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3 Conditions That May Be Mistaken For Lyme Disease

https://www.rheumatologyadvisor.com/home/topics/lyme-disease/3-conditions-that-may-be-mistaken-for-lyme-disease/

3 Conditions That May Be Mistaken for Lyme Disease

Lyme disease ring on body
Not all patients with Lyme disease present with a rash, making it difficult to diagnose the condition in some cases.

Lyme disease is difficult to diagnose accurately. Not all patients present with its signature symptom, erythema migrans (EM), with or without the presence of a bull’s-eye-shaped rash. Other symptoms such as fever, chills, fatigue, and headache are nonspecific. The people who are infected with the tick-borne illness don’t always remember being bitten by a tick. And, to compound matters, testing for Lyme disease is not an exact science.

As a result, sometimes people who are infected with Lyme disease are incorrectly diagnosed with other ailments such as fibromyalgia, rheumatoid arthritis, and multiple sclerosis (MS). These chronic conditions aren’t the only illnesses that can be mistaken for Lyme disease. We explore 3 Lyme-like conditions that might not immediately come to mind.

Borrelia miyamotoi Disease

Borrelia miyamotoi (B miyamotoi) disease is an emerging infectious disease spread by deer ticks. First discovered by Japanese scientists in 1995, B miyamotoi disease can be found in all areas of the United States where Lyme disease is endemic.1

The first human cases of B miyamotoi infection were found in Russia in 2011, when researchers identified 46 patients who had presented with the influenza-like illness.2 Two years later, the first recognized cases in North America were reported in the Northeastern United States.3

Symptoms of B miyamotoi infection are similar to those seen in Lyme disease: fever, chills, headache, joint pain, muscle pain, and fatigue. One key difference: patients with B miyamotoi disease rarely develop a rash. Whereas just 4 (9%) of the 46 cases of B miyamotoi infection identified in Russia involved EM, an estimated 70% to 80% of people with Lyme develop a rash.4

Blood tests to identify Lyme disease are not effective in diagnosing B miyamotoi disease. Instead, polymerase chain reaction (PCR) that detect B miyamotoi DNA and antibody-based tests are used to confirm a diagnosis.  Doxycycline, amoxicillin, and ceftriaxone have been used successfully to treat patients with B miyamotoi infection.5

Summer Flu

Early symptoms of Lyme disease such as fever, chills, fatigue, and pain closely resemble those of influenza. Because Lyme disease is not always accompanied by a rash, the tick-borne illness can be mistaken for the summer flu. One such case was documented in Orthopedic Reviews.6

A 58-year-old woman presented with flu-like symptoms including body aches, headache, and fever. She was diagnosed with acute influenza and prescribed antiviral medication. Two days later, she reported a welt on her stomach and generalized joint pain. She revealed that 3 weeks prior she had irritation or a bite behind her knee that she couldn’t see. Examination revealed an EM lesion behind her knee, and the patient was administered doxycycline. Her symptoms resolved in the following week.

“This case report illustrates the difficulty in distinguishing patients with early Lyme disease from those with an undifferentiated viral illness,” the authors wrote. “The viral-like symptoms of fever, headache, stiff neck, body aches, and fatigue are the common presenting features of many infections, both viral and non-viral. These illnesses often lack localizing symptoms such as cough, diarrhea, or urinary symptoms that point to more specific diagnosis such as pneumonia, gastroenteritis, or genitourinary infection.”

Related Articles

Cellulitis

Patients with cellulitis typically present with warmth, tenderness, inflammation, swelling, redness, and/or pain in the affected area. As such, the bacterial infection can be mistaken for Lyme disease.

A study in the Archives of Family Medicine identified several patients who were originally diagnosed with cellulitis but actually had Lyme disease. The researchers noted that, despite its distinctive appearance, EM may be confused with the bacterial infection. 7

A case study in Clinical Infectious Diseases chronicled a 39-year-old man who suddenly lost consciousness and collapsed. After the patient was revived in the emergency department (ED), he reported that he had consulted a clinician 3 weeks earlier for a rash that was subsequently diagnosed as cellulitis. However, following cardiology consultation in the ED, an ELISA test for Lyme disease was conducted; the study was reported as positive and confirmed by Western blot.8

The author argued that the case history “illustrates failure of patients to be aware of tick bites and failure of diagnosis by a primary physician even in an area of endemicity.”

References

  1. Glatter R. The disease that looks like Lyme – but isn’t. Forbes. July 12, 2013. Accessed May 28, 2019.
  2. Platonov AE, Karan LS, Kolyasnikova NM, et al. Humans infected with relapsing fever spirochete Borrelia miyamotoi, Russia. Emerg Infect Dis. 2011;17(10):1816-1823.
  3. Molloy PJ, Telford SR 3rd, Chowdri HR, et al. Borrelia miyamotoi disease in the northeastern United States: a case series. Ann Intern Med. 2015;163(2):91-98.
  4. Signs and symptoms of untreated Lyme disease. Centers for Disease Control and Prevention. Reviewed December 21, 2018. Accessed May 28, 2019.
  5. B. miyamotoi. Centers for Disease Control and Prevention. Reviewed January 10, 2019. Accessed May 28, 2019.
  6. Aucott JN, Seifter A. Misdiagnosis of early Lyme disease as the summer flu. Orthop Rev. 2011;3(2):e14.
  7. Nowakowski J, McKenna D, Nadelman RB, et al. Failure of treatment with cephalexin for Lyme disease. Arch Fam Med. 2000;9(6):563-567.
  8. Plotkin SA. Correcting a public health fiasco: the need for a new vaccine against Lyme disease. Clin Infect Dis. 2011;52 Suppl 3:s271-s275.

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**Comment**

The oft quoted 70-80% patients getting the EM rash is WRONG.  Once again, the percentages range widely from 25-80% depending upon who’s counting:

https://madisonarealymesupportgroup.com/2019/03/26/study-says-only-about-18-of-children-with-lyme-recall-tick-bite/

https://madisonarealymesupportgroup.com/2019/03/26/formally-challenging-cdc-advice-on-lyme-disease-rashes/

https://madisonarealymesupportgroup.com/2019/02/21/lyme-disease-dont-wait-for-blood-tests-where-patients-have-bullseye-rash/Read comment after article

Lyme disease is commonly misdiagnosed as 1,000 different things. Mainstream medicine needs to wake up.

For more:  https://madisonarealymesupportgroup.com/2019/05/09/seven-conditions-lyme-disease-gets-misdiagnosed-as/

https://madisonarealymesupportgroup.com/2018/10/03/lyme-patient-misdiagnosed-with-anxiety-depression/

https://madisonarealymesupportgroup.com/2019/05/15/life-with-lyme-disease-a-womans-15-year-journey-to-diagnosis/  Initially diagnosed wth depression, then epilepsy, fibromyalgia, chronic fatigue, & suffered numerous miscarriages.  A friend told her about Lyme.  Finally diagnosed with Lyme.

https://madisonarealymesupportgroup.com/2017/04/11/diagnosed-with-ebv-had-lyme/

https://madisonarealymesupportgroup.com/2018/07/24/diagnosed-with-cellulitis-child-had-lyme-docs-said-it-was-a-non-relevant-tick-bite/  “Non relevant tick bite,” what a joke.

https://madisonarealymesupportgroup.com/2017/08/13/diagnosed-with-hiv-14-year-old-really-had-lyme/

https://madisonarealymesupportgroup.com/2019/03/21/bartonella-sudden-onset-adolescent-schizophrenia-a-case-study/

Oh, I could go on and on all day…..

 

 

Former CDC Chief Pleads Guilty in Connection with Misconduct Case, Won’t Serve Jail Time

https://www.foxnews.com/us/former-head-of-the-cdc-pleads-guilty-to-violation  (News Story Here)

Former CDC chief pleads guilty in connection with misconduct case, won’t serve jail time

The former head of the Centers for Disease Control and Prevention(CDC) has pleaded guilty to disorderly conduct related to his arrest last August for alleged sexual misconduct and will not serve jail time, Fox News has learned.

Dr. Thomas Frieden, also a former New York City health commissioner, appeared Tuesday in Brooklyn Criminal Court.

Under the terms of his plea, Frieden’s case will be sealed and dismissed in a year if he isn’t arrested during that time.

Frieden was the director of the CDC from 2009 to 2017.

Frieden was arrested in August. A woman he knew had accused Frieden of grabbing her buttocks on Oct. 20, 2017, in his Brooklyn home.

He did not admit guilt in the groping allegation.

He and his attorney declined to comment.

The Associated Press contributed to this report.

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**Comment**

This isn’t the first time CDC directors have been guilty:  https://madisonarealymesupportgroup.com/2018/01/31/another-cdc-conflict-of-interest-director-resigns/

It becomes clearer all the time, why we are in the fix we are in.

Petition Update: Nearly 19,000 Have Signed So Far Against Eugene Shapiro Being on the TBDWG – Also, Updates

https://www.change.org/p/tick-borne-disease-working-group-keep-eugene-shapiro-off-the-federal-tbdwg?

Go to link for more information as well as to sign the petition if you haven’t already.

Also:  https://madisonarealymesupportgroup.com/2019/05/19/if-true-shapiro-on-tbd-working-group-will-outrage-lyme-community/  In Comment section you can listen to Shapiro in action on a youtube video. The man is clearly mad, deceived, or evil.

For more on the TBDWG:  https://madisonarealymesupportgroup.com/2018/12/14/tbdwg-on-surveillance-in-humans/

https://madisonarealymesupportgroup.com/2018/12/11/tbdwg-reviews-over-700-public-comments-uses-zero/

https://madisonarealymesupportgroup.com/2018/07/27/tbdwg-draft-report/

https://madisonarealymesupportgroup.com/2018/05/12/tweets-of-tbd-working-group-may-10-2018-meeting/

https://madisonarealymesupportgroup.com/2018/05/16/summary-of-may-15-tbd-working-group-meeting-in-tweets/

https://madisonarealymesupportgroup.com/2018/12/18/gla-counters-idsa-criticisms-of-tbdwg-report/

Please sign if you haven’t already and send a clear message to HHS.

Recently Dorothy Kupcha Leland came out with the following article:  https://www.lymedisease.org/what-gives-tbdwg/

In short, she states, “Things are getting weird with the TBDWG,” because HHS was supposed to come out with the names of new members of the group by April but all that happened was an announcement by the IDSA finally on May 15 that Dr. Eugene Shapiro, had been named to the Working Group. When asked for confirmation from TBDWG staff, they said no decision had been made.

Her following questions deserve answers:

  • did the IDSA hallucinate Shapiro’s appointment—or
  • were they privy to decisions that have not been made public? 
  • why did the IDSA feel sure enough to enshrine this revelation on its website?
  • if not true, why wouldn’t HHS ask them take it down? It’s been sitting there for the world to see, for two weeks.

For Lorraine Johnson’s (Lymedisease.org) letter to the TBDWG in advance of it’s June 4, 2014 meeting:

https://www.lymedisease.org/effective-representation-tbdwg/

LYMEPOLICYWONK: Will patients be effectively represented on Working Group?

 

Lyme Disease Changed My Relationship With The Outdoors

https://www.outsideonline.com/2395555/lyme-disease-changed-my-relationship-outdoors

Lyme Disease Changed My Relationship with the Outdoors

For Blair Braverman, physical activity was a given. Until it wasn’t.

Photo: Sarah Marshalldogs

 

 

Septic Shock Caused by RMSF in Suburban Texas Patient With Pet Dog Exposure: A Case Report

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091339/

. 2018; 19: 917–919.
Published online 2018 Aug 4. doi: 10.12659/AJCR.909636
PMCID: PMC6091339
PMID: 30076285

Septic Shock Caused by Rocky Mountain Spotted Fever in a Suburban Texas Patient with Pet Dog Exposure: A Case Report

Abstract

Patient: Female, 45

Final Diagnosis: Rocky mountain spotted fever

Symptoms: Altered mental state • ataxia • dyspnea • fever • headache

Objective:

Unusual clinical course

Background:

Rocky Mountain spotted fever (RMSF) is associated with high mortality and requires prompt identification and treatment to ensure better outcomes.

Case Report:

We describe an advanced case of RMSF in a 45-year-old female patient with pet dog exposure who presented with altered mental status, dyspnea, and ataxia progressing to septic shock and acute hypoxic respiratory failure requiring intubation and mechanical ventilation.

Conclusions:

This case illustrates the importance of keeping RMSF in the differential diagnosis in patient populations outside of the usual geographic areas of incidence in the appropriate clinical setting.

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**Comment**

This is what can happen when diagnosis is delayed.

This woman that lived in the suburbs had a 7-day history of fevers associated with headache, arthralgias, nausea, fatigue, and neck pain, but did NOT have the tell-tale blotchy RMSF rash.

Two days later, she worsened with confusion, combativeness, dyspnea, and ataxia. She got multiple recent bug bites from her pet dogs sleeping in her bed. The dogs were not up to date on flea and tick medication but were healthy and showed no sign of illness.
  • Rule #1:  Do NOT sleep with pets.  The risk is too great.
  • Rule #2:  If you choose to have pets, make sure you treat them if they go outdoors.  The risk is too great.
  • Rule #3:  Doctors need to start treating this plague with the respect it deserves and frankly should keep it in the back of their minds AT ALL TIMES.
Positive findings were R. typhi IgM 1: 1024 (normal <1: 64), R. Rickettsii IgM 1: 1024 (normal <1: 64), IgG 1: 128 (normal <1: 64), and echovirus Ab 1: 80 titer (normal <1: 80). The Rickettsial titers were repeated for possible cross-reactivity and R. typhi antibodies were noted to be negative (<1: 64).
Although R.typhi was ruled out due to cross-reactivity, I believe we will start seeing more of this strain in the future.
The patient improved on doxycycline, the drug of choice for RMSF and was discharged.
Why isn’t there a full-out media blitz on this like there was on Zika?