Archive for the ‘research’ Category

Latent Lyme Disease Resulting in Chronic Arthritis & Early Career Termination in a U.S. Army Officer

https://www.ncbi.nlm.nih.gov/m/pubmed/30839071/

Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer.

Weiss T, et al. Mil Med. 2019.

Abstract

Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. Although gonococcal arthritis was initially suspected from preliminary laboratory results, a comprehensive evaluation contradicted this diagnosis.

Despite antibiotic therapy, aspiration of the effusions, and steroid treatment to control inflammation, the condition of the patient deteriorated to the point where he was found to be unfit for duty and subsequently discharged from active military service. This case illustrates the profound effect that latent Lyme disease can have on the quality of life and the career of an active duty military member. It highlights the need for increased surveillance for Borrelia burgdorferi (B. burgdorferi) in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease.

Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019.

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**Comment**
Our military has been in ‘harms way’ for decades. Glad this case study was made.  I have military friends who receive training in Northern Wisconsin. They sleep outside and literally pick thousands of ticks off their bodies. I can only imagine the high numbers of soldiers with similar stories not being counted or recognized.
Excerpt: 
After congressional investigation, he was finally discharged from the Air Force after 14 years of highly recognized and awarded military service that ended in shame because doctors did not understand Lyme disease.  Attorneys laughed and joked as they decided he was no longer fit for duty and discharged him from the Air Force without benefits, pay, or health insurance. He was essentially dumped on the streets homeless, disabled, and unable to work, with a wife and a child to provide for.
Three decades later, the VA still cannot diagnose Lyme disease based upon symptoms.
The VA did not recognize Lyme disease until the mid-1990s. That means that veterans who had Lyme disease before then were misdiagnosed and some are perhaps homeless and disabled.  According to Sims the government is no wiser today than before they recognized Lyme disease.
The real problem is:
military and VA healthcare systems follow CDC two-tier tests Lyme disease guidelines that capture less than 10% of Lyme disease cases nationwide.
Over 90% of Lyme disease cases are diagnosed and treated by a minority of doctors who specialize in Lyme disease and tick-borne disease and understand CDC guidelines are fatally flawed.
He also states that according to many medical experts, the largest cause of death from Lyme disease is suicide.
Soldiers are also forced to get vaccines and many are injured by them:
Ticks are found:

Beaches:  https://madisonarealymesupportgroup.com/2018/06/07/ticks-on-beaches/

Rocks and picnic benches: https://madisonarealymesupportgroup.com/2017/03/13/ticks-found-on-rocks/

Caves:  https://madisonarealymesupportgroup.com/2018/04/23/tick-borne-relapsing-fever-found-in-austin-texas-caves/, and https://madisonarealymesupportgroup.com/2017/10/27/israeli-kids-get-lyme-disease-from-ticks-in-caves/

Birds:  https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/

California:  https://madisonarealymesupportgroup.com/2018/05/19/infected-ticks-in-california-its-complicated/

In the South:  https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/, and https://madisonarealymesupportgroup.com/2017/10/06/remembering-dr-masters-the-rebel-for-lyme-patients-who-took-on-the-cdc-single-handedly/, and https://madisonarealymesupportgroup.com/2017/03/02/hold-the-press-arkansas-has-lyme/

Southern Hemisphere: https://madisonarealymesupportgroup.com/2018/02/06/lyme-in-the-southern-hemisphere-sexual-transmission/

Australia:  https://madisonarealymesupportgroup.com/2016/11/03/ld-not-in-australia-here-we-go-again/

And everywhere else…..

Remember, there are 300 strains and counting of Borrelia worldwide and 100 strains and counting in the U.S.  Current CDC two-tiered testing tests for ONE strain!  Do the math….

Lyme has been found in ALL 50 states and is worldwide:  https://madisonarealymesupportgroup.com/2018/08/18/lyme-found-in-all-50-states/
And remember, Lyme is the rock star we know by name.  There are plenty of other illnesses ticks transmit and it isn’t JUST the black-legged tick.
There’s no such thing as a “safe” tick or an “irrelevant” tick bite.

 

 

 

 

 

Abstract: Bartonella in Boy with PANS

https://journals.sagepub.com/doi/full/10.1177/1179573519832014

Bartonella henselae Bloodstream Infection in a Boy With Pediatric Acute-Onset Neuropsychiatric Syndrome

First Published March 18, 2019 Case Report

In March 2017, Bartonella spp. serology (indirect fluorescent antibody assays) and polymerase chain reaction (PCR) amplification, DNA sequencing, and Bartonella enrichment blood culture were used on a research basis to assess Bartonella spp. exposure and bloodstream infection, respectively. PCR assays targeting other vector-borne infections were performed to assess potential co-infections.

For 18 months, the boy remained psychotic despite 4 hospitalizations, therapeutic trials involving multiple psychiatric medication combinations, and immunosuppressive treatment for autoimmune encephalitis. Neurobartonellosis was diagnosed after cutaneous lesions developed. Subsequently, despite nearly 2 consecutive months of doxycycline administration, Bartonella henselae DNA was PCR amplified and sequenced from the patient’s blood, and from Bartonella alphaproteobacteria growth medium enrichment blood cultures. B henselae serology was negative. During treatment with combination antimicrobial chemotherapy, he experienced a gradual progressive decrease in neuropsychiatric symptoms, cessation of psychiatric drugs, resolution of Bartonella-associated cutaneous lesions, and a return to all pre-illness activities.

 

Please note that this boy would be in a psych ward if not treated with antimicrobials for Bartonella.

 

 

 

Case Series: Bartonella & Ocular Manifestations

https://www.ncbi.nlm.nih.gov/pubmed/30852734

2019 Mar 9. doi: 10.1007/s10792-019-01096-7. [Epub ahead of print]

Bartonella henselae- and quintana-associated uveitis: a case series and approach of a potentially severe disease with a broad spectrum of ocular manifestations.

Abstract

PURPOSE:

To evaluate the clinical manifestations of intraocular inflammation associated with Bartonella infection and describe the assessment and management of patients with cat-scratch disease (CSD).

METHODS:

This is a retrospective review of the clinical records of patients diagnosed with Bartonella henselae and Bartonella quintana intraocular inflammation from 2011 to 2018 in the Department of Ocular Inflammations and Infections of the University Eye Clinic of Ioannina (Greece). An analysis of the current literature concerning Bartonella-related intraocular infections was also carried out.

RESULTS:

This is a retrospective study of 13 patients (7 males and 6 females) with a mean age of 39.2 years that were diagnosed with unilateral intraocular inflammation, except one case with bilateral affection, attributed to Bartonella (either henselae or quintana). Twelve (12) patients (92.3%) had a positive history of traumatic cat contact. The main ocular clinical findings with regard to the type of uveitis included neuroretinitis in 5 eyes (38.5%), vasculitis in 3 eyes (23.1%), iridocyclitis in 2 eyes (15.4%), intermediate uveitis in 2 eyes (15.4%), posterior uveitis in 1 eye (7.7%), panuveitis in 2 eyes (15.4%), retinochoroiditis in 2 eyes (15.4%), vitritis in 1 eye (7.7%), peripheral choroidal granuloma in 1 eye (7.7%). Immunoglobulin (Ig) G was positive in all cases. All patients were treated with antibiotics (mainly rifampicin, doxycycline and azithromycin). The visual acuity was noted to be improved in all patients after treatment, but some of them experienced disturbing complications.

CONCLUSION:

CSD may manifest with various ocular pathological findings. Taking into consideration the increasing frequency of infections by B. henselae and B. quintana, clinicians should always incorporate CSD in the differential diagnosis of such presentations of uveitis. Educating vulnerable groups (children, immunosuppressed, etc.) and also general population, the appropriate preventing measures can contribute in limiting the risk of infection.

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**Comment**

While this study showed a high percentage with cat contact, many have become infected with Bartonella who were completely healthy and had no contact with cats:  https://madisonarealymesupportgroup.com/2019/03/02/skin-inflammation-nodules-letting-the-cat-out-of-the-bag/  I include links after the abstract.

Also, Bartonella can cause severe psychiatric symptoms:  https://madisonarealymesupportgroup.com/2019/03/24/cat-scratch-disease-caused-teens-schizophrenia-like-symptoms-report-says/

More on Bartonella & ocular manifestations:  https://madisonarealymesupportgroup.com/2018/09/06/ocular-manifestations-of-bartonellosis/

https://madisonarealymesupportgroup.com/2017/10/23/opthalmic-manifestations-of-bartonella-infection/

https://madisonarealymesupportgroup.com/2017/07/21/bartonella-and-neuroretinitis/

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/

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

More on Bartonella:  https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/  Slides within link.  Links included to give to Dr. Ericson’s research on Bartonella.

Missing Links? Connect the Dots Between Lyme & Mental Health

https://www.enaturalawakenings.com/FAIR/April-2019/Missing-Links/

Missing Links?

Connect the Dots Between Lyme and Mental Health

Is it possible that a tiny little tick could assault the brain and body and cause lingering mental health issues in its wake? Yes. But even with decades of research that demonstrates a causal link between infectious disease and psychiatric issues, our healthcare system still isn’t appropriately identifying and treating those afflicted with Lyme disease. The real question is: why are we missing these individuals?

It isn’t an easy answer. Ultimately the complexity of how the disease impacts the brain and body and how uniquely the symptoms can present is a major factor, as some show symptoms right away and delete others not until months or years later. A lack of definitive diagnostics is another factor in accurate identification. Lastly, a lack of acceptance of the disease and not enough Lyme-literate medical and mental health professionals is a hurdle in both diagnosis and treatment.

Research on Lyme Disease and Mental Health

Since the early 1990s, research has demonstrated a clear link between psychiatric conditions and Lyme disease, and continues to signify a connection. In 2002, Tomáš Hájek, MD and colleagues found that 33 percent of screened psychiatric patients showed signs of an infection with the Lyme spirochete, Borrelia burgdorferi. Many mental health issues have been linked to tick-borne bacteria, including: depression, mood lability, bipolar disorder, irritability, anxiety, panic attacks, obsessive compulsive disorder, attention and executive functioning problems, memory issues, word finding difficulties and even psychosis.

A 2018 study by Shreya Doshi, MA and colleagues found that in patients with post-treatment Lyme symptoms, they had depression symptoms 8 to 45 percent of the time, and suicidal ideation was reported by 19.8 percent of these patients. In 2017, Dr. Rosalie Greenberg’s study found that 89 percent of participants diagnosed with Pediatric Bipolar Disorder tested positive to one or more pathogens, including tick-borne Babesia, Bartonella and Lyme, as well as Mycoplasma pneumoniae.

Even with many research studies over decades that demonstrate a causal link between infectious disease and mental health, the average person sees between five and seven doctors before a diagnosis of Lyme disease.

Lyme’s Effect on the Brain

When Lyme disease affects the brain, it is frequently referred to as Lyme neuroborreliosis or Lyme encephalopathy. Neuroborreliosis is an infection within the brain that can mimic virtually any type of encephalopathy or psychiatric disorder and is often compared to neurosyphilis. Both are caused by spirochetes, are multi-systemic and can affect a patient neurologically, producing cognitive dysfunction (memory, word finding, attention problems) and organic psychiatric illness (anxiety, depression, OCD).

The causative agent of Lyme disease, Borrelia burgdorferi, is a highly neurotropic organism that not only can produce neurologic disease, but also can exist dormant within the central nervous system (CNS) for long periods—even months or years. It is an evolved pathogen that uses several strategies to survive in both human and animal hosts, including using a screw-like mechanism that allows the bacteria to embed in the cell’s membrane.

There are multiple ways in which Lyme disease affects the brain and body and produces changes in the CNS that leads to mental health issues. The Lyme spirochete can burrow into the brain and nervous system, causing damage within the brain that leads to long-term issues. It causes brain swelling or inflammation that leads to psychiatric issues, causes immune reactions to the bacteria and impacts the endocrine system and hormones. Lyme can impact any area of the brain, including the emotional center of the brain: the limbic system. The bacteria in Lyme releases toxins in the brain and body, and these exotoxins are continuously released as waste material that may cause symptoms.

Why is Lyme Disease Hard to Identify?

Lyme disease is known as the great imitator because its symptoms mimic and overlap with so many other diseases that it can be hard to diagnose. It is a multi-systemic illness that can affect the CNS, causing a wide array of neurologic and psychiatric symptoms. In 1994, Fallon and Nields noted up to 40 percent of patients with Lyme disease develop neurologic involvement of either the peripheral or central nervous system.

Most people don’t realize that there are three stages of Lyme disease: early with dermatological symptoms, disseminated, and late stage. Late stage Lyme is when there is a dissemination of the bacteria to the CNS, which can occur within as little as two weeks. Lyme disease may lie dormant for months to years before symptoms of late infection emerge when something (head injury, toxins, EMF) causes the bacteria to cross the blood-brain barrier into the brain.

Patients with late stage Lyme disease present with a variety of neurological and psychiatric problems, ranging from mild to severe, which makes it very hard to connect to infectious disease. Most patients have no recollection of tick bite or falsely believe that a tick has to be engorged to carry bacteria and parasites that can be transmitted. Moreover, they are often told that their prior Lyme disease was “cured” and can’t be related to their current symptoms. These problems delay treatment and make it more likely to have late stage Lyme with a neurocognitive or neuropsychiatric impact.

Common Features of Psychiatric Issues Due to Lyme

Since tick-borne bacteria affects the CNS as noted previously, a multitude of symptoms can present. Afflicted individuals can show symptoms immediately or months later and can show a combination of physical, cognitive or psychiatric issues.

Common symptoms of tick-borne disease include: chronic fatigue, sleep problems, brain fog, cognitive and memory impairments, slowed cognitive processing, attention or executive functioning deficits, depression or mood dysregulation, anxiety, OCD, sensory sensitivity, irritability, anger and headaches.

It is important to note that one can have a pre-existing condition prior to Lyme disease that can exacerbate with infectious disease, which further complicates proper diagnosis and treatment. Lyme and tick-borne disease is co-morbid with ADHD, autism, sleep disorders, depression, anxiety disorder, pain and migraines, and can be a source of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).

What Should You Do? 

If you or your child has a history of unexplained medical and mental health symptoms or haven’t gotten better with traditional therapies and psychotherapy, consider that infectious disease might be the source of your mental health issue. It is important to note that infectious disease takes many forms and that one may have a single illness, but it is more likely that one is affected by more than one infection, including strep, virus, other bacteria or environmental contaminants such as mold.

The first step is to find a Lyme-literate medical or mental health professional for proper diagnosis and treatment. The best way to do that is to seek a referral from a trusted friend or from Lyme organizations at the regional or national level, such as ILADS, your state Lyme organization or PANDAS.org. As many a patient who has taken this path can attest, you waste your time and may cause further damage to your health by going to an untrained professional. 

Dr. Roseann Capanna-Hodge is an integrative psychologist, certified neurofeedback practitioner and director of wellness centers in Ridgefield and Newtown. She is a member of ILADS and is a co-author of Brain Under Attack: A Resource Guide for Parents and Caregivers of Children with PANS, PANDAS, and Autoimmune Encephalitis for the nonprofit organization Epidemic Answers. Connect at 203-438-4848, Info@DrRoseann.com or DrRoseann.com

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**Comment**

So thankful for mental health professionals who understand what’s happening in Lyme-land.  Her advice about finding a Lyme literate professional was also spot on as you will waste a lot of money if you see mainstream medicine for this.

For more on what Lyme/MSIDS can do to the brain:  https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/

https://madisonarealymesupportgroup.com/?s=psychiatric+lyme

https://madisonarealymesupportgroup.com/2010/08/09/tom-grier-lyme-lecture-outline/

https://madisonarealymesupportgroup.com/2010/08/18/lyme-on-the-brain-part-2-by-tom-grier/

https://madisonarealymesupportgroup.com/2010/08/27/lyme-on-the-brain-by-tom-grier-part-3-a-lecture-notes/

https://madisonarealymesupportgroup.com/2010/08/29/lyme-on-the-brain-by-tom-grier-part-3-b-lecture-notes/

https://madisonarealymesupportgroup.com/2010/08/30/lyme-on-the-brain-by-tom-grier-part-4-lecture-notes/

 

 

Human Ehrlichiosis: Clinical Associations & Outcomes of Transplant Patients & Patients With Hemophagocytic Lymphohistiocytosis

https://www.ncbi.nlm.nih.gov/pubmed/30913447

Human ehrlichiosis at a tertiary-care academic medical center: Clinical associations and outcomes of transplant patients and patients with hemophagocytic lymphohistiocytosis.

Abstract

BACKGROUND:

Ehrlichiosis is an acute febrile tick-borne disease which can rarely be a trigger for secondary hemophagocytic lymphohistiocytosis (HLH).

METHODS:

We reviewed our experience with Ehrlichia infections at a tertiary-care academic medical center.

RESULTS:

Over 10  years, 157 cases of ehrlichiosis were identified. Ten patients (6.4%) had infection with E. ewingii, 7(4.5%) of whom were transplant patients as compared to 3(1.9%) non-transplant patients (p = .035). Transplant patients were more likely to have leukopenia and elevated creatinine compared to immunocompetent patients; length of hospital stay and early mortality were not different between the two groups. Ten patients met the HLH-2004 diagnosis criteria, which could be an underestimation of HLH occurrence as most patients were not completely evaluated for these criteria. We calculated the H-Score to find the probability of HLH; 25 patients scored high making the occurrence rate of HLH at least 16%. Ehrlichia-induced HLH patients (N = 25) had more anemia, thrombocytopenia, elevated creatinine and AST. Moreover, they had a significantly longer hospital stay (median 9 days) compared to patients without HLH (median 4 days) (p = .006).

CONCLUSIONS:

Ehrlichia-induced HLH is a potential serious complication with relatively high occurrence rate; patients manifest severe disease with end-organ damage requiring longer hospital stay.

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For more:  https://madisonarealymesupportgroup.com/?s=ehrlichiosis+