Archive for the ‘Lyme’ Category

They Shall Not Be Left to Rot: The Emerging Law of Lyme Disease

https://www.belmontlawreview.org/articles/volume-8-issue-1-2020/

transparent-law-logo-retina

VOLUME 8, ISSUE 1: 2020

Creighton R. Meland, Jr.

They Shall Not Be Left to Rot: The Emerging Law of Lyme Disease

For the excellently written paper for the Belmont Law Review, on the state of affairs with Lyme disease, please see this pdf:  https://cpb-us-w2.wpmucdn.com/blogs.belmont.edu/dist/8/25/files/2020/11/Meland_95-163.pdf

Table of Contents:

INTRODUCTION 96

I. WHAT IS LYME DISEASE AND WHY IS IT MEDICALLY CONTROVERSIAL? 97

     A. What is Lyme Disease? 97

     B. Lyme Disease Detection and Diagnosis 101

     C. Lyme Disease Treatment Regimens 104

          1. IDSA v. ILADS 104

          2. Coinfections and their Effect on Treatment 106

     D. Lyme Disease is not a Research Priority 107

II. LYME DISEASE LEGAL ISSUES 108

     A. IDSA and CDC Set Treatment Standards 108

          1. Effects on Quality and Availability of Care 108

          2. Antitrust Implications 112

     B. State Lyme Disease Legislation 122

          1. Health Insurance Coverage Mandates 122

          2. Professional Standards 125

          3. Lyme Testing Disclosures 127

          4. Safe Harbors 130

          5. Awareness, Prevention, and Government Support 133

**J.D. University of Michigan; B.S. Economics, Major in Finance, Wharton School, Undergraduate Division, University of Pennsylvania.**

I am grateful to Belmont Law Review for the opportunity to critique laws designed to redress health care problems presented by Lyme disease. Despite a pervasive presence and severe symptoms, Lyme disease is widely misunderstood by the medical community and too often goes untreated or improperly treated. While we await advances in medical science, the law can help those who suffer. I recognize and thank the International Lyme and Associated Diseases Society and its many contributors, who have deepened my understanding of medical problems associated with Lyme disease.  These insights have influenced positively the form of the work I now submit.

Category:

Activism, Lyme, Prevention, research, Testing, Treatment

Lyme Disease As a Reversible Cause of Chronic Illness For Some Patients

https://danielcameronmd.com/lyme-disease-cause-chronic-illnesses/

LYME DISEASE AS A REVERSIBLE CAUSE OF CHRONIC ILLNESS FOR SOME PATIENTS

lyme-disease-cause-chronic-illness

As the number of individuals with chronic illnesses continues to rise, clinicians and patients are looking for reversible causes to chronic symptoms that are often debilitating to patients. Reversible causes have included dementia, [1] coma, [2] complex arrhythmia, [3] and autoimmune encephalitis. [4]

By
Studies indicated that Lyme disease can lead to chronic disease including Lyme encephalopathy, [5] Lyme neuropathy, [6] chronic neurologic Lyme disease, [6] and Neuropsychiatric Lyme disease. [7]

Could Lyme disease be a reversible cause of other chronic illnesses in some patients? Having a high index of suspicion will prevent missing the diagnosis.

Following are dozens of published papers, described in an Inside Lyme Blog series, which features cases in which Lyme disease was a reversible cause of other chronic medical conditions. [8]

Brain Diseases and Neurological Disorders

80-year-old with Lyme encephalopathy instead of dementia
Chronic post-concussion syndrome symptoms due to Lyme disease
POTS patients with brain fog have neurocognitive deficits
When it looks like a brain tumor, but it is Lyme disease
Untreated Lyme disease triggers a stroke in 9-year-old boy
Lyme podcast: man with Lyme disease and stroke
Child with Lyme disease presenting as pseudotumor cerebri
Chronic inflammatory demyelinating polyneuropathy (CIDP) case resolved with antibiotics
Lyme meningitis, manifesting as parkinsonism, is fully reversed with ceftriaxone
Seizures and altered mental status after a tick bite
Dementia and normal pressure Hydrocephalus
Cognitive issues following a stroke due to Lyme disease
Stroke as a manifestation of Lyme disease
Lyme disease causes ‘false brain tumor’ in young child

Cardiac Disease

Broad range of presentations for Lyme carditis cases
Lyme carditis presenting as atrial fibrillation treated successfully
First report of Lyme disease causing mitral valve endocarditis
Lyme endocarditis in 68-year-old avid outdoorsman
Another cardiac manifestation of Lyme myocarditis
When Lyme disease mimics a heart attack
Physician-turned-patient becomes Lyme advocate – required a heart transplant

Autonomic Disorders

POTS: an autonomic disorder in Lyme disease patients
Subacute transverse myelitis caused by Borrelia infection
Femoral neuropathy as a neurologic symptom of Lyme disease
Autonomic dysfunction, small fiber neuropathy and Lyme disease
Acute transverse myelitis in a 25-year-old man with Lyme disease

Sleep Disorders

Lyme disease is associated with various sleep disorders

Psychiatric Illnesses

16-year-old boy with Lyme disease presenting as depression
Don’ t confuse somatic symptoms with depression in early Lyme disease
Oppositional behavior in children with Lyme disease
Can Lyme disease trigger obsessive compulsive symptoms?
Depression common in Lyme disease patients
Suicidal behaviors in patients with Lyme and associated diseases
7-year-old girl with Lyme disease presenting as attention deficit disorder
Treatment options for an anxious, suicidal patient with a history of Lyme disease

Movement Disorders

Subacute Parkinsonism as a complication of Lyme disease

Auditory Problems

Study finds hearing loss and tinnitus common in patients with tick-borne diseases
Lyme disease patient with permanent tinnitus and hearing loss

Autoimmune/Immune System Disorders

Lyme podcast: Sjögren’s syndrome secondary to Lyme disease
Can Lyme disease trigger an autoimmune disease? – Adult-onset Still’s disease (AOSD)
Lyme disease mimics autoimmune disorder in elderly woman – dermatomyositis
Could Lyme disease be another infection associated with the onset of Guillain-Barre syndrome?
PANDAS and Lyme disease in a 7-year-old child

Dermatological Conditions

6-year-old girl with a rare cutaneous presentation of Lyme disease – areolar lymphocytomainvolving her breast
Lyme disease mimics cellulitis skin infection
Lyme disease misdiagnosed as shingles in 62-year-old man

Sensory Impairments

What is that smell?

Eye or Ocular Disorders

Study looks at uveitis due to Lyme disease
69-year-old man with Lyme disease and double vision
Visual changes due to Lyme disease
Growing list of eye problems in Lyme disease
Lyme disease causes vision loss in 46-year-old woman

Inflammatory Disease

Can Lyme disease trigger sarcoidosis?

Joint Infections

Lyme disease mimics prosthetic joint infection following knee replacement

Gastrointestinal Illnesses

Neurologic Lyme disease presenting as abdominal pain in 71-year-old patient
Lyme disease manifests as abdominal pain in young child

 Kidney Disease

Doctors recognize Lyme disease in a patient with kidney disease
Kidney failure and disseminated rashes associated with Lyme disease

Conclusion: Substantial variability exists in the presenting features and clinical course of patients with Lyme disease. A diagnosis depends upon a thorough clinical evaluation, physical and neurologic examinations, along with laboratory testing. An accurate diagnosis and proper treatment can improve the outcome of patients with reversible causes of chronic symptoms.

References:
  1. Bello VME, Schultz RR. Prevalence of treatable and reversible dementias: A study in a dementia outpatient clinic. Dement Neuropsychol. Jan-Mar 2011;5(1):44-47. doi:10.1590/S1980-57642011DN05010008
  2. Edlow JA, Rabinstein A, Traub SJ, Wijdicks EF. Diagnosis of reversible causes of coma. Lancet. Dec 6 2014;384(9959):2064-76. doi:10.1016/S0140-6736(13)62184-4
  3. Pozzolini A, Rio T, Padeletti M, De Ponti R, Leonelli FM, Bagliani G. Complex Arrhythmias Due to Reversible Causes. Card Electrophysiol Clin. Jun 2019;11(2):375-390. doi:10.1016/j.ccep.2019.03.002
  4. Pandit AK, Ihtisham K, Garg A, Gulati S, Padma MV, Tripathi M. Autoimmune encephalitis: A potentially reversible cause of status epilepticus, epilepsy, and cognitive decline. Ann Indian Acad Neurol. Oct 2013;16(4):577-84. doi:10.4103/0972-2327.120476
  5. Logigian EL, Kaplan RF, Steere AC. Successful treatment of Lyme encephalopathy with intravenous ceftriaxone. J Infect Dis. Aug 1999;180(2):377-83. doi:10.1086/314860
  6. Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. Nov 22 1990;323(21):1438-44. doi:10.1056/NEJM199011223232102
  7. Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness. Am J Psychiatry. Nov 1994;151(11):1571-83. doi:10.1176/ajp.151.11.1571
  8. Inside Lyme Science blog. https://danielcameronmd.com/daniel-cameron-md-lyme-blog/ Last accessed 12/19/20.

Category:

Lyme, research

Managing Mental Health & Neuropsychiatric Symptoms of Lyme Disease

https://www.lymedisease.org/neuropsych-lyme-jane-marke/

Managing mental health and neuropsychiatric symptoms of Lyme disease

dr jane marke

By Dr. Jane Marke

The mental health problems associated with Lyme disease are varied and often call for a variety of specialists to help the patient: child psychiatrists, adult psychiatrists, and family therapists or social workers.

Parents especially must deal with a variety of issues: the symptoms themselves that children present, the stress of and between family members, parents and relationships, as well as getting and coordinating treatment and education for their children.

Children can present with myriad symptoms including attention deficit disorder, anxiety, autism, depression, eating disorders, insomnia, learning disorders, obsessive compulsive disorder, opposition disorder, PANS/PANDAS.

Any change in personality without obvious cause should raise suspicion. Children often present with “school refusal” because they are feeling unwell in a way they cannot express in words.

This could be due to sensitivity to light, sounds, or sensory integration. The activity of a classroom filled with children, social stimulation, and tasks to be accomplished maybe experienced as overwhelming, even bordering on painful.

The child may have changes in mood that approaches bipolar disorder seen in adults and be oppositional, angry, and difficult to manage.

Parenting these children is an unbelievable stress. They require a pediatrician who will treat the Lyme, a psychiatrist who understands it, and frequently, a social worker or psychologist who can help navigate the school situations and provide support to the family. Sometimes the parents find themselves at odds and end up in marital therapy.

Adult issues are different

Adults are a different story. Young adults dealing with college and post-college years miss key experiences they were anticipating to move into adulthood and lose out on their sense of entering adulthood.

They may present with any psychiatric disorder: bipolar disease, severe anxiety, depression, depersonalization, or OCD.

Hypersensitivity to light, sound, and smells can be profound, and the hypersensitivity may produce illusions or a sense of hallucination. Sometimes they are hospitalized in psychiatric hospitals with other very ill patients and the experience can be traumatizing.

Older adults may develop major psychiatric symptoms which interfere with their ability to work or care for family.

All these situations and stimuli can present major psychological issues for the affected patient. They may have personality changes. Their preoccupation with symptoms may make them seem self-centered or un-empathic with family or friends. They experience loss of sense of value, purpose, meaning and worth.

Relationship problems arise from feeling like a burden or being perceived as a burden by others and there is guilt and shame over psychiatric symptoms. It’s a lonely illness.

Project Lyme recently sponsored a webinar for the public on the mental health challenges of Lyme patients. Dr Rosalie Greenberg addressed the issues of children, I addressed the issues of adults, and social worker Audrey Amir addressed emotional and social issues.

You can watch the video here:

Click here to watch on YouTube.

Jane Marke, MD, practices integrative psychiatry and psychotherapy in New York City.

________________________

For more: 

Category:

Lyme, PANS, Psychological Aspects

Lyme & Other Tick-borne Diseases With Dr. Philips & Dana Parish

Approx. 47 Min.
April 11, 2021

Relieve Chronic Pain – Steven Phillips, M.S. & Dana Parish

The Empowering Neurologist
David Perlmutter
It has been estimated that some 50 million Americans have been diagnosed with an autoimmune disease. As such, we have become all too familiar with things like rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis, to name a few.
On our program today we are going to speak with the authors of a new book entitled Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again by Dr. Steven Phillips and Dana Parish.
Dr. Phillips and his patient, Dana Parish, reveal the role that chronic underlying infections, like Lyme disease, may play as it relates to autoimmune conditions. We will explore not just Lyme disease, but other chronic infections that also may have long-term manifestations. We explore how these diseases present, how they are diagnosed, and of course, treatment, as well as the politics that may well be keeping this information from gaining widespread acceptance or at least recognition.
I think you will find this program to be very intriguing. 
  • Steven Phillips, M.D., is a renowned Yale-trained physician, international lecturer, and media go-to expert. Well-published in the medical literature, he has treated over 20,000 patients with complex, chronic illness from nearly 20 countries. Phillips experienced firsthand the nightmare of an undiagnosed, serious infection after nearly dying from his own “mystery illness,” and having to save his own life when 25 doctors could not.
  • Dana Parish developed Lyme-induced heart failure as a result of being improperly diagnosed by multiple physicians—and had her life saved by Dr. Phillips. A chart-topping Sony/ATV singer/songwriter who has written songs for artists like Celine Dion and Idina Menzel, she has become a major voice in the world of chronic illness. Her popular column on Huffington Post has been read by more than one million people globally.

______________________

**Comment**

Around 26:00, I was thankful Dr. Phillips touched upon the “Lyme vaccine,” and the fact that when they gave the vaccine to animals infected with Lyme, they got sicker.

He also relates how there are some similarities with Long-COVID and chronic Lyme particularly how latent infections are being stirred up with both illnesses.

Category:

Lyme, vaccines

Humans Infested with Ixodes Ricinus Are Exposed to a Diverse Array of Tick-borne Pathogens in Serbia

https://www.sciencedirect.com/science/article/abs/pii/S1877959X20304799

Humans infested with Ixodes ricinus are exposed to a diverse array of tick-borne pathogens in Serbia

Abstract

Tick-borne pathogens (TBPs) pose a major threat to human health in Europe and the whole northern hemisphere. Despite a high prevalence of TBPs in Ixodes ricinus ticks, knowledge on the incidence of tick-borne diseases in humans infested by this tick species is limited. This study was conducted in the year 2019 on patients who presented themselves to the Pasteur Institute Novi Sad with tick infestations. Ticks (n = 31) feeding on human (n = 30) and blood samples from the same individuals were collected by physicians and a microfluidic real-time high-throughput PCR system was used to test the genomic DNA of the samples for the presence of 27 bacterial and eight parasitic microorganisms in Serbia. Except for one Rhipicephalus sanguineus s.l. adult male tick, all ticks infesting humans were morphologically identified as I. ricinus.

  • A high proportion of ticks (74%, 23/31) were infected with at least one of the tested TB microorganisms, being Rickettsia helvetica (54 %, 17/31) the most common pathogen, but
  • Borrelia afzelii (9 %, 3/31),
  • Anaplasma phagocytophilum (6 %, 2/31),
  • Borrelia miyamotoi (6 %, 2/31), and
  • Francisella like-endosymbiont (6 %, 2/31),
  • Borrelia valaisiana (3 %, 1/31),
  • Borrelia lusitaniae (3 %, 1/31),
  • Rickettsia felis (3 %, 1/31) and
  • Rickettsia aeschlimannii (3 %, 1/31) were also identified.

Despite the high infection rate of TBPs in ticks, only two human blood samples (6 %, 2/30) tested positive for the presence of TBPs, one patient (code H12, 67 years old female) was diagnosed with Borrelia spp. and the other patient was diagnosed (code H17, 71 years old female) with R. felis infection. The tick infesting patient H12 tested positive for B. afzelii, and R. helvetica and the tick infesting patient H17 tested positive for R. felis. Upon clinical examination, both patients were diagnosed with erythema migrans. No additional discomfort was reported by the patient and no additional pathology was observed by the physician. We concluded that humans bitten by I. ricinus in Serbia are exposed to a diverse array of TBPs with clinical impact in the Serbian cohort studied.

Category:

Anaplasmosis, Lyme, research, Rickettsia, Ticks