for LD and tick-borne co-infections41,42. However, these new technologies do not address seroprevalence of non-tick-borne opportunistic infections in patients suffering from TBD and they are limited to certain co-infections41,42. Non-tick-borne opportunistic microbes can manifest an array of symptoms24,29 concerning the heart, kidney, musculoskeletal, and the central nervous system as seen in patients with Lyme related carditis43, nephritis44, arthritis45, and neuropathy46, respectively. Therefore, Chlamydia spp., Coxsackievirus, Cytomegalovirus, Epstein-Barr virus, Human parvovirus B19, Mycoplasma spp., and other non-tick-borne opportunistic microbes play an important role in the differential diagnosis of LD24,29. As the current knowledge regarding non-tick-borne opportunistic microbes is limited to their use in differential diagnosis of LD, it is unclear if LD patients can present both tick-borne co-infections and non-tick-borne opportunistic infections simultaneously.

For the first time, we evaluate the involvement of Borrelia spirochetes, Borrelia persistent forms, tick-borne co-infections, and non-tick-borne opportunistic microbes together in patients suffering from different stages of TBD. To highlight the need for multiplex TBD assays in clinical laboratories, we utilized the Bradford Hill’s causal inference criteria47 to elucidate the likelihood and plausibility of TBD patients responding to multiple microbes rather than one microbe. The goal of this study is to advocate screening for various TBD microbes including non-tick-borne opportunistic microbes to decrease the rate of misdiagnosed or undiagnosed48 cases thereby increasing the health-related quality of life for the patients39, and ultimately influencing new treatment protocol for TBDs.

Results
Positive IgM and IgG responses by CDC defined acute, CDC late, CDC negative, PTLDS immunocompromised, and unspecific patients to 20 microbes associated with TBD (Fig. 1) were utilized to evaluate polymicrobial infections (Figs 2–4). Patient categories included CDC acute (n = 43), CDC late (n = 43), CDC negative (n = 46), PTLDS (n = 31), immunocompromised (n = 61), unspecific (n = 31), and healthy (n = 177).

Polymicrobial infections are present at all stages of tick-borne diseases.

Microbes include Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii, Borrelia burgdorferi sensu stricto persistent form, Borrelia afzelii persistent form, Borrelia garinii persistent form, Babesia microti, Bartonella henselae, Brucella abortus, Ehrlichia chaffeensis, Rickettsia akari, Tick-borne encephalitis virus (TBEV), Chlamydia pneumoniae, Chlamydia trachomatis, Coxsackievirus A16 (CVA16), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Mycoplasma pneumoniae, Mycoplasma fermentans, and Human parvovirus B19 (HB19V).

In Fig. 2A, 51% and 65% of patients had IgM and IgG responses to more than one microbe, whereas 9% and 16% of patients had IgM and IgG responses to only one microbe, respectively. Immune responses to Borrelia persistent forms (all three species) for IgM and IgG were 5–10% higher compared to Borrelia spirochetes in all three species (Fig. 2B). Interestingly, the probability that a randomly selected patient will respond to Borrelia persistent forms rather than the Borrelia spirochetes (Fig. S2) is 80% (d = 1.2) for IgM and 68% for IgG (d = 0.7). Figure 2A and B indicated that IgM and IgG responses by patients from different stages of TBDs are not limited to only Borrelia spirochetes.

In Fig. 3 sub-inlets, more than 50% of the patients reacted to only the individual Borrelia strains suggesting that Borrelia antigens are not cross-reactive. If patients were cross-reacting among antigens, a larger percentage of the patients would be seen with the combination of all three species (Fig. S2). These results provide evidence to suggest that the inclusion of different Borrelia species and their morphologies in current LD diagnostic tools will improve its efficiency.

Discussions
The study outcome indicated that polymicrobial infections existed at all stages of TBD with IgM and IgG responses to several microbes (Fig. 2). Results presented in this study propose that infections in patients suffering from TBDs do not obey the one microbe one disease Germ Theory. Based on these results and substantial literature11,15,16,17,27,49,50,51 on polymicrobial infections in TBD patients, we examined the probability of a causal relationship between TBD patients and polymicrobial infections following Hill’s nine criteria47.

An average effect size of d = 1.5 for IgM and IgG (Fig. 4A) responses is considered very large52. According to common language effect size statistics53, d = 1.5 indicates 85% probability that a randomly selected patient will respond to Borrelia and other TBD microbes rather than to only Borrelia. Reports from countries such as Australia27, Germany49, Netherlands11, Sweden50, the United Kingdom51, the USA15,16, and others indicate that 4% to 60% of patients suffer from LD and other microbes such as Babesia microti and human granulocytic anaplasmosis (HGA). However, previous findings11,15,16,27,49,50,51 are limited to co-infections (i.e., Babesia, Bartonella, Ehrlichia, or Rickettsia species) in patients experiencing a particular stage of LD (such as Erythema migrans). In contrast, a broader spectrum of persistent, co-infections, and opportunistic infections associated with diverse stages of TBD patients have been demonstrated in this study (Fig. 2). From a clinical standpoint, the likelihood for IgM and IgG immune responses by TBD patients to the Borrelia spirochetes versus the Borrelia persistent forms, and responses to just Borrelia versus Borrelia with many other TBD microbes has been quantified for the first time (Fig. S2).

Borrelia pathogenesis could predispose individuals to polymicrobial infections because it can suppress, subvert, or modulate the host’s immune system18,19,20,21,22 to create a niche for colonization by other microbes54. Evidence in animals55 and humans11,15,16,27,49,50,51 frequently indicate co-existence of Borrelia with other TBD associated infections. Interestingly, IgM and IgG immune levels by patients to multiple forms of Borrelia resulted in immune responses to 14 other TBD microbes (Fig. 4B). In contrast, patient responses to either form of Borrelia (spirochetes or persistent forms) resulted in reactions to an average of 8 other TBD microbes (Fig. 4B). Reaction to two forms of Borrelia reflected an increase in disease severity indicating biological gradient for causation as required by Hill’s criteria47.

Multiple microbial infections in TBD patients seem plausible because ticks can carry more than eight different microbes depending on tick species and geography56,57. Moreover, Qiu and colleagues reported the presence of at least 18 bacterial genera shared among three different tick species and up to 127 bacterial genera in Ixodes persulcatus58. Interestingly, research indicates Chlamydia-like organism in Ixodes ricinus ticks and human skin59 that may explain immune responses to Chlamydia spp., seen in this study (Fig. 2). Additionally, prevalence of TBD associated co-infections such as B. abortus, E. chaffeensis, and opportunistic microbes such as C. pneumoniae, C. trachomatis, Cytomegalovirus, Epstein-Barr virus, and M. pneumoniae have been recorded in the general population of Europe and the USA (Table S2). However, true incidence of these microbes is likely to be higher considering underreporting due to asymptomatic infections and differences in diagnostic practices and surveillance systems across Europe and in the USA. More importantly, clinical evidence for multiple microbes has been reported in humans11,15,16,27,49,50,51, and livestock55 to mention the least. Our findings regarding the presence of polymicrobial infections at all stages of TBD further supports the causal relationship between TBD patients and polymicrobial infections (Fig. 2). Various microbial infections in TBD patients have been linked to the reduced health-related quality of life (HRQoL) and increased disease severity39.

An association between multiple infections and TBD patients relates well to other diseases such as periodontal, and respiratory tract diseases. Oral cavities may contain viruses and 500 different bacterial species60. Our findings demonstrate that TBD patients may suffer from multiple bacterial and viral infections (Fig. 4). In respiratory tract diseases, influenza virus can stimulate immunosuppression and predispose patients to bacterial infections causing an increase in disease severity61. Likewise, Borrelia can induce immunosuppression that may predispose patients to other microbial infections causing an increase in disease severity.

Traditionally, positive IgM immune reaction implies an acute infection, and IgG response portrays a dissemination, persistent or memory immunity due to past infections. Depending on when TBD patients seek medical advice, the level of anti-Borrelia antibodies can greatly vary as an Erythema migrans (EM) develops and may present with IgM, IgG, collective IgM/IgG, or IgA62. This study recommends both IgM and IgG in diagnosing TBD (Figs 5 and S4–S6) as unconventional antibody profiles have been portrayed in TBD patients. Presence of long-term IgM and IgG antibodies have been reported in LD patients that were tested by the CDC two-tier system. In 2001, Kalish and colleagues reported anti-Borrelia IgM or IgG persistence in patients that suffered from LD 10–20 years ago63. Similarly, Hilton and co-workers recorded persistent anti-Borrelia IgM response in 97% of late LD patients that were considered cured following an antibiotic treatment64.

Similar events of persistent IgM and IgG antibody reactions were demonstrated in patients treated for Borrelia arthritis and acrodermatitis chronica atrophicans65, chronic cutaneous borreliosis66, and Lyme neuroborreliosis67. A clear phenomenon of immune dysfunction is occurring, which might account for the disparities in LD patient’s antibody profiles and persistence. Borrelia suppresses the immune system by inhibition of antigen-induced lymphocyte proliferation18, reducing Langerhans cells by downregulation of major histocompatibility complex class II molecules on these cells19, stimulating the production of interleukin-10 and anti-inflammatory immunosuppressive cytokine20, and causing disparity in regulation and secretion of cytokines21. Other studies have demonstrated low production or subversion of specific anti-Borrelia antibodies in patients with immune deficiency status22.

In the USA alone, the economic healthcare burden for patients suffering from LD and ongoing symptoms is estimated to be $1.3 billion per year69. Additionally, 83% of all TBD diagnostic tests performed by the commercial laboratories in the USA accounted for only LD70. Globally, the commercial laboratories’ ability to diagnose LD has increased by merely 4% (weighted mean for ELISA sensitivity 62.3%) in the last 20 years71. This study provides evidence regarding polymicrobial infections in patients suffering from different stages of TBDs. Literature analyses and results from this study followed Hill’s criteria indicating a causal association between TBD patients and polymicrobial infections. Also, the study outcomes indicate that patients may not adhere to traditional IgM and IgG responses.

__________________

**Comment**

For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

I’m thankful they included Bartonella as that one is often omitted but definitely a player.  I’m also thankful for the mention of viruses as they too are in the mix.  The mention of the persister form must be recognized as well as many out there deny its existence.

Key Quote:  Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

But there is another important point.

According to this review, 83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe.  The review also states it takes 11 different visits to 11 different doctors, utilizing 11 different tests to be properly diagnosed.  https://www.news-medical.net/news/20181101/Tick-borne-disease-is-multiple-microbial-in-nature.aspx?

This is huge.  Please spread the word.

 

Lyme Carditis Presenting With Atrial Fibrillation

https://www.hindawi.com/journals/cric/2018/5265298/

Case Reports in Cardiology

Volume 2018, Article ID 5265298, 5 pages
https://doi.org/10.1155/2018/5265298

A Case of Lyme Carditis Presenting with Atrial Fibrillation

Peter J. Kennel,1 Melvin Parasram,2 Daniel Lu,3 Diane Zisa,1 Samuel Chung,1 Samuel Freedman,1 Katherine Knorr,1 Timothy Donahoe,1 Steven M. Markowitz,3 and Hadi Halazun3

Published 2 September 2018

Academic Editor: Kjell Nikus

Abstract

We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi. After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis.

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**Comment**

Sigh….there it is again – “highly unusual presentation of Lyme carditis……”

Nothing about Lyme is rare.  It’s just not reported.  Please remember, most of these patients for the past 40 years have been told they are imagining their symptoms and, “it’s all in their head.”  Autopsies have rarely been done on these people and they have faced denial the entire time.

For more on heart-related symptoms with tick borne infections:  https://madisonarealymesupportgroup.com/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/

https://madisonarealymesupportgroup.com/2018/08/14/vermont-resident-dies-of-rare-lyme-disease-complication-that-isnt-rare/  Trust me, folks have been dying from this for a long time.  It’s just now beginning to make the radar.  If you have Lyme/MSIDS and heart issues, speak loudly about it.

https://madisonarealymesupportgroup.com/2018/07/09/with-unexpected-death-autopsies-should-look-for-lyme-carditis/

Microbiologist Tom Greer has a fantastic article about how post-mortem work is one of the only ways we are going to get to the bottom of the Lyme Wars: https://madisonarealymesupportgroup.com/2018/04/13/chronic-lyme-post-mortem-study-needed-to-end-the-lyme-wars/
For information on preparing for brain and tissue donations upon death for Lyme research, please see: http://whatislyme.com/guidelines-for-brain-and-tissue-donations-for-lyme-patients/

Lyme, BTW, is NOT the only tick borne illness that can cause heart issues:  https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/  (cases listed here)

Most common parasites causing carditis:

  • Borrelia burgdorferi
  • Ehrlichia species
  • Babesia species
  • Trypanosoma cruzi (Chagas Disease)
  • Bartonella (My addition due to the following…..)
    (RESEARCH NEEDED. TONS OF PARASITES INVOLVED WITH TBD)

 

Bartonella Infective Endocarditis With Dissemination: A Case Report & Literature Review

https://www.ncbi.nlm.nih.gov/m/pubmed/30155407/

Bartonella henselae infective endocarditis with dissemination: A case report and literature review in Southeast Asia.

Noopetch P, et al. IDCases. 2018.

Abstract

Bartonella is among the most common causes of culture-negative infective endocarditis, with B. henselae being one of the most frequently reported species. The clinical presentation of Bartonella endocarditis is similar to that of subacute bacterial endocarditis caused by other bacteria and the diagnosis can be challenging since the organism is difficult to isolate using standard microbiologic culture techniques. In clinical practice, Bartonella endocarditis is usually diagnosed based on serology. To date, only a handful of cases of infective endocarditis caused by Bartonella have been reported in Thailand. Here, we report the case of 51-year-old Thai male with B. henselae endocarditis with dissemination to the lungs, bones, subcutaneous tissue (below dermis, and is primarily loose connective tissue and lobules of fat), epididymis (coiled tube at the back of the testes), and lymph nodes with a successful outcome.

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**Comment**

Please notice the dissemination to lungs, bones, testes, lymph nodes, and area below skin.  Bartonella does not play nice.

This right here is an example of why Lyme/MSIDS patients can suffer so.  Nobody is considering the implications of Bartonella with Lyme.  

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

https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2018/09/07/bartonella-infectious-endocarditis-associated-with-cryoglobulinemia-multifocal-proliferative-glomerulonephritis/

https://madisonarealymesupportgroup.com/2017/01/04/endocarditis-consider-bartonella/

https://madisonarealymesupportgroup.com/2017/05/11/bartonella-henselae-in-children-with-congenital-heart-disease/

https://madisonarealymesupportgroup.com/2018/09/20/humana-bartonellosis-perspectives-of-a-veterinary-internist/