Introduction: Antinuclear antibody (ANA) tests are widely used for the diagnosis of autoimmune diseases, but ANAs are also commonly found in patients with various infections. This retrospective study aimed to investigate the relationship between infections and ANA status.
Methods: Patients that visited the Department of Infectious Diseases at Inha University Hospital between January 2007 and July 2018 were investigated. We analysed their ANA test results and reviewed rheumatic and infectious diagnoses of patients with positive ANA findings.
Results: Of the 9,320 patients during the study period, 1,111 underwent ANA testing and 110 tested positive. Seven of the 110 patients were previously diagnosed with ANA-positive disease, and 21 were diagnosed with autoimmune disease during the present study. Of the remaining 82 patients, 43 were confirmed with infectious disease. The most common pathogen was Mycobacterium tuberculosis (n = 10), followed by Treponema pallidum (n = 5), Orientia tsutsugamushi (n = 5), Escherichia coli (n = 5), Bartonella henselae(n = 3), and human immunodeficiency virus (n = 3). Of the 39 patients without a confirmed pathogen, 7 were seropositive for O. tsutsugamushi, B. henselae, or Rickettsia spp. Patients were observed at an average of 24 weeks in our hospital. One patient developed systemic lupus erythematosus after being diagnosed with Epstein-Barr virus-induced infectious mononucleosis, and another patient developed adult-onset Still’s disease after being diagnosed with scrub typhus.
Conclusion: This study showed that various relationships exist between infections and rheumatic diseases. In particular, several patients with a positive ANA test result were found to have intracellular infections such as mycobacterial infections, syphilis, or scrub typhus.
Both Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae (SFGR) are pathogens carried by ticks. There is a possibility of co-infection with these tick-borne diseases.
Male patient, 63 years-of-age, admitted to hospital with skin rash presenting for 1 week and fever with cough and expectoration for 3 days before admission.
We diagnosed that the patient was co-infected by B burgdorferi sl and SFGR using laboratory test results and the patient’s clinical manifestations.
The patient started therapy with oral minocycline, then levofloxacin by intravenous injection for SFGR. Meanwhile, he was treated with penicillin G sodium, cefoperazone sulbactam sodium and ceftriaxone by intravenous injection for B burgdorferi sl.
After the patient was in stable condition, he was discharged from hospital.
This case report highlights the possibility of co-infection by 2 tick-borne diseases in Urumqi, Xinjiang Uygur Autonomous Region, China. The antibiotic therapy should be based on the detection of pathogenic bacteria, and the different susceptibilities of co-infecting bacteria should be considered.
Persistent and debilitating fatigue characterized coinfection.
ANIMAL STUDIES ALSO SHOW ENHANCED SEVERITY WITH LYME & BABESIA
https://www.sciencedirect.com/science/article/abs/pii/S0020751918302406 Similar to humans, B. microti coinfection appears to enhance the severity of Lyme disease-like symptoms in mice. Coinfected mice have lower peak B. microti parasitaemia compared to mice infected with B. microti alone, which may reflect attenuation of babesiosis symptoms reported in some human coinfections. These findings suggest that B. burgdorferi coinfection attenuates parasite growth while B. microti presence exacerbates Lyme disease-like symptoms in mice.
Mainstream medicine hasn’t even factored this into the equation yet.
As tick-borne diseases continue to emerge across the United States, there is need for a better understanding of the tick and pathogen communities in the southern states and of habitat features that influence transmission risk. We surveyed questing and on-host ticks in pine-dominated forests with various fire management regimes in the Sam Houston National Forest, a popular recreation area near Houston, Texas. Four linear transects were established- two with a history of controlled burns, and two unburned. Systematic drag sampling yielded 112 ticks from two species, Ixodes scapularis (n=73) and Amblyomma americanum (n=39), with an additional 106 questing ticks collected opportunistically from drag cloth operators.
There was a significant difference in systematically-collected questing tick density between unburned (15 and 18 ticks/1000 m2) and burned (2 and 4 ticks/1000 m2) transects. We captured 106 rodents and found 74 ticks on the rodents, predominantly Dermacentor variabilis. One unburned transect had significantly more ticks per mammal than any of the other three transects. DNA of Rickettsia species was detected in 146/292 on and off-host ticks, including the ‘Rickettsial endosymbiont of I. scapularis’ and Rickettsia amblyommatis, which are of uncertain pathogenicity to humans. Borrelia lonestari was detected in one A. americanum, while Borrelia burgdorferi sensu stricto, the agent of Lyme disease, was not detected in any tick samples. Neither Borrelia nor Rickettsia spp. were detected in any of the mammal ear biopsies (n=64) or blood samples (n=100) tested via PCR.
This study documents a high prevalence in ticks of Rickettsia spp. thought to be endosymbionts, a low prevalence of relapsing fever group Borrelia in ticks, and a lack of detection of Lyme disease-group Borrelia in both ticks and mammals in an east Texas forested recreation area. Additionally, we observed low questing tick density in areas with a history of controlled burns. These results expand knowledge of tick-borne disease ecology in east Texas which can aid in directing future investigative, modeling, and management efforts.
Minimal Duration of Tick Attachment Sufficient for Transmission of Infectious Rickettsia rickettsii (Rickettsiales: Rickettsiaceae) by Its Primary Vector Dermacentor variabilis(Acari: Ixodidae): Duration of Rickettsial Reactivation in the Vector Revisited
It has been reported that starving ticks do not transmit spotted fever group Rickettsia immediately upon attachment because pathogenic bacteria exist in a dormant, uninfectious state and require time for ‘reactivation’ before transmission to a susceptible host. To clarify the length of reactivation period, we exposed guinea pigs to bites of Rickettsia rickettsii-infected Dermacentor variabilis (Say) and allowed ticks to remain attached for predetermined time periods from 0 to 48 h. Following removal of attached ticks, salivary glands were immediately tested by PCR, while guinea pigs were observed for 10–12 d post-exposure. Guinea pigs in a control group were subcutaneously inoculated with salivary glands from unfed D. variabilis from the same cohort. In a parallel experiment, skin at the location of tick bite was also excised at the time of tick removal to ascertain dissemination of pathogen from the inoculation site. Animals in every exposure group developed clinical and pathological signs of infection.The severity of rickettsial infection in animals increased with the length of tick attachment, but even attachments for less than 8 h resulted in clinically identifiable infection in some guinea pigs.Guinea pigs inoculated with salivary glands from unfed ticks also became severely ill.Results of our study indicate that R. rickettsii residing in salivary glands of unfed questing ticks does not necessarily require a period of reactivation to precede the salivary transmission and ticks can transmit infectious Rickettsia virtually as soon as they attach to the host.
For far too long authorities have told us that there’s something called a “grace period,” in which ticks supposedly delay transmitting pathogens to us and that a period of 24-48 hours is required before we can become infected.
There is only one study which they base that information upon, and there’s never been a study on the minimum time for transmission.
This study blows the “grace period” theory out of the water and proves what we all know to happen in reality. People can become infected in mere hours upon attachment. It also proves another point as well: that some ticks have the pathogens already in their salivary glands making transmission times even shorter.
How many have been sent home with a false sense of security after a doctor, going by information authorities have proliferated, told them they can’t be infected because the tick wasn’t attached for a long enough period of time? Thousands?
Please spread the word. There shouldn’t be any more patients falling through the cracks.
Rickettsial diseases or rickettsioses are infections caused by various bacteria belonging to the genus Rickettsia. These bacteria are transmitted through the bites of certain hard-bodied ticks and some other arthropods. Rickettsial diseases are not to be confused with rickets, which is a condition affecting the bones and resulting from vitamin D deficiency.
The infections caused by Rickettsia bacteria have traditionally been classified into two groups: spotted fever and typhus. However, they’re sometimes divided into further categories. Either way, all groups include species of pathogens that can infect humans. Although Rickettsia bacteria can be found worldwide, the most common rickettsial illnesses are normally contracted in Africa and Asia.
Lyme disease is also transmitted to humans by ticks. It’s the most common tick-borne illness in the northern hemisphere. However, Lyme isn’t a rickettsial disease, since it’s caused by a bacterium of a different genus: Borrelia burgdorferi.
However, the same tick that carries Rickettsia bacteria might also be infected with Borrelia burgdorferi. Therefore, it’s possible to contract both illnesses via one tick bite. Therefore, the answer to question ‘is Rickettsia a Lyme co-infection?’ is that yes – rickettsiosis can be a potential co-infection of Lyme disease.
What Are The Symptoms of Rickettsia Diseases?
Some of the most common rickettsial diseases are Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis and typhus. All of these are generally difficult to diagnose. Some of them rarely cause symptoms, and most of them only cause moderate illness even when symptomatic. However, certain forms of spotted fever and typhus may be fatal if left unrecognised and untreated. The sooner these illnesses are diagnosed, the easier they are to treat using antibiotics.
The clinical presentation of rickettsial diseases varies greatly. Even infections caused by the same species of bacteria may produce different symptoms in different patients. Nonetheless, the most common symptoms include
rashes and eschar (a piece of dry and dark dead skin at the site of the bite). These tend to develop within two weeks after the bacteria have entered the body.
African tick bite fever is one of the mildest forms of rickettsiosis. Patients usually present with fever, headache, muscle pain and an eschar shortly after contracting the disease during a visit to southern Africa.
Mediterranean spotted fever is a serious and potentially life-threatening illness. It’s prevalent in the Mediterranean region, including northern Africa. In addition to fever, rashes and an eschar are typical signs of the illness.
Patients with Rocky Mountain spotted fever often experience fever, headache, nausea, and stomach pain. A rash at the site of the bite is also commonly seen, but eschars aren’t usually present.
The only common symptom of murine or endemic typhus is fever. About half of all patients also develop a rash. Scrub typhus can be contracted in Asia, and it’s characterised by a severe fever, headache and muscle pain. An eschar, cough, enlarged lymph nodes and encephalitis (inflammation of the brain) may also occur in some patients.
The symptoms of ehrlichiosis and anaplasmosis are similar to those of other rickettsial diseases. However, they’re also known to significantly reduce white blood cell count in affected people.
Is Rickettsia The Same As Lyme Disease?
Rickettsiosis and Lyme disease share several symptoms in their early stages, such as fever, headache, fatigue, malaise and muscle pain. Moreover, all of these symptoms also overlap with those of the flu and other non-specific viral infections, making diagnosis even more challenging.
The only distinctive sign of Lyme disease is the circular bull’s eye rash that develops around the tick bite within a few weeks. However, the rash can also appear elsewhere on the body, and in 20-30% of patients it’s not seen at all.
The diagnosis of Lyme and rickettsial diseases is usually based on a combination of factors, including signs, symptoms, patient history and laboratory tests. Unfortunately, currently there aren’t any completely reliable diagnostic tests available for Lyme disease: in the first weeks after infection, there’s a 60% rate of false negative results. Serological assays for rickettsiosis are more reliable, but these can take 10–12 days to provide a decisive result.
What To Do If You Think You’ve Been Infected With Rickettsia
Ticks are very tiny, and their bites aren’t painful. Many people don’t even realise they’ve been bitten.
It’s important to note that being bitten by a tick doesn’t mean you’ve contracted an illness. In fact, out of the approximately 800 different tick species in the world, less than 60 can transmit infections to humans and animals. Most types of tick also have to be attached to the host’s body for an extended period of time in order to pass on any bacteria.
Nevertheless, you must see your doctor if you have a fever and any other flu-like symptoms or a rash shortly after being bitten by a tick. You should also arrange a medical appointment if you don’t recall being bitten but you do experience some suspicious symptoms within a few weeks of returning from a high-risk area. Be sure to tell your doctor about your recent travels, so that they can evaluate the probability of a tick-borne infection and order any appropriate diagnostic tests.
According to information written in Carl Tuttle’s petition against the IDSA, he mentions an article that indicates the persistent form of Lyme disease might be caused by another organism altogether.
“The STAT article reports that both Jorge Benach and Allen Steere now say it is time to take a closer look at Rickettsia helvetica’s role in Lyme disease. Benach says the research “should be done” because public health concerns warrant a closer look.”
“Dr. Willy Burgdorfer reviewed and tested patient blood samples from Dr. Anderson for C9P09, which is a rickettsial helical Mycoplasma; P09 being a Rickettsia bellii and C9 being a Mycoplasma (FIG. 2).35 This is further supported by the theory that an endosymbiotic infection produces spirochetes that are uncultivable Mycoplasmas, which are also called spirochetes. 1, 22, 31, 32
The “Swiss Agent” is documented by Dr. Willy Burgdorfer (FIG. 3),25 who also wrote a speech on “Pandora’s Box”.5 Although the Swiss Agent paper is associated with the suspected African Swine Flu, Dr. Willy Burgdorfer appears to be famous for leaving clues throughout his work regarding Lyme disease. Upon reviewing the structure of the Lyme disease “Swiss Agent” and the “Pandora Giant Virus”, there is a striking resemblance that deserves further examination.”
I don’t think we actually know precisely what the agent(s) causing Lyme disease is. This would explain why it can’t be picked up in current testing and why many fail treatment.
While it’s true that the early stages can often yield unspecific symptoms, an experienced eye will be able to diagnose a patient with tick borne illness. Also, please remember that in some patients their only symptoms are psychological: https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/Any acute onset behavior changes should be suspect. Please don’t mess around with mainstream medicine should this occur. Get to an experienced and recommended ILADS practitioner who understands the mental illness aspect of tick borne disease.
To describe a patient whose retinal findings suggestive of tick-borne disease but evaluations led to early diagnosis and treatment of human immunodeficiency virus (HIV) infection.
A young patient presented with bilateral uveitis, branch retinal artery occlusion and retinal findings suggestive of infective/inflammatory etiology. Laboratory evaluations revealed that the patient was positive for co-infection with Rickettsia conorii and Bartonella henselae. On further investigation, the patient tested positive for HIV infection. The patient was treated with doxycycline as well as highly active anti-retroviral therapy (HAART) to control both opportunistic infections as well as HIV infection.
Conclusion and Importance
Patients with HIV infection are at risk for multiple, simultaneous opportunistic co-infections, including those with tick-borne diseases.
Invasive Tick Detected in Six Additional Tennessee Counties
Thursday, October 17, 2019
NASHVILLE – The Tennessee Department of Agriculture, United States Department of Agriculture – Animal and Plant Health Inspection Services, Tennessee Department of Health, and University of Tennessee Institute of Agriculture today announced the detection of the invasive Asian longhorned tick in an additional six Tennessee counties: Knox, Jefferson, Claiborne, Cocke, Putnam, and Sevier. The tick was detected in Union and Roane Counties in May.
The Centers for Disease Control and Prevention reports that there is no evidence to date that the tick has transmitted pathogens to humans in the U.S. There are concerns that the tick may transmit the agent of Theileriosis in cattle, and heavy infestations can cause blood loss and lead to death.
It is important to be aware of this tick, as cattle and canines are particularly susceptible to tick bites. Livestock producers are reminded to be vigilant when purchasing animals, apply a tick treatment to cattle prior to bringing them to your farm, and always use best practices for herd health. Dog owners should provide their animals with a tick preventative and check for ticks.
“Tennessee has numerous animal hosts and a suitable habitat for this tick species,” Dr. R.T. Trout Fryxell, Associate Professor of Medical and Veterinary Entomology for UTIA, said. “While it is always important to be diligent and keep an eye out for all ticks, the unique biology of the Asian longhorned tick helps this species to establish quickly and become a problem.”
Tips to prevent tick bites in animals and livestock include:
· Coordinate with your veterinarian to determine appropriate pest prevention for pets and livestock.
· Check pets and livestock for ticks frequently.
· Remove any ticks by pulling from the attachment site of the tick bite with tweezers.
· Monitor your pets and livestock for any changes in health
If your animals are bitten by a tick, Dr. Trout Fryxell suggests putting the tick in a ziplock bag, writing down the date and where the tick was most likely encountered, and storing it in a freezer.
For additional information about the longhorned tick in the United States, click here. To find more information on tick-borne diseases, click here.
The Asian Tick has been found in the following 12 states: Arkansas, Delaware, Kentucky, New Jersey, New York, North Carolina, Virginia, West Virginia, Pennsylvania, Maryland, Connecticut and Tennessee.