Archive for the ‘research’ Category

Manifestation of Anaplasmosis as Cerebral Infarction: a Case Report

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3321-4

Manifestation of anaplasmosis as cerebral infarction: a case report

  • Seok Won Kim†, Choon-Mee Kim†, Dong-Min Kim and Na Ra Yun
†Contributed equally
BMC Infectious Diseases201818:409

https://doi.org/10.1186/s12879-018-3321-4

Abstract

Background

Human granulocytic anaplasmosis is a tick-borne zoonotic disease caused by Anaplasma phagocytophilum, an obligate intracellular granulocytotropic bacterium.

Case presentation

A 70-year-old female patient was admitted with the clinical signs of fever and an altered state of consciousness 1 week after experiencing a tick bite while planting lawn grass. Magnetic resonance imaging, performed at the time of admission, indicated cerebral infarction in the left basal ganglia, whereas increasing immunofluorescence assay antibody titers for A. phagocytophilum were also documented. A. phagocytophilum was identified using groEL and ankA targeted polymerase chain reaction and sequencing. Because of severe thrombocytopenia, only doxycycline was administered, without any antiplatelet agents. Subsequently, the symptoms improved without any focal neurologic sequela.

Conclusion

This is the first reported case of cerebral infarction occurrence in an anaplasmosis patient.

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**Comment**

I could literally hug these researchers who didn’t make the mistake of pronouncing this to be a “rare occurrence.”  They wisely stated it is the first reported case. 

Big difference.

Please notice the altered state of consciousness.  This stuff is surreal and unless you’ve had it, nearly unbelievable.  The basal ganglia is often affected with Lyme/MSIDS and certainly has been a marquee symptom for me personally.  Thankful this woman got prompt treatment.  Let’s pray the doxy was enough but she should be followed up on.  

Most practitioners don’t treat this seriously enough.  It can kill you.

It is a head scratcher; however, that even with severe thrombocytopenia (low platelets) and a cerebral infarction in the brain, it appears she obtained just 12 days of doxycycline.  This is a great example of an issue for further research as to treatment type and duration.  Just because “the patient exhibited an improvement in symptoms after doxycycline treatment and was discharged on the 12th day with no specific sequela,” does not mean she’s out of the woods.

 

 

 

Category:

Anaplasmosis, research, Testing, Treatment

As the Threat of Lyme Disease Rises, Why Hasn’t Research Funding Followed Suit?

https://undark.org/2018/09/06/lyme-research-funding/

As the Threat of Lyme Disease Rises, Why Hasn’t Research Funding Followed Suit?

The tick-borne illness now costs Americans up to $1.3 billion a year in medical expenses. It’s time for politicians to mount a response.
/ By Rocky Kistner Federal funding for Lyme disease research has stagnated in recent years.  Visual: NIH NIAID/Flickr
In 1987, Sherrill Franklin was pregnant and living in Delaware County, Pennsylvania, when she discovered a rash on her leg as big as a dinner plate. She had been bitten by a tick. She soon began to suffer fatigue, a sore throat, and severe arthritis that made her hands feel “like claws.” It took almost two years, and a three-week course of intravenous antibiotics, for her to get back on her feet.
Two decades later, Franklin got a second tick bite, and this time she developed more extensive neurological symptoms. She lost weight, experienced heart complications, and had to be rushed to the hospital by ambulance. She was eventually diagnosed with Graves’ disease, an immune disorder that her endocrinologist said could have been triggered by Lyme disease. Today, Franklin is still experiencing symptoms. After countless visits to health care experts, she says she’s spent $50,000 of her own money on medical help.

 

“The best thing about Lyme disease is you usually don’t die,” Franklin says. “The worst thing about it is that you don’t die.”

Franklin is not alone. According to the U.S. Centers for Disease Control and Prevention (CDC), annual cases of Lyme disease and other tick-borne illnesses in the U.S. have skyrocketed to more than 300,000 — up from just 50,000 three decades ago. And those totals are thought to underestimate the true tally of patients who suffer from chronic tick-borne illnesses. A Johns Hopkins study estimates that Americans now spend up to $1.3 billion a year battling Lyme disease alone. Yet, the research that could help us better understand, treat, and prevent the disease remains woefully underfunded. That needs to change.

The recent explosion in Lyme disease cases stems from a perfect storm of climate and environmental change: Global warming has made northern latitudes more hospitable to the tiny blacklegged ticks that transmit the disease, and rapid deforestation and development have left large populations exposed to the wooded areas that harbor the ticks. The CDC reports that the number of tickborne illnesses in the U.S. has doubled from 2004 to 2016, and a new study finds that Lyme disease, once primarily a scourge of the northeast, has now spread to all 50 states. Economist Marcus Davidsson predicts that as many as one million Americans will be infected in 2018. And experts say it will only get worse.  (Please see my comment after article)

The growing medical crisis has exacted not only a physical but a financial toll as well. Policy experts say that, after accounting for lost productivity and hard-to-detect chronic conditions, the real costs of Lyme disease could be many times more than the $1.3 billion estimated in the Johns Hopkins study.

Laurie Johnson, executive director of the Climate Cost Project, and co-founder Sieren Ernst are working to home in on the true societal costs of Lyme disease. The team has been collecting surveys from Lyme disease patients to create a database of the patients’ medical expenses. So far, the results are astounding. Half of the respondents reported more than $30,000 in out-of-pocket expenditures on Lyme disease treatments, with some reporting more than $200,000.

“We believe the data is just the tip of the iceberg,” Ernst says.

What’s more, the rising threat of tick-borne disease has led Americans to take fewer trips outdoors — up to a billion fewer trips annually in the northeastern U.S. alone, according to a Yale study published last year. The authors of that study estimate that the economic burden associated with the lost trips could amount to as much as $5 billion annually.

As the societal costs of Lyme disease soar, funding for Lyme disease research remains in a rut. An unpublished draft report by the U.S. Department of Health and Human Services Tick-Borne Disease Working Group finds that, while the National Institutes of Health and the CDC spend $53,571 and $14,054 respectively for each new case of HIV/AIDS, they spend just $90 and $35 per new case of Lyme disease.

“Federal funding for tick-borne disease today is orders of magnitude lower, compared to other health threats, and it has failed to increase as the problem has grown,” the report states.

Dr. John Aucott, chair of the working group and director of the Johns Hopkins Lyme Disease Research Center, says the federal research community is not doing enough to find an accurate test and a cure for Lyme disease. He adds that the problem is compounded by controversies surrounding the symptoms of chronic Lyme disease, which makes it difficult for patients to get proper medical care.

In late August came a ray of hope from Capitol Hill. Senate Minority Leader Charles Schumer announced that, after five years of stagnant funding, the Senate had authorized a 12 percent increase for the CDC’s research on Lyme disease and other tick-borne illnesses for the 2019 fiscal year. The measure would raise allocations from $10.7 million to $12 million.

Still, patients like Sherrill Franklin say that’s sorely inadequate, and that the measure would do little to address chronic conditions that afflict millions like her. As the planet warms and populations grow, tick-borne illnesses are skyrocketing. It’s time for politicians to mount a serious response to the rising threat.

William “Rocky” Kistner is a multimedia journalist who writes about environmental issues and climate change. He publishes stories at www.TheRockyFiles.com and lives near Washington, D.C.

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**Comment**

Once again, according to independent tick researcher John Scott, the climate has absolutely nothing to do with the spread of ticks and therefore Lyme/MSIDS:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/ A recent study shows that warm winters are lethal to I. scapularis (black-legged) ticks. In fact, overwinter survival dropped to 33% when the snow melted. This has been substantiated by other researchers as well. Scott & Scott, 2018, ticks and climate change, JVSM

This is an important distinction for a number of reasons:

  1. Earmarking tick/MSIDS research with the moniker “climate change” will divert precious money to the wrong subject matter when issues like accurate testing, education on how to clinically diagnose, settling the matter of pathogen persistence once and for all, and the need for research studying the cumulative effects of ALL of the pathogens involved on the human body would get a great start in helping patients.  But, there are hundreds of other topics as well.  
  2. Scott goes as far as to state the climate change issue is a “red herring” to divert attention away from the fact nothing has been done to help patients in over 40 years and is actually part of a “nefarious plot.”  https://madisonarealymesupportgroup.com/2017/08/14/canadian-tick-expert-climate-change-is-not-behind-lyme-disease/
  3. Scott, infected himself, has determined black legged ticks require 14 hours to molt to the next stage, something he dubs “photo period.”  Light has much more of an impact on ticks than climate as ticks are marvelous ecoadaptors and will seek out leaf litter and snow when conditions become harsh.
  4. Scott offers that yearly bidirectional, songbird migration in spring and fall is behind tick expansion and that the climate change model actually reflects migratory flight not warmer futuristic temperatures.
  5. Research on migratory birds and their impacts on tick expansion would be a far better topic to spend money on than more climate data.
  6. We need to know if other insects can transmit this.  To date, researchers smugly point to a 30 year old study and say it can’t, yet patients all over the world have far different experiences:  https://madisonarealymesupportgroup.com/2018/03/01/strides-in-lyme-research-links-to-mosquitos-as-carriers/.  The potential for ALL blood sucking insects to transmit all or some of the pathogens commonly blamed on ticks is very real.  And just because it can’t be seen doesn’t mean it isn’t there.  These are notoriously stealthy pathogens who thrive on hiding and avoiding detection.
  7. We all know that MS, Lupus, Fibro, ALS, dementia, and Alzheimer’s can be undiagnosed Lyme as well as the fact that according to a prominent Wisconsin Lyme doctor, 80% of his PANS/PANDAS patients have Lyme/MSIDS as well.  Research on these topics would again, be far more helpful than the same – o- same-o climate data that’s been collected for years.
  8. Since many couples are infected and they’ve actually found borrelia in semen and vaginal secretions, we need to know if this is a STD:  https://madisonarealymesupportgroup.com/2017/02/24/pcos-lyme-my-story/  We also need the medical community to admit it’s congenital and spread via breast milk https://madisonarealymesupportgroup.com/2018/06/19/33-years-of-documentation-of-maternal-child-transmission-of-lyme-disease-and-congenital-lyme-borreliosis-a-review/ and https://madisonarealymesupportgroup.com/2018/05/24/new-berlin-mom-given-life-altering-lyme-disease-diagnoses-after-pregnancy/  These are practical day to day issues that require answers.  Knowledge is power and we need it!  I literally could go on and on to infinity here but these 7 issues are screaming for research.  Nobody is touching this with a 10 foot pole yet life marches on with the very real probability we are transmitting this is far more ways than the dastardly black legged tick.  We need to know.
We needed to know these answers 40 years ago.

Category:

Activism, Lyme, research, Testing, Ticks, Transmission

Bartonella Infectious Endocarditis Associated with Cryoglobulinemia & Multifocal Proliferative Glomerulonephritis

https://www.ncbi.nlm.nih.gov/pubmed/30151411

Open Forum Infect Dis. 2018 Jul 27;5(8):ofy186. doi: 10.1093/ofid/ofy186. eCollection 2018 Aug.

Bartonella Infectious Endocarditis Associated With Cryoglobulinemia and Multifocal Proliferative Glomerulonephritis.

Babiker A1, El Hag MI2, Perez C1.

Abstract
Bartonella sp. are a common cause of culture-negative infective endocarditis. Glomerulonephritis is a well-documented consequence of the immune activation associated with infective endocarditis. However, Cryoglobulinemia has not previously been reported in association with Bartonella infective endocarditis. Below we report a case of a 48-year-old male with Bartonella henselae infective endocarditis complicated by cryoglobulinemia and multifocal proliferative glomerulonephritis, highlighting a possible link between Bartonella sp. infection and type III cryoglobulinemia.

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**Comment**

Word on how devastating Bartonella is, is finally getting out.

https://www.kidney.org/atoz/content/glomerul  Glomerulonephritis is a group of diseases that injure the part of the kidney that filters blood (called glomeruli). Other terms you may hear used are nephritis and nephrotic syndrome. When the kidney is injured, it cannot get rid of wastes and extra fluid in the body. If the illness continues, the kidneys may stop working completely, resulting in kidney failure. There are two types of glomerulonephritis—acute and chronic. The acute form develops suddenly. You may get it after an infection in your throat or on your skin. Sometimes, you may get better on your own. Other times, your kidneys may stop working unless the right treatment is started quickly. The early symptoms of the acute disease are:

  • puffiness of your face in the morning
  • blood in your urine (or brown urine)
  • urinating less than usual.
  • short of breath
  • cough because of extra fluid in your lungs
  • high blood pressure.

The chronic form may develop silently (without symptoms) over several years. It often leads to complete kidney failure. Early signs and symptoms of the chronic form may include:

  • Blood or protein in the urine (hematuria, proteinuria)
  • High blood pressure
  • Swelling of your ankles or face (edema)
  • Frequent nighttime urination
  • Very bubbly or foamy urine

Symptoms of kidney failure include:

  • Lack of appetite
  • Nausea and vomiting
  • Tiredness
  • Difficulty sleeping
  • Dry and itchy skin
  • Nighttime muscle cramps

https://www.vasculitisfoundation.org/education/forms/cryoglobulinemia/  Cryogloblinemia is a vasculitis of small blood vessels that is caused by deposition of immune complexes: large aggregates of antibodies and the other proteins they are bound to. Some other types of vasculitis are also caused by immune complexes, but cryoglobulinemia is defined by a laboratory test that identifies immune complexes that fall out of solution in the cold. The severity of the disease is highly variable. Skin, joints, and nerves are commonly affected. Kidney disease is somewhat less common and with a wide range of severity. The heart, brain, or gastrointestinal tract each are affected in fewer than 10% of cases.  Most patients with cryoglobulinemia are chronically infected with hepatitis C virus (HCV). Many of the remaining patients with cryoglobulinemia have lupus, Sjogren’s syndrome, rheumatoid arthritis, or white blood cell cancers (lymphoma, myeloma, or Waldenstrom’s macroglobulinemia) as the underlying cause.

Symptoms include:

  • weakness
  • fatigue
  • sore joints or muscles
  • purpura (bright red circles, from the size of a pinhead up to half an inch, often painful or itchy)
  • open sores are also common
  • damage to nerves (neuropathy) causes numbness, tingling, severe burning pain, and or weakness in a hand or foot
  • involvement of the gastrointestinal organs causes abdominal pain
  • heart involvement could cause symptoms of a heart attack (chest pain) or congestive heart failure (difficulty breathing, swelling in the legs)
  • brain involvement can cause strokes, including multiple small strokes, and might also cause headache
  • any symptoms that resolve within a few hours are unlikely to be caused by vasculitis
  • kidney disease causes no symptoms until severe kidney failure occurs

Most patients will have a biopsy of skin or nerve that shows vasculitis, or a kidney biopsy that shows a characteristic type of inflammation called membranoproliferative glomerulonephritis (MPGN). In those settings, a positive blood test for cryoglobulins establishes the diagnosis of cryoglobulinemia. In patients with syndromes highly suggestive of cryoglobulinemia, the blood test may allow diagnosis without biopsy.

For patients with HCV, anti-viral therapy is indicated regardless of the degree of severity. For less severe cases (e.g., purpura, weakness, and joint pain), anti-viral therapy alone is the treatment of choice. Involvement of vital organs requires addition of immune-suppressive drugs. Prednisone, azathioprine, and cyclophosphamide have been widely used, but recent studies have indicated that rituximab may be superior to these medications. Cryoglobulinemia without HCV infection is also treated using these medications or methotrexate (which is not used in HCV-infected patients), but no comparison of treatments has been reported. Patients with life-threatening or organ-threatening cryoglobulinemic vasculitis often receive plasmapheresis in addition to immune-suppressive medications.

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Bartonella and vasculitis are pretty common in Lyme-land.  This article shows how two young women developed cerebral vasculitis after receiving Gardasil & subsequently died:  https://madisonarealymesupportgroup.com/2017/02/16/gardasil-vasculitis-msids/

For more on Bartonella:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/  Bartonella causes vascular disease, and has an affinity for endothelial cells, red blood cells, microglial cells, macrophages, and CD34 progenitor cells hindering nutrient, oxygen, and antibiotic delivery due to vascular trauma causing pain, fatigue, cognitive/mood issues, and vascular tumors.
Bartonella has been found in 50-95% in selected rodent, cat, deer, and cattle populations. It causes lameness, endocarditis, grandulomatous lymphadenitis (chronic inflammation and buildup of immune cells), and peliosis hepatis (blood filled cavities in the liver) in dogs.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88941/
Drs. Breitschwerdt and Mozayeni report over 60% of Lyme patients were also seroreactive to Bartonella antigens.

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

https://madisonarealymesupportgroup.com/2018/07/10/infective-endocarditis-associated-with-bartonella-henselae-a-case-series/

https://madisonarealymesupportgroup.com/2017/05/20/bartonella-endocarditis-opportunistic-infection-in-cancer-patients-and-eye-inflammation/

And, this article points out that in Nova Scotia, 76% of dog ticks and 40 per cent of black-legged ticks tested carried Bartonella, which causes endocarditis, and several other serious and potentially fatal diseases in humans.  https://madisonarealymesupportgroup.com/2018/09/07/lyme-taking-toll-on-lunenburg-county-search-and-rescue-team/

So ticks, and not just the dreaded black legged tick, carry Bartonella.  It’s time for mainstream medicine to accept that Lyme/MSIDS patients very well could be contracting Bartonella, Lyme, and a whole host of tick borne infections with one bite.  If the tick isn’t transmitting it, the bite is perhaps activating a latent infection, but either way, WE GOT IT.

Category:

Bartonella, research

Ocular Manifestations of Bartonellosis

https://www.ncbi.nlm.nih.gov/m/pubmed/30124532/

Ocular manifestations of bartonellosis.

Curr Opin Ophthalmol. 2018 Aug 18. doi: 10.1097/ICU.0000000000000522. [Epub ahead of print]

Authors
Mabra D1, Yeh S2, Shantha JG2.
Abstract

PURPOSE OF REVIEW: To review the systemic and ocular complications of Bartonella spp. infections specifically cat scratch disease, encompassing epidemiology, laboratory diagnostics, ophthalmic imagining, and treatment.

RECENT FINDINGS: Recent studies have shown that ocular manifestations occur in approximately 4.4% of cat scratch disease patients. The annual prevalence is lower than previously reported to be approximately 12 500 cases annually. Mainstay treatment continues to be oral antibiotics with and without corticosteroids and is dependent on associated systemic manifestations, age, and patient immune status. More recently anti-VEGF agents have been used for complications such as cystoid macular edema and choroidal neovascularization.

SUMMARY: Bartonella spp. infections continue to be a common cause uveitis with ophthalmic manifestations ranging from neuroretinits, vascular occlusions, to choroidal granulomas. Review of associated risk factors including contact with feline reservoirs will aid in recognition and diagnosis of this disease entity. Laboratory diagnostics continue to improve to help with the diagnosis of this entity.

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**Comment**

Thankful that more is coming out on how Bartonella affects the eyes.  This crossed my desk just last year:  https://madisonarealymesupportgroup.com/2017/10/23/opthalmic-manifestations-of-bartonella-infection/

As well as these:  https://madisonarealymesupportgroup.com/2017/07/21/bartonella-and-neuroretinitis/

https://madisonarealymesupportgroup.com/2017/04/06/ocular-bartonellosis/

What ISN’T coming across my desk is the fact many feel strongly that ticks carry and transmit Bartonella.  Mainstream medicine & researchers still mostly deny this to the demise of patients.  Bartonella alone is a formidable foe, but couple it with Lyme and other viruses and tick borne infections and you have a seriously ill patient on your hands.  Regardless if it is transmitted by ticks, there is also the potential of reactivating latent infections within the body when bitten by a tick.  So if the Bart is hanging around but the patient is asymptomatic, a tick bite could activate the latent Bart and cause a hail storm of symptoms.  In my experience testing is horrific in this area and wise doctors treat patients based upon clinical presentation.

Research is required in this area.  Doctors need to know about the potential for this pathogen to be in the mix of tick borne illnesses.  This is another reason why the mono therapy of doxycycline rarely works in patients.  They are often dealing with more than one pathogen/illness.

Until this changes people will not improve.

According to this doctor, Bartonella is the new Lyme:  https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

 

 

 

 

 

 

 

 

 

Category:

Bartonella, Eye Issues, research, Transmission, Treatment

PCR Assays for Borrelia Hermsii (Tick-borne Relapsing Fever Species)

https://www.ncbi.nlm.nih.gov/m/pubmed/30131238/

Novel real-time PCR assays for genomic group identification of tick-borne relapsing fever species Borrelia hermsii.

Modarelli JJ, et al. Diagn Microbiol Infect Dis. 2018.
Diagn Microbiol Infect Dis. 2018 Aug 8. pii: S0732-8893(18)30257-8. doi: 10.1016/j.diagmicrobio.2018.08.001. [Epub ahead of print]

Abstract

Borrelia hermsii is a non-Lyme borreliosis pathogen that is responsible for causing tick-borne relapsing fever in humans and animals in the western United States. B. hermsii has been described to encompass two divergent genomic groups, GGI and GGII, which have been suggested to maintain a unique geographical distribution and potential range of pathogenicity. Though the genomic groups have been extensively documented in the literature, a real-time PCR tool for identifying these genomic groups is lacking. This study describes the development and validation of two flaB-based quantitative real-time PCR assays for differentiating between the two genomic groups of B. hermsii while also maintaining specificity against other closely related Borrelia species. The diagnostic specificity of the assays were evaluated using a large panel of various Borrelia species, including a collection of 22 B. hermsii culture isolates purified from various hosts. The high sensitivity and specificity of the assays provide a useful tool for supporting future studies aimed at evaluating the geographical distribution as well as potential intraspecies pathogenicity within arthropod vectors and mammalian hosts.

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**Comment**

While the study outcome was to determine geographical distribution and potential intraspecies pathogenicity, I for one would like to see a switch in thinking to less concern for geography and more concern for accurate testing for patient diagnosis.  The geographical emphasis has worked against patients for over 40 years and according to everything coming across this desk, I think we need to embrace this pandemic for what it is – a pandemic that knows no borders.

The sooner we quit looking at maps the sooner patients are going to be believed, validated, and actually helped.

Go here for more on Tick-relapsing fever:  https://madisonarealymesupportgroup.com/2018/09/04/borrelia-miyamotoi-in-immunocompetent-patient/  Please notice Dr. Cameron’s comment about another relapsing fever caused by Bm:  “You might assume a patient infected with Borrelia miyamotoi, a relapsing fever spirochete, to present with a relapsing fever. However, your assumption would be wrong 48 out of 50 times, according to a case series published in the Annals of Internal Medicine. [1] The authors found that only 2 out of 50 patients infected with the relapsing spirochete B. miyamotoi actually presented with a relapsing fever. [1]….The individuals exhibited symptoms similar to those found in other tick-borne illnesses.

So while researchers are trying to separate out all the various strains and the particular geography, clinicians are struggling with the fact that although many of the strains are supposed to be “relapsing fever” they actually present clinically like other TBI’s such as Lyme and cause a clinical picture quite different from relapsing fever.  This is paramount for clinicians to understand as the patients showing up in their offices have symptoms quite different from what the researchers are stating.

Be your own advocate and learn as much as you can.  Chances are you will be educating your practitioner.

 

Category:

Borrelia Miyamotoi (Relapsing Fever Group), research, Testing