Rickettsia is the pathogen of Q fever, Brucella ovis is the pathogen of brucellosis, and both of them are Gram-negative bacteria which are parasitic in cells. The mixed infection of rickettsia and Brucella ovis is rarely reported in clinic. Early diagnosis and treatment are of great significance to the treatment and prognosis of brucellosis and Q fever. Here, we report a case of co-infection Rickettsia burneti and Brucella melitensis. The patient is a 49-year-old sheepherder, who was hospitalized with left forearm trauma. Three days after admission, the patient developed fever of 39.0°C, accompanied by sweating, fatigue, poor appetite and headache. Indirect immunofluorescence (IFA) was used to detect Rickettsia burneti IgM. After 72 hours of blood culture incubation, bacterial growth was detected in aerobic bottles, Gram-negative bacilli were found in culture medium smear, the colony was identified as Brucella melitensis by mass spectrometry. Patients were treated with doxycycline (100 mg bid, po) and rifampicin (600 mg qd, po) for 4 weeks.After treatment, the symptoms disappeared quickly, and there was no sign of recurrence or chronic infection.Q fever and Brucella may exist in high-risk practitioners, so we should routinely detect these two pathogens to prevent missed diagnosis.
An antimalarial treatment made from the plant Artemisia annua (Sweet Wormwood) shows promise as a COVID-19 treatment
The drug artesunate — which contains two compounds found in Artemisia annua: artemisinin and dihydroartemisinin — is a first-line treatment for malaria
In a recent in vitro study, both pretreatment and treatment with artemisinin extracts, synthetic artemisinin and the drug artesunate were able to inhibit SARS-CoV-2 infection. However, artesunate was the most potent in terms of treatment, and from a clinical perspective may be the only one worth pursuing
Artesunate’s mechanism of action against SARS-CoV-2 is as yet unknown, but artemisinin does have confirmed antiviral activity
The World Health Organization has come out in opposition to artemisinin-based products, warning their use can bolster drug-resistant strains of malaria parasites. For this reason, people living in malaria-prone areas should be cautious about using this plant remedy
This article was previously published January 4, 2021, and has been updated with new information.
A second antimalarial treatment is now being seriously considered and evaluated for its efficacy against COVID-19. The treatment is made from the plant Artemisia annua, which most people know as Sweet Wormwood. Other names for this plant include Annual Sagewort and Sweet Annie.
Research over the past few decades has revealed multiple health benefits from this medicinal herb, which has a centuries-long history of use in folk medicine. In 2015, Chinese scientist Tu Youyou received a partial Nobel Prize in Physiology or Medicine for his discovery of artemisinin and dihydroartemisinin,1 both of which have potent malaria-fighting properties.
As reported by the University of Kentucky,2 “The popular malaria drug artesunate was developed from those compounds and is still used as a first-line treatment for the disease today.”
Artemisinin — A Viable COVID-19 Remedy?
Interestingly, in addition to having a long-standing history of being used as a highly effective antiparasitic, it also has anticancer properties. Additionally, artemisia annua has antiviral activity that might be helpful against SARS-CoV-2.
In an April 8, 2020, SEC filing, Mateon Therapeutics reported3 that “Artemisinin is highly potent at inhibiting the ability of the COVID-19 causing virus (SARS-CoV-2) to multiply while also having an excellent safety index.”
After testing the plant’s antiviral effects in a laboratory setting for a couple of years, University of Kentucky researchers are also exploring its use for the treatment of COVID-19,4 as are researchers in Denmark and Germany.5 According to the University of Kentucky:6
“Surprisingly, results showed that the plant’s leaves, when extracted with absolute ethanol or distilled water, provided more antiviral activity than the actual drug itself — meaning that an Artemisia annua-blended coffee or tea could possibly be more effective than taking the drug.”
Based on these findings, researchers have decided to test artemisinin in patients diagnosed with COVID-19. Some of the first human studies, set to investigate both the extract blended into coffee and tea, as well as the drug artesunate, were implemented by UK HealthCare.
University of Kentucky researchers have founded a company called ArtemiFlow to develop and manufacture the drug, in collaboration with the Kentucky Tobacco Research & Development Center.7 A sister company, ArtemiLife, is marketing Artemisia tea and coffee to raise research funds.
Mechanism of Action Remains Unknown
As for its mechanism of action, such details still remain to be discovered. C&EN explains:8
“When countering malaria, artemisinin exploits the parasite’s taste for hemoglobin in its host’s blood. As the parasite digests hemoglobin, it frees the iron-porphyrin heme complex from the protein.
Because this heme is toxic to the parasite, the organism normally converts the complex to a more benign crystalline form. ‘But artemisinin corrupts this heme-detoxification pathway,’ says Paul O’Neill, a medicinal chemist at the University of Liverpool.
If artemisinin does have any effect against SARS-CoV-2, though, it likely relies on a completely different mechanism than the one it uses against the malaria parasite, Harvard’s [malaria researcher Dyann F.] Wirth says.”
In Vitro Study Reports Positive Results
An in vitro study9,10 looking at the efficacy of artemisinin-based treatments against SARS-CoV-2, posted on the prepublication server bioRxiv, October 5, 2020, report promising results.
The study was a collaboration between researchers from Germany, Denmark and Hong Kong, led by Kerry Gilmore, Ph.D., from the Max Planck Institute for Colloids and Interfaces in Potsdam, Germany.
Three artemisinin extracts, as well as pure, synthetic artemisinin, artesunate and artemether were evaluated. During the initial screening for antiviral activity, a German SARS-CoV-2 strain obtained from Munich was used.
Later on, during the concentration-response phase of the trial, they used a Danish SARS-CoV-2 strain from Copenhagen. These two strains are said to be “more closely related to the majority of SARS-CoV-2 strains circulating worldwide than the Wuhan strain.”11,12
In summary, they found that both pretreatment and treatment with artemisinin extracts, synthetic artemisinin and the drug artesunate were able to inhibit SARS-CoV-2 infection of Vero E6 cells and human hepatoma Huh7.5 cells. That said, artesunate was the most potent in terms of treatment, and from a clinical perspective may be the only one worth pursuing.13,14
World Health Organization Warns Against Its Use
While the world is eager to add another remedy to its COVID-19 treatment list, the World Health Organization has come out in opposition to artemisinin-based products. In a May 27, 2020, article, C&EN reported:15
“One of the most high-profile advocates for using the herbal remedy against the novel coronavirus is Madagascar president Andry Rajoelina, who has been touting Covid-Organics, a tonic containing A. annua that the Malagasy Institute of Applied Research developed …
But health officials are deeply concerned about the promotion and use of these herbal remedies for three principal reasons. First, no evidence exists that A. annua extracts can prevent or cure COVID-19 …
Second, A. annua preparations such as teas, tonics, or herbal capsules also contain a cocktail of bioactive compounds in addition to artemisinin that can have side effects such as dizziness, hearing problems, and vomiting.
Third, and perhaps most worrying of all, widespread use of A. annua herbal extracts could bolster drug-resistant strains of malaria parasites such as Plasmodium falciparum.16
For people living in regions where malaria is endemic, exposure to subtherapeutic doses of artemisinin in A. annua may be enough to kill off some of the parasites in their bodies, but not all of them. Clearing out weakling parasites leaves more room for drug-resistant siblings to proliferate, rendering vital ACTs [artemisinin-based combination therapies] ineffective.”
According to Pascal Ringwald, who heads up the drug resistance and response unit of the WHO Global Malaria Program, artemisinin resistance is a significant problem in Southeast Asia, where Artemisia readily grows and is commonly used.17
That said, this risk is bound to be slight for Americans and people in many other Western countries where malaria is exceedingly rare. According to C&EN,18 “Scientists interviewed by C&EN agree that although this use is against WHO recommendations, it does not risk accelerating resistance because there are so few cases of malaria in the U.S.”
Two recently published studies confirm quercetin is useful as an adjunct therapy in the early outpatient treatment of mild SARS-CoV-2 infection
In one study, COVID patients who received quercetin in addition to analgesics and an antibiotic cleared the virus faster than those who only received analgesics and antibiotics, and a greater number of patients reported reduced symptoms
In the second study, daily quercetin supplementation for one month reduced the frequency and length of hospitalization, the need for noninvasive oxygen therapy, intensive care and deaths
Quercetin has antiviral, anti-blood clotting, anti-inflammatory and antioxidant properties, all of which are important in the treatment of SARS-CoV-2 infection
Quercetin also inhibits binding of specific spike proteins to your ACE2 receptors, thereby blocking the virus’ ability to infect your cells. It’s also been shown to directly neutralize viral proteins that are critical in the replication of SARS‐CoV‐2
In an August 21, 2021, newsletter,1 Dr. Michael Murray discussed the use of quercetin for respiratory infection symptoms. In November 2020, he’d suffered a “very mild and brief bout of COVID-19.”
He also recounts an anecdotal story of a friend who developed suspicious respiratory symptoms. His friend had been taking a number of supplements said to offer protection, but was still feeling awful.
As it turns out, the one thing he’d not taken was quercetin, and as soon as he did, that same day, his symptoms started to dissipate. This experience, Murray says, “is consistent with the results from two clinical trials” that were recently published.
Quercetin seems to be a safe, far less expensive, and easier-to-obtain and it works by a similar mechanism, driving zinc into the cells to stop viral replication.
Statistical Improvement in Clinical Outcomes
In the first study,2 42 COVID-19 outpatients were divided into two groups. One group of 21 patients received standard medical therapy consisting of analgesics and an antibiotic (acetaminophen 500-milligram (mg) to 1,000-mg dose if body temperature was higher than 37.5 degrees C — 99.5 F — with a maximum daily dosage of 3 grams, and 500 mg azithromycin for three consecutive days).
The other group of 21 patients received standard therapy plus the equivalent of 600 mg of quercetin per day (divided into three doses) for seven days, followed by another seven-day course of 400 mg of quercetin per day (divided into two doses).
The quercetin was used with sunflower lecithin, which has been demonstrated to increase absorption in the gut by as much as 20 times, compared to pure quercetin formulations.
The main outcomes being evaluated were virus clearance and symptoms. After one week of treatment, 16 of the 21 patients in the quercetin group tested negative for SARS-CoV-2 and 12 reported that all symptoms had diminished.
In the standard care group, only two tested negative and four had partially improved symptoms. By the end of Week 2, the five remaining patients in the quercetin group tested negative. In the standard care group, 17 of the 19 remaining patients tested negative and one had died.
“These results are impressive and hopefully additional studies will be conducted on hospitalized patients to see how quercetin might be helpful in more severe cases,” Murray wrote in his newsletter.
Can Quercetin Reduce Hospitalizations and Deaths?
The second study3 — a prospective, randomized, controlled and open-label trial — gave 152 COVID-19 outpatients a daily dose of 1,000 mg of quercetin for 30 days to evaluate its adjuvant effects in the treatment of early symptoms and the prevention of severe infection. According to the authors:
“The results revealed a reduction in frequency and length of hospitalization, in need of non-invasive oxygen therapy, in progression to intensive care units and in number of deaths. The results also confirmed the very high safety profile of quercetin and suggested possible anti-fatigue and pro-appetite properties.
QP (Quercetin Phytosome®) is a safe agent and in combination with standard care, when used in early stage of viral infection, could aid in improving the early symptoms and help in preventing the severity of COVID-19 disease. It is suggested that a double-blind, placebo-controlled study should be urgently carried out to confirm the results of our study.”
Mechanisms of Action
As noted in the first study4 above, quercetin was chosen based on the fact that it has antiviral, anti-blood clotting, anti-inflammatory and antioxidant properties, all of which are important in the treatment of SARS-CoV-2 infection. In the second study, more detailed mechanisms of action are reviewed. According to the authors:5
“SARS-CoV-2 proteases, like 3-chymotrypsin-like protease (3CLpro), papain-like pro-tease (PLpro), RNA-dependent RNA polymerase, spike (S)protein and human angiotensin-converting enzyme 2 (hACE2) are considered possible targets for developing effective anti-COVID-19 drugs.
Recently, molecular docking studies have suggested the possible binding interaction of quercetin with the 3CLpro, PLpro, and S-hACE2 complex. Some recent results, obtained by biophysical techniques, appear to support the results of the molecular docking studies.
Quercetin, a flavonol not naturally present in the human body, is the most abundant polyphenol in fruits and vegetable and is widely used as a dietary supplement to boost the immune system and promote a healthy lifestyle.
Quercetin is characterized by three crucial properties: antioxidant, anti-inflammatory and immunomodulatory. The combination of these actions allows quercetin to be a potential candidate to support all unhealthy conditions where oxidative stress, inflammation and immunity are involved.”
Initially, quercetin gained attention because it’s a zinc ionophore, meaning it shuttles zinc — which has well-known antiviral effects — into your cells just like the drug hydroxychloroquine.
Some proposed the primary reason hydroxychloroquine and quercetin worked was because of this feature. Of course, you also had to take zinc along with either of them. To effectively act as a zinc ionophore, the quercetin also needs vitamin C.
Since then, other studies, including the two reviewed here, have shown quercetin has other actions that makes it useful against SARS-CoV-2 as well. As reported by Murray in his newsletter:
“In particular, quercetin exerts significant inhibition on the binding of specific spike proteins to ACE-2 receptors, thereby blocking the ability of the virus to infect human cells. Quercetin has also been shown to directly neutralize viral proteins the are critical in the replication of SARS-CoV-2.”
In some studies, quercetin has also been shown to inhibit the release of inflammatory cytokines, which could help alleviate infection-related symptoms and suppress excessive inflammatory responses from occurring. Its antioxidant effects may also help prevent tissue damage caused by scavenging free radicals, thereby aiding in the recovery process of viral infections.6
Quercetin’s Antiviral Properties
Quercetin’s antiviral properties have been attributed to three main mechanisms of action:
Inhibiting the virus’ ability to infect cells
Inhibiting replication of already infected cells
Reducing infected cells’ resistance to treatment with antiviral medication
For example, research7 funded by the U.S. Defense Advanced Research Projects Agency (DARPA), published in 2008, found it lowers your risk of viral illness such as influenza and boosts mental performance following extreme physical stress, which might otherwise undermine your immune function and render you more susceptible to infections.
Here, cyclists who received a daily dose of 1,000 mg of quercetin in combination with vitamin C (which enhances plasma quercetin levels8,9) and niacin (to improve absorption) for five weeks were significantly less likely to contract a viral illness after bicycling three hours a day for three consecutive days, compared to untreated controls. While 45% of the placebo group got sick, only 5% of the treatment group did.
Quercetin Works Against Many Common Viruses
Before the COVID-19 pandemic struck, several studies had highlighted quercetin’s ability to prevent and treat the common cold and seasonal influenza.10,11,12,13,14,15,16,17,18 By attenuating oxidative damage, it also lowers your risk of secondary bacterial infections,19 which is actually the primary cause of influenza-related deaths.
Importantly, quercetin increases mitochondrial biogenesis in skeletal muscle, which suggests part of its antiviral effects are due to enhanced mitochondrial antiviral signaling.20 Quercetin also works against other viruses, as demonstrated in the following studies:
• A 1985 study found quercetin inhibits infectivity and replication of herpes simplex virus type 1, polio-virus type 1, parainfluenza virus type 3 and respiratory syncytial virus (RSV).21
• A 2016 animal study22 found quercetin inhibited mouse dengue virus and hepatitis virus.
• Other studies have confirmed quercetin’s power to inhibit both hepatitis B23 and C24 infection.
• A March 2020 study25 found quercetin provides “comprehensive protection” against Streptococcus pneumoniae infection, both in vitro and in vivo, primarily by neutralizing pneumolysin (PLY),26 one of the toxins released from pneumococci that encourages S. pneumoniae infection to blossom in the first place.
Streptococcus pneumoniae is responsible not only for pneumonia, but can also be involved in some ear and sinus infections, meningitis and certain blood infections.27 As reported by the authors of this study:28
“The results indicated that quercetin significantly reduced PLY-induced hemolytic activity and cytotoxicity via repressing the formation of oligomers.
In addition, treatment with quercetin can reduce PLY-mediated cell injury, improve the survival rate of mice infected with a lethal dose of S. pneumoniae, alleviate the pathological damage of lung tissue and inhibit the release of cytokines (IL-1β and TNF-α) in bronchoalveolar lavage fluid.
Considering the importance of these events in antimicrobial resistant S. pneumoniae pathogenesis, our results indicated that quercetin may be a novel potential drug candidate for the treatment of clinical pneumococcal infections.”
How Quercetin Combats Inflammation and Boosts Immunity
Aside from its antiviral activity, quercetin is also known for boosting immunity and combating inflammation. As noted in a 2016 study29 in the journal Nutrients, mechanisms of action include (but is not limited to) the inhibition of:30
Lipopolysaccharide (LPS)-induced tumor necrosis factor α (TNF-α) production in macrophages. TNF-α is a cytokine involved in systemic inflammation, secreted by activated macrophages, a type of immune cell that digests foreign substances, microbes and other harmful or damaged components
LPS-induced mRNA levels of TNF-α and interleukin (IL)-1α in glial cells, which results in “diminished apoptotic neuronal cell death”
The production of inflammation-producing enzymes
Calcium influx into the cell, which in turn inhibits pro-inflammatory cytokine release, as well as histamine and serotonin release from intestinal mast cells31
According to this paper, quercetin also stabilizes mast cells, has cytoprotective activity in the gastrointestinal tract, and “a direct regulatory effect on basic functional properties of immune cells,” which allows it to inhibit “a huge panoply of molecular targets in the micromolar concentration range, either by down-regulating or suppressing many inflammatory pathways and functions.”32
While quercetin does have potent antiviral effects, in order for it to work effectively you need sufficiently high dosages to raise the level of quercetin in your body’s tissues.
The relatively low absorption rate of quercetin is why a sunflower lecithin formulation was used.
Research33 published in the July-December 2021 issue of the Journal of Natural Health Products Research, found a quercertin matrix has the same total absorption rate as quercetin phytosome — and higher peak blood levels.
“Since both of these forms of quercetin produce similar blood levels, they should produce the same effects at equal dosages based upon quercetin content,” Murray wrote in his newsletter, adding:
“My dosage recommendation as part of a nutritional supplement program to support immune function is 250 mg twice daily.
And in patients with active Infection, my recommendation is … six capsules twice a day providing a total of 3,000 mg of quercetin. This high dosage should be taken for at least 10 days and then reduced to a maintenance dosage of 250 mg twice daily …
[This] high dosage may not be necessary. But my dosage calculations are based upon likely tissue concentrations needed to exert the strongest antiviral effects. And given the safety of quercetin, there is no harm at this level.”
Protocol Using Quercetin
One doctor who early brought quercetin into the limelight was Dr. Vladimir Zelenko. As hydroxychloroquine became difficult to obtain, Zelenko switched to recommending quercetin instead, as it’s readily available as an over-the-counter supplement. For a downloadable “cheat sheet” of Zelenko’s protocol for COVID-19, visit VladimirZelenkoMD.com.
Other Health Benefits of Quercetin
There are also other lesser known benefits and uses for quercetin, including the prevention and/or treatment of:34
High blood pressure35,36
Obesity38 and metabolic syndrome39 (a cluster of conditions including high blood pressure, high blood sugar, high triglyceride levels and fat accumulation around the waist that raise your risk for Type 2 diabetes, heart disease and stroke)
Certain kinds of cancer, in particular leukemia, and to a lesser degree breast cancer40
Nonalcoholic fatty liver disease (NAFLD)41
Aluminum-induced neurodegenerative changes, such as those seen in Alzheimer’s, Parkinson’s and amyotrophic lateral sclerosis (ALS).45
Longevity, thanks to its senolytic benefits (clearing out damaged and worn-out cells)46,47
Research has also highlighted quercetin’s epigenetic influence and ability to:48
Interact with cell-signaling pathways
Modulate gene expression
Influence the activity of transcription factors
MicroRNAs used to be considered “junk” DNA. But far from being useless, research has revealed so-called “junk” DNA is actually microRNA and plays a crucial role in regulating genes that make the proteins that build your body.
The microRNA function as “on/off” switches for the genes. Depending on the microRNA input, a single gene can code for any of more than 200 protein products. Quercetin’s ability to module microRNA may also help explain its cytotoxic effects, and why it appears to improve cancer survival (at least in mice).
Head trauma, prolonged neurological symptoms, and Lyme disease
By Daniel A. Kinderlehrer MD
When Brian finished college, he had dreams of becoming a professional hockey player. Unfortunately, he got a rough blow to the head and sustained a concussion. Although he didn’t lose consciousness, he developed a host of symptoms that led to leaving the ice.
He complained of daily headaches that were worse with exertion, physical and mental fatigue, decreased concentration and short-term memory, joint pains, muscle pains, muscle cramps, chest pain, sore soles that were more tender when first getting out of bed, paresthesias (pins and needles sensations) in his fingers and toes; daytime sweats and urethritis—pain on urination.
Sound familiar? Brian had spent time in upstate New York and went to college in Massachusetts. He had never seen a tick attachment nor an EM rash. An alert physician ran a Lyme Western Blot test but the only positive band was the IgG 18 kd, which was interpreted as negative.
The plot thickens
Because of his ongoing urethritis, Brian was put on Cipro for one week and all his symptoms flared. Later he was prescribed Levaquin, but he suffered the same reaction and stopped it after two days
Brian got checked out by specialists at a highly regarded medical center, but they could shed no light on the matter.
Brian’s symptoms were getting worse, including a sore throat with swollen glands. He had another Lyme Western Blot (performed at Labcorp) in which the IgM was now reactive at 23 kd. This was interpreted as positive for Lyme disease.
He was then prescribed doxycycline 100 mg twice daily. He herxed for five days and over the next two months he experienced mild improvement.
I’m going to take a break from Brian to discuss post-concussive syndrome (PCS), symptoms that persist after a traumatic brain injury (TBI). The symptoms of PCS include headache, dizziness, neck pain, exercise intolerance, irritability, anxiety, sleep problems, diminished cognition with memory loss, poor concentration and difficulty with problem-solving, noise and light sensitivity.
In 2019, Sergio Azzolino and colleagues published a report entitled “The prevalence of Lyme disease and associated co-infections in people with a chronic post-concussive syndrome.”1 They wondered if patients with TBIs who continued to have symptoms of post-concussive syndrome a year after their head trauma had undiagnosed Lyme disease.
They did a retrospective chart review of patients who fit the criteria of ongoing symptoms of PCS at least a year after suffering a TBI. To be included in the study, patients had to have a negative brain computed tomography (CT) or magnetic resonance imaging (MRI) scan. Participants were excluded from the study if they had previously tested positive for Lyme and/or co-infections; had two weeks of antibiotics since the date of injury; had been diagnosed with a primary neurological illness (e.g., seizure disorder or multiple sclerosis), or had post-stroke syndrome.
The researchers tested 69 patients who met those criteria: 38% had a positive IgM Western Blot and 26% had a positive Western Blot IgG. They also tested 18 patients without a history of TBI but who had symptoms consistent with PCS: 72% had a positive IgM Western Blot and 33% had a positive IgG Western Blot.
IgM in Lyme disease is not only acute infection
The IgM antibody is considered an acute phase reactant—acute in medicine means recent onset. In most infections, the IgM antibody to a pathogen starts rising soon after the onset of infection. Then begins its decline about a month later, when IgG–the chronic phase reactant–starts increasing. Usually, the IgM becomes negative and the IgG remains elevated while the infection is still active, but IgG can remain elevated long after the infection has been eradicated.
However, this is not the case with Lyme disease. In Lyme, the IgM does indeed rise early—it is usually detectable within one to two weeks. But if the infection is untreated, the elevation in IgM will persist.2,3 This may be due to changes in outer surface proteins on the bacteria that continually signal a new infection to our immune systems.
In the series by Azzolino et al., IgM positivity was disproportionately higher than IgG. And the same was true in the group of people who had the neurological symptoms of PCS without a history of TBI.
Most of my patients present with chronic persistent Lyme disease that has not been previously treated—they have been ill for years or even decades. The vast majority have Western Blot IgM positivity disproportionate to IgG positivity. It is not unusual for these patients to be told that the positive IgM is a false positive, since they have been ill for a long time and do not have an acute infection.
Prolonged neurological symptoms after TBI may be caused by Lyme disease
It turns out that a significant number of folks who get banged in the head and develop prolonged neurological symptoms were already suffering from a dormant infection with Borrelia burgdorferi, the Lyme pathogen. We know that some people get a tick attachment but don’t see a rash and don’t experience acute Lyme disease—but weeks, months or years later they become ill with chronic Lyme disease.
Sometimes, the symptoms develop gradually, but often they develop almost overnight. In the latter situation, there is usually a trigger—a viral infection, mold exposure, taking an agent that suppresses the immune system like corticosteroids, a vaccine, emotional stress, and trauma of any kind—especially head trauma.
Dr. Chad Prusmack is a neurosurgeon in Denver who sees a lot of patients with head trauma. He is unique among neurosurgeons in that he also diagnoses and treats Lyme disease. Chad told me that in his clinical experience, a third of his patients with PCS have Lyme disease and improve with appropriate treatment.
He also notes that most of these patients have issues with mold sensitivity and mold toxins, as well as dysautonomia, especially POTS—Postural Orthostatic Tachycardia Syndrome–and they improve considerably when they are stabilized.
Back to Brian
When I initially saw Brian, I told him I didn’t know how much his neurological symptoms were still attributable to the TBI he sustained over a year earlier as opposed to symptoms caused by the tick-borne diseases.
I suspect many readers of Lymedisease.org have already surmised that Brian was suffering from both Lyme disease and bartonellosis. Morning pain on the soles of the feet, urethritis, daytime sweats, and Herxheimer reactions to Cipro and Levaquin are big tip-offs.
The short story is that with treatment Brian experienced a 100% remission. He wisely decided not to pursue a professional career on the ice, but instead went to medical school. At the time of this writing, he is completing an orthopedic residency.
When Brian was a fourth-year medical student, I asked him what attending physicians on the wards had to say about Lyme disease. His reply: “They think it’s a joke, it’s not real.” This level of denial among mainstream physicians is, distressingly, still quite common.
I talked with Dr. Azzolino recently. He told me his clinical experience has been similar to that of Dr. Prusmack, who found that treating his long-term PCS patients for their tick-borne infections “…resulted in a dramatic improvement in function and reduction in disability” in this patient population.
The bottom line is that head trauma can activate dormant infections that manifest with chronic neurological symptoms that overlap with those of PCS. Anyone with head trauma with persistent PCS should get checked for Lyme disease.
Azzolino S, Zaman R, Hankir A, Carrick FR. The prevalence of Lyme disease and associated co-infections in people with a chronic post-concussive syndrome. Psychiatr Danub. 2019 Sep;31(Suppl 3):299-307. PMID: 31488744.
Craft JE, Fischer DK, Shimamoto GT, Steere AC. Antigens of Borrelia burgdorferi recognized during Lyme disease. Appearance of a new immunoglobulin M response and expansion of the immunoglobulin G response late in the illness. J Clin Invest. 1986;78(4):934–939.
Steere AC, et al. Lyme arthritis: correlation of serum and cryoglobulin IgM with activity, and serum IgG with remission. Arthritis Rheum.1979;22(5):471-83
Bloodstream infections (BSIs) are an emerging cause of significant morbidity and mortality in severe Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill COVID-19 patients.
This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age > 18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 admitted in the intensive care unit (ICU) were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs.
Out of 750 patients admitted in COVID ICU, 8.5% developed secondary BSIs.All severe COVID-19 patients who developed BSIs succumbed to illness. A significant proportion of BSIs were Gram-negative pathogens (53/64, 82.8%). Acinetobacter baumanniiwas the commonest isolate, followed by Klebsiella pneumoniae (32.8% and 21.9%, respectively).Multidrug-resistance organisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of Gram-negative bacteria resistant to carbapenems was 47.2% (25/53). On multivariate analysis, raised total leukocyte counts, mechanical ventilation and presence of comorbidities were significantly associated with the incidence of BSIs.
We found a significant prevalence of Acinetobacter baumannii in COVID-19 associated BSIs. The presence of comorbidities raised leukocyte counts and mechanical ventilation should alarm clinicians for possible BSIs. The timely initiation of empirical antibiotics and rapid de-escalation is vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.
Biology Centre Czech Academy of Sciences, Institute of Parasitology, Branisovska 31, 37005 Ceske Budejovice, Czech Republic; email@example.com *Correspondence: firstname.lastname@example.org; Tel.: +420-387775468
Transmission of the causative agents of numerous infectious diseases might be potentially conducted by various routes if this is supported by the genetics of the pathogen. Various transmission modes occur in related pathogens, reflecting a complex process that is specific for each particular host–pathogensystem thatreliesonand isaffectedbypathogen andhostgenetics andecology, ensuring the epidemiological spread of the pathogen. The recent dramatic rise in diagnosed cases ofLymeborreliosismightbeduetoseveralfactors:theshiftingofthedistributionalrangeof tickvectorscausedbyclimatechange;dispersalofinfectedticksduetohostanimalmigration; recenturbanization;anincreasingoverlapofhumans’habitatwithwildlifereservoirsandthe environmentoftickvectorsofBorrelia;improvementsindiseasediagnosis;orestablishmentof adequatesurveillance.Theinvolvementofotherbloodsuckingarthropodvectorsand/orother routes of transmission (human-to-human) of the causative agent of Lyme borreliosis, the spirochetes from theBorrelia burgdorferisensu lato complex, has been speculated to be contributing to increased disease burden. It does not matter how controversial the idea of vector-free spirochete transmission might seem in the beginning. As long as evidence of sexual transmission ofBorrelia burgdorferiboth between vertebrate hosts and between tick vectors exists, this question must be addressed. In order to confirm or refute the existence of this phenomenon, which could have important implications for Lyme borreliosis epidemiology, the need of extensive research is obvious and required.
SO DO IT ALREADY!
How long must we wait? I think 40 years is sufficient.
Reminder: the climate has little to nothing to do with tick and disease proliferation. Ticks are remarkably ecoadaptive according to independent research. Migrating birds and photo-period have a great hand in it and would explain why tropical ticks are found in Canada (and other Northern climates) and Canadian ticks are found in the topics. Climate change is a popular topic that fits into the current accepted narrative, which is why it is being pushed regarding ticks, despite evidence to the contrary (which is frankly ignored by mainstream research). Researchers need grant money, and in order to obtain that, they must genuflect to corrupt, mafia overlord Dr. Anthony Fauci, which simply means they must tout the accepted narrativeor miss out on funding. According to a former French Health Minister, real science no longer exists due to the fact Big Pharma is also exerting pressure on scientific publications.