Archive for the ‘Lyme’ Category

Dermatological & Genital Manifestations of Lyme Disease Including Morgellons Disease

https://www.dovepress.com/dermatological-and-genital-manifestations-of-lyme-disease-including-mo-peer-reviewed-fulltext-article-CCID

Dermatological and Genital Manifestations of Lyme Disease Including Morgellons Disease

Authors Middelveen MJ, Haggblad JS, Lewis J, Robichaud GA, Martinez RM, Shah JS, Du Cruz I, Fesler MC, Stricker RB

Received 5 January 2021

Accepted for publication 9 April 2021

Published 6 May 2021 Volume 2021:14 Pages 425—436

DOI https://doi.org/10.2147/CCID.S299526

Article has an altmetric score of 23

Download Article [PDF] 

Abstract: Although the erythema migrans (EM) skin rash is traditionally considered a hallmark of Lyme disease, other dermatological manifestations of the tickborne disease are less well known. We describe a 49-year-old woman with erosive genital ulcerations, secondary EM rashes and jagged skin lesions associated with Lyme disease. The skin rashes exhibited fibers characteristic of Morgellons disease. Molecular testing confirmed the presence of Borrelia DNA in both vaginal culture and serum specimens. In further studies on a secondary EM lesion containing filaments, Gömöri trichrome staining revealed the presence of collagen in the filaments, while Dieterle and anti-Borrelia immunostaining revealed intracellular and extracellular Borrelia organisms. Intracellular staining for Borrelia was also observed in lymphocytic infiltrates. Lyme disease may present with a variety of genital lesions and dermatological manifestations including Morgellons disease. Careful evaluation is required to determine the presence of Borreliaorganisms associated with these dermopathies.

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**Comment**

Morgellons patients in many ways suffer worse than Lyme patients.  Most doctors still believe Morgellons is a figment of the imagination, while Lyme is getting some air-time and recognition – which unfortunately, doesn’t mean things are changing for the better.

This new case study is reminiscent of previous work done by some of the same study researchers:

  • https://madisonarealymesupportgroup.com/2019/05/20/vaginal-lesion-associated-with-lyme/  This 57-year-old woman previously diagnosed with Lyme disease had a painful erosive genital lesion. At the time of the outbreak, she was being treated with oral antibiotics, and she tested serologically positive for B burgdorferi and serologically negative for syphilis. Dieterle-stained biopsy sections revealed visible spirochetes throughout the stratum spinosum and stratum basale, and anti-B burgdorferi immunostaining was positive. Motile spirochetes were observed by darkfield microscopy and cultured in Barbour-Stoner-Kelly-complete medium inoculated with skin scrapings from the lesion. Cultured spirochetes were identified genetically as B burgdorferi sensu stricto by polymerase chain reaction, while polymerase chain reaction amplification of treponemal gene targets was negative. The condition resolved after treatment with additional systemic antibiotic therapy and topical antibiotics. 
  • https://f1000research.com/articles/3-309/v3  Culture and identification of Borrelia spirochetes in human vaginal and seminal secretions.  This study has gone through 3 versions dating from December, 2014-April 2015.  Only 2 of 4 reviewers approved it.  Results:  Control subjects who were asymptomatic and seronegative for Bb had no detectable spirochetes in genital secretions by PCR analysis. In contrast, spirochetes were observed in cultures of genital secretions from 11 of 13 subjects diagnosed with Lyme disease, and motile spirochetes were detected in genital culture concentrates from 12 of 13 Lyme disease patients using light and darkfield microscopy. Morphological features of spirochetes were confirmed by Dieterle silver staining and immunohistochemical staining of culture concentrates. Molecular hybridization and PCR testing confirmed that the spirochetes isolated from semen and vaginal secretions were strains of Borrelia, and all cultures were negative for treponemal spirochetes. PCR sequencing of cultured spirochetes from three couples having unprotected sex indicated that two couples had identical strains of Bb sensu stricto in their semen and vaginal secretions, while the third couple had identical strains of B. hermsii detected in their genital secretions.  Conclusions: The culture of viable Borrelia spirochetes in genital secretions suggests that Lyme disease could be transmitted by intimate contact from person to person. Further studies are needed to evaluate this hypothesis.  
  • Lida Mattman has isolated Bb from many sources, including semen, urine, blood, plasma, and CSF:  https://madisonarealymesupportgroup.com/2019/04/02/transmission-of-lyme-disease-lida-mattman-phd/
  • Lyme advocate Carl Tuttle points out that 45 lab acquired infections with Borrelia burgdorferi are on record, all of which were NOT vector-borne (didn’t come from a tick bite). How did these workers get infected?   https://madisonarealymesupportgroup.com/2019/04/14/lab-acquired-infections-lyme/

More on Morgellons:

Category:

Lyme, Morgellons, research

Kidney Failure & Disseminated Rashes Associated With Lyme Disease

https://danielcameronmd.com/kidney-failure-associated-with-lyme-disease/  Podcast Here

KIDNEY FAILURE AND DISSEMINATED RASHES ASSOCIATED WITH LYME DISEASE

kidney-failure-lyme-disease

Hello, and welcome to another Inside Lyme Podcast. I am your host Dr. Daniel Cameron. In this episode, I will be discussing the case of a 66-year-old woman who ignored a Bull’s eye rash, indicative of Lyme disease, and later developed acute renal failure, also referred to as kidney failure.

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Mishra and colleagues described this case, entitled “Disseminated Erythema Migrans,” in the American Journal of Medicine. [1]

CASE REPORT: Kidney failure, disseminated rashes associated with Lyme disease

Over a two-week period, a 66-year-old woman with a history of obesity, hypertension, and hyperlipidemia, developed fever and malaise.

One month earlier, she reportedly had a tick bite on her right groin. “A few days later she noticed a bull’s eye lesion over the same area which she ignored,” the authors explain.

READ MORE: Doctors recognize Lyme disease in a patient with kidney disease

I can’t tell you how many patients I have had in my practice who ignore the importance of a tick bite or a rash.

The woman developed clear findings of disseminated Lyme disease. She had “high grade, intermittent fever, malaise, and fatigability,” along with “multiple, painless, red color skin lesions involving her arms, legs and lower back,” the authors write.

Early disseminated Lyme disease typically occurs shortly after a tick bite when the infection has spread throughout the body.  

The patient was hospitalized and found to have unexplained acute renal failure (or kidney failure) with a creatinine of 4.49 mg/dl.  Normal levels are closer to 1. (Dialysis is typically necessary if the creatinine were to stay over 5.)

The woman’s IgM Western blot test was positive which is expected in early Lyme disease.

She was treated clinically with IV ceftriaxone and oral doxycycline. “Her renal functions improved following hydration, antibiotics, and discontinuation of her losartan and non-steroidal anti-inflammatory drugs,” the authors explain.

The following questions are addressed in this podcast episode:

  1. What is the importance of the rash in this case?
  2. When does an EM rash typically appear?
  3. A rash will fade after a few days? Does this mean that Lyme disease is no longer a concern?
  4. This patient had multiple disseminated rashes. How common is this and what does it indicate?
  5. Does a rash always appear at the site of the tick bite?
  6. What is the risk of Lyme disease from a tick?
  7. What is the risk of Lyme disease once a rash is identified?
  8. How often are there treatment delays, even when a rash is present?
  9. What types of treatment delays have you seen?
  10. What are the consequences of delayed treatment?
  11. Have you seen kidney failure associated with Lyme disease?
  12. Could this patient’s hospitalization and kidney failure have been prevented?
  13. Have you seen kidney failure in dogs associated with Lyme disease?
  14. Do you feel treatment was appropriate in this case?
  15. What can we learn from this case?
    Thanks for listening to another Inside Lyme Podcast. You can read more about these cases in my show notes and on my website @DanielCameronMD.com. As always, it is your likes, comments, reviews, and shares that help spread the word about Lyme disease. Until next time on Inside Lyme.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Inside Lyme Podcast Series

This Inside Lyme case series will be discussed on my Facebook and made available on podcast and YouTube.  As always, it is your likes, comments, and shares that help spread the word about this series and our work. If you can, please leave a review on iTunes or wherever else you get your podcasts.

References:
  1. Mishra AK, Hashmath Z, Oneyssi I, Bose A. Disseminated Erythema Migrans. Am J Med. 2020 Feb 13. pii: S0002-9343(20)30114-5.

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For more:

Category:

Lyme, research

Long Haul COVID & Persistent Lyme; Is There a Silver Lining?

 

http://  Approx. 1 Hour

May 13, 2021

Long Haul COVID & Persistent Lyme; is There a Silver Lining?

About This Event:

National experts and patients come together to explore how these two diseases may be confused and address the ongoing health repercussions they each represent – particularly as outdoor activities increase and Lyme disease continues to be widely misdiagnosed. Both organizations are well positioned to host this event.

As early responders to the pandemic, Project Lyme provided professionally managed patient support to the Lyme community through the Lyme & COVID Facebook group. In addition, during its educational outreach to the community, Dr. Richard Horowitz correctly predicted the overlap between these diseases over a year ago.

For its part, Bay Area Lyme Foundation, a renowned as a leading sponsor of Lyme disease research in the U.S., is also a supporter of the Resilience Project, which seeks to identify people who, despite high risk of exposure to COVID-19, Lyme disease or other illnesses, do not exhibit any symptoms.

Featuring:

  • Dr. Richard Horowitz — a board certified internist, medical director of the Hudson Valley Healing Arts Center, scientific advisor to Bay Area Lyme Foundation and author of How Can I Get Better?
  • Dr. Christine Green — a practicing physician who has been treating Lyme disease since 1989 and has seen more than 100 patients with COVID-19 including those who have both Lyme and COVID-19. Dr. Green also serves on the boards of the International Lyme and Associated Disease Society (ILADS), LymeDisease.org and Bay Area Lyme Foundation.
  • Dr. Steven Phillips — Yale-educated expert on zoonotic infections, co-author of the newly-released and highly-acclaimed book Chronic, and scientific advisor to Bay Area Lyme Foundation.
  • David Roth — Lyme disease and COVID-19 patient. Executive Committee Chair, Project Lyme.
  • Laure Woods — Lyme disease and COVID-19 patient. Founder and Co-Chair, Bay Area Lyme Foundation.

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For more:

Category:

Lyme, Viruses

Enroll in ImmuneSense – a Clinical Study For Lyme Testing

 
I posted about this previously here.  It appears they are still accepting qualified patients.  You must be ages 18 and up, have symptoms suggestive of Lyme disease, WITH an EM rash, if on antibiotics, initiated less than a week ago, and you will be required up to 4 blood draws to be taken over 12 months.

 

https://1nhealth.com/health-care-providers/?  Go here for more information.  

Lyme season is here.

Your patients may hold the key to a new and potentially better diagnostic test.
About 300,000 people in the U.S. are infected with Lyme disease through tick bites each year. 1,2

You may hold the key to a new and potentially better diagnostic test.

Join us in the fight against Lyme disease by enrolling in the ImmuneSense™ Lyme clinical study. If you’ve been recently diagnosed with Lyme disease or you suspect you have Lyme disease, your immune system may hold key information that can help advance the development of a novel test.

 
GET INVOLVED

The Northeast, the Mid-Atlantic region and the Upper Midwest are hotspots.

 
GET INVOLVED

Only 30% of people with acute Lyme infections receive a positive test result with existing laboratory tests. 3

GET INVOLVED

The ImmuneSense™ Lyme study is currently collecting blood samples from patients for clinical validation of a T-cell-based assay that is a potential diagnostic for Lyme disease.

The T-cell-based test may offer:

• Earlier detection of Lyme disease than current tests

• A look at patients’ T-cell immune response to the bacteria that causes Lyme disease

Your patients can contribute to validating this novel test, and may be eligible to earn as much as $400 for taking part in the study.

Your patients can enroll in ImmuneSense™ Lyme study by filling out this questionnaire.

Category:

Activism, Lyme, Testing

What Does a Lyme Flare-Up Feel Like?

https://danielcameronmd.com/what-does-a-lyme-flare-up-feel-like/

WHAT DOES A LYME FLARE-UP FEEL LIKE? ASK THE LYME DOC

What does a Lyme flare-up feel like

Lyme disease is a tick-borne illness that can lead to unpredictable disease flare-ups and remissions. The best know flare-up is called a Herxheimer reaction. A Herxheimer reaction was first identified in patients with syphilis and occurs when the body reacts to endotoxin-like products released by the death of bacteria in the body after starting an antibiotic. A flare-up may occur following a trigger or as part of the illness.

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When a Lyme disease flare occurs, patients will notice a return of the symptoms they have experienced before or a worsening of existing symptoms. Some patients may also develop new symptoms. A flare-up can come and go and vary in intensity.  What does a Lyme flare-up feel like? The symptoms of a flare-up can include:

  • an increase in fatigue
  • problems with memory and concentration, sometimes referred to as ‘brain fog’
  • extreme sensitivity to bright lights, heat, cold, and noise
  • muscle stiffness
  • mood changes (including irritability)
  • poor quality sleep
  • dizziness
  • numbness or tingling in hands and feet
  • widespread muscle pain
  • blurred vision
  • general body pain

What triggers a flare-up?

One of the best ways to prevent a flare is to determine what might be causing it in the first place. These causes are called triggers. Triggers for Lyme disease vary by person, but they can include:

  • emotional stress (such as a divorce, death in the family, or accidents)
  • physical stress to the body (i.e., surgery, physical harm, concussion)
  • life stress or stressful events
  • infections, colds or viral illnesses
  • exhaustion
  • diets including processed sugars and alcohol
  • menstrual period
  • lack of sleep
  • traveling and/or changes in schedule
  • changes in treatment

How do you prevent a flare-up?

There are ways to help prevent a flare-up but most importantly, patients need to listen to their bodies and identify triggers that set off a flare in symptoms. Following are several ways to prevent a flare-up:

  • Treat your Lyme disease
  • Reduce your stress
  • Get enough rest and sleep
  • Stay away from foods that make you feel worse, including alcohol and processed sugars
  • Learn to pace yourself to avoid doing too much when you are feeling well
  • Keep up your health
  • Stay hydrated
  • Work with your doctor to get your symptoms under control
  • Some people find ‘positive thinking’ helpful
  • Try focusing on the things you can do, rather than those you can’t
  • You might find a mental health provider helpful

Editor’s note. What does a Lyme flare-up feel like?  Ask the Lyme doc sponsored by Dr. Cameron

Related Articles:

Herxheimer reaction in 13-year-old boy with Lyme disease

Can I consume simple sugar or alcohol if I have Lyme disease?

Clinical judgment leads to successful Lyme disease treatment in young child

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**Comment**

Great read.  One of the toughest aspects of this illness(es) is deciphering what is causing what.  I did notice trends throughout treatment but it was difficult to completely understand what was causing symptoms.  Unfortunately, due to feeling worse, patients often want to either stop treatment or change doctors.  I can not count the times I felt this as well.  This disease(s) is unbelievable and causing unbelievable suffering.  That’s the first thing to remember.  The second thing to remember is it takes time.  LOTS of time.  For us, it took over 5 years of persistent treatment often using 4-5 things simultaneously, as well as copious supplements, dietary changes, and stuff I’ve forgotten or blocked out!

Stay the course!  That’s my best advice.  Don’t quit at the first sign of trouble.  Discuss it with your practitioner but try and learn about the herxheimer reaction, and talk with other experienced patients, which alone can alleviate fear that you are somehow “off your rocker” or your treatment isn’t working.

Now, if you aren’t feeling anything during treatment, that’s a potential problem as well.  One of the things I learned from Dr. Burrascano is drug dosage matters.  Many doctors do not consider this issue, but I have found it be explain many patients’ lack of improvement.  Other times they might have hit a plateau and need to switch up the medications.  Since we are fighting stealth infections our treatment needs to also be stealthy and change often.

One personal experience relating to dosage remains embedded in my mind:  the pharmacist neglected to tell me that since they were out of a certain dosage of a particular antibiotic, they gave me a different dosage of which I was required to take double the amount to equal what I took previously.  So instead of taking 500mg, I was only getting 250mg.  Immediately I began suffering with unimaginable PAIN in my shoulder joint.  I was a wreck.  During this time my PT was offering free Biomat sessions.  I went daily and told him to crank it as high as it would go.  He covered my entire body – but not my head – creating a “sauna” effect.  I either did 30 or 60 minutes of this DAILY and it got me by.  After nearly a week of this, I discovered the dosage error and started taking TWO pills which gave me 500mg.  Within ONE dose, PAIN GONE!  POOF!

This little unplanned experiment taught me much about the importance of dosage.  And bizarrely, dosages are often somewhat arbitrarily given to everyone despite their weight and size.  Even veterinarians weigh pets to determine dosage!  Why isn’t this considered for humans!

So, one of the first things I ask patients who aren’t herxing or noticing any change is what dosage they are taking and if they’ve discussed the dosage issue with their practitioner.  Please keep this in mind – I believe this is a major reason why some don’t see improvement or stagnate.

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For more:

Category:

Lyme