https://dermagicexpress.blogspot.com/2018/07/congenital-transmission-of-erythema.html?m=1
July 22, 2018
CONGENITAL TRANSMISSION OF ERYTHEMA MIGRANS OR LYME DISEASE, MYTH OR REALITY ?
AUTHORS
1.) Dr. Lapenta, J Medic Surgeon, Specialty Dermatology, 24 years of exercise. Highly trained in the field of research; University of Carabobo, Venezuela. CEO DERMAGIC EXPRESS. www.dermagicexpress.blogspot.com
2.) Dr. Lapenta, JM. Medic Surgeon. University of Carabobo. Diplomat in Facial Aesthetics Occupational Medicine and Prehospital Auxiliary. Resident Doctor Ambulatorio Del Norte Maracay Aragua State. COO DERMAGIC EXPRESS. www.dermagicexpress.blogspot.com
ABSTRACT
Lyme disease or Erythema Migrans, described many years ago, and previously known under the name of Lyme Juvenile Arthritis, is produced by a spirochete transmitted by the bite of a family tick. Ixodidade, Ixodes scapularis and many others; discovered by the scientist Willy Burgdorfer in the year of 1981, being named Borrelia Burgorferi, in honor of its discoverer. Apart from the numerous cutaneous and organic manifestations attributed to Borrelia, it is nowadays discussed in the scientific field if it is capable of crossing the placenta and causing fetal damage. In this review we will show you that this biological agent, as in syphilis, produced by Treponema Pallidum, another spirochete, crosses the placenta and can produce serious consequences to the fetus, including death.
Key words: Lyme disease, Borrelia burgdorferi, congenital lyme, fetal damage and pregnancy
MAIN OBJECTIVE
The main objective of this work is to demonstrate that Lyme disease and their biological agent, spirochete Borrelia Burgdorferi, is not only an illness with cutaneous manifestations. It can cross the placenta during pregnancy and produce fetal damage that in severe cases can cause death in newborns.
SECONDARY OBJECTIVES.
1.) Describe the clinical manifestations in children born from positive Lyme mothers who did not receive treatment in pregnancy, or in those who received treatment with resistance to it.
2.) Alert the World community that there is indeed transplacental transmission of Borrelia Burgdorferi in pregnant Lyme positive women and if there is not adequate treated in time, both the mother and fetus can present clinical symptoms ranging from mild, to severe, even stillbirth.
3.) To call attention to the World Health Organization so that in the revision of the international codes of diseases (ICD-11), this year 2018, the code “Congenital Lyme” be included in them.
INTRODUCTION
The Center for Disease Control and Prevention (CDC) affirms in its website that the pregnant woman Lyme positive when making her treatment, the child will be born healthy and recommends for this, the use of the antibiotic amoxicillin or cefuroxime, because doxycycline, which is the antibiotic of choice, can cause damage to the developing fetus. [1]
Other antibiotics recommended by the CDC are the macrolides azithromycin, clarithromycin or erythromycin in case of allergy or intolerance to those previously mentioned. [2]
The CDC itself recognizes that Lyme disease and its causative agent Borrelia Burgdorferi can cross the placenta and cause stillbirths. [1-2]
The question here is what would happen if the Borrelia species, as in some cases, is resistant to amoxicillin or another antibiotic, or the antibiotic to which Borrelia is sensitive cannot be indicated because it would harm the fetus? And beyond, if the patient does not receive the treatment by omission or carelessness? [3]
As we said previously the Borrelia Burgdorferi was discovered by Willy Burgdorfer in the year 1981, and just two (2) year later, in 1983 the first study was published by Shirts SR, and Brown MS, Bobitt Jr, where it is suspected that this spirochete can cross the placenta. [4]
After this study others began to appear, who definitely showed that this spirochete is able to cross the placenta and cause fetal damage, of which we will present in chronological order the most important and confirm the above said.
CHRONOLOGICAL EVOLUTION
1983
The first suspicion described that ante partum fever may be caused by the Borrelia Burgdorferi species, was made in 1983 in two febrile pregnant women in the third-trimester. The two newborn survived, but the scientists suggested the establishment of early laboratory tests to identify the causative agent and the establishment of a rapid treatment to avoid future complications in the pregnant and the fetus. [4]
1985
Really, the first study describing the maternal-fetal transmission of Lyme disease, Borrelia Burgdorferi was published in 1985 by Schlesinger PA, Duray PH, Burke BA, Steere AC, and Stillman MT., Where they describe a case of a pregnant woman who acquired Lyme Borreliosis and did not receive treatment with antibiotics. The child was born at 35 weeks of pregnancy and died of congenital heart disease the first week of life. The autopsy revealed the Borrelia Burgdorferi spirochete in the spleen, kidneys and bone marrow. [5]
1986-1989
In the year 1986, MacDonald A, describes 4 cases of abortions in pregnant women who tested positive for Lyme, and in whose fetuses the Borrelia Burgdorferi was found in their tissues. This same author does another work in 1989 about Lyme disease and its implications for the fetus and describes side effects such as fetal death, hydrocephalus, cardiovascular abnormalities, neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical blindness, sudden death syndrome of the infant and maternal toxemia of pregnancy, and raises the similarity of these with neonatal syphilis. [6-7].
1987
Later, the same Willy Burgdorfer the discoverer of the Borrelia Burgdorferi, together with Dr. Alan Mc Donald and Jorge Benach PhD, published in year 1987 (31 years ago) a work where they relate this disease with children born dead associated in pregnant Lyme positive.
Among the highlights the description of congenital malformations, fetal death, cardiac anomalies and alert the scientific community to investigate exposure during the first trimester of pregnancy in the presence of Borrelia Burgdorferi; and in this cases to determine if cardiac organogenesis is complete by the end of the first trimester of pregnancy. They also recommend starting treatment with Penicillin at the same dose of syphilis in those cases of pregnant women who show signs and early symptoms of the disease. [8]
1988-2012
In these 24 years a total of more than 80 papers were published where Lyme disease is effectively related to pregnancy with fetal damage, studies done in the countries: United States, Canada, Hungary, Germany, Italy, Switzerland, Africa, Turkey, Czech Republic, Poland and Belgrade former Yugoslavia, and others [10-52]
Another study that is worth noting is that carried out by the updated MEDLINE database for the year of July 2012, the last revision of November 2012 of 88 journal articles from the PUBMED database, which we summarize in this way
Maternal-fetal transmission of Lyme disease (Findings):
1.) Mothers with active Lyme disease, treated: 14.6% of pregnancies resulted in sequel (a morbid condition following or occurring as a consequence of having Lyme).
2.) Mothers with active Lyme disease not treated: 66.7% of pregnancies resulted in sequel.
3.) Positive Lyme mothers, the treatment is unknown: 30.3% resulted in sequel.
4.) Specific adverse results included:
– Cardiac 22.7%,
– Neurological 15.2%,
– Orthopedic 12.1%,
– Ophthalmologic 4.5%,
– Genitourinary 10.6%,
– Miscellaneous anomalies 12.1%. [53]
Now we will put a summary of the most frequent clinical manifestations described in a study of more than 100 children born to mothers with LYME positive disease, conducted in the year 2005.
COMMON SIGNS AND SYMPTOMS IN LYME POSITIVE CHILDREN:
1.) Low grade fever: 59% -60%
2.) Fatigue and lack of resistance: 72%
3.) Nocturnal sweating: 23%
4.) Pale, dark circle under the eyes: 42%
5.) Abdominal pain: 20-29%
6.) Diarrhea or constipation: 32%
7.) Nausea: 23%
8.) Cardiac anomalies: 23%: palpitations / PVC, heart murmur, mitral valve prolapse.
9.) Orthopedic disorders: sensitivity (55%), pain (69%) spasms and generalized muscle pain (69%), rigidity and / or retarded motion (23%).
10.) Respiratory infections of the superior tract and otitis: 40%
11.) Arthritic disorders and painful joints: 6% -50-%
12.) Neurological disorders:
A- Headaches: 50%
B-) Irritability: 54%.
C-) Bad memory: 39%
13.) Delay in development: 18%
14.) Seizure disorder: 11%
15.) Vertigo: 30%
16.) Tic disorders: 14%
17.) Involuntary athetoid movements: 9%.
18.) Earning disorders and humor changes: 80%
A-) Cognitive speaking: 27%
B-) Speech delay: 21%
C-) Reading-writing problems: 19%
D.) Problems of vocal articulation: 17%.
E-) Auditory / visual processing problems: 13%
F-) Word selection problems: 12%
G-) Dyslexia: 8%
19.) Suicidal thoughts: 7%
20.) Anxiety: 21%
21.) Anger or rage: 23%
22.) Aggression or violence: 13%
23.) Irritability: 54% -80%
24.) Emotional disorders: 13%
25.) Depression: 13%
26.) Hyperactivity: 36%
27.) Photophobia: 40-43%
28.) Gastroesophageal reflux with vomiting and coughing: 40%
29.) Secondary eruptions: 23%
30.) Other eruptions: 45%
31.) Cavernous haemangioma: 30%
32.) Ocular problems: posterior cataracts, myopia, stigmatism, conjunctive erythema (Lyme eyes), optical nerve atrophy and / of uveitis: 30%
33.) Sensitivity of skin and noise (hyperacuity): 36-40%
46.) Autism: (9%). [41]
2013-2018
In recent years the number of cases of Lyme disease has increased notably in North America, Europe, Asia and Africa; in the United States and Canada, it is the most commonly transmitted vector-borne disease reported today [54-62].
For the year 2017 the World Health Organization (WHO) in charge of “coding” diseases through the ICD-10 (International Classification of Diseases year 2.017), had not yet included and recognized the code “Congenital Lyme”. It is expected for this year 2018 that all codes of Lyme disease will be recognized by this organization. [63-68]
You can read this classification and codes here: UNDERSTANDIG THE LYME DISEASE CLASSIFICATION AND CODES. [69]
CONCLUSIONS
1.) Lyme disease is caused by the bite of a tick transmitted by the Borrelia Burgdorferi spirochete, discovered by Willy Burgdorfer in the year 1981. Initially, skin, joint and cardiac manifestations were described in those affected, but not in pregnant women or the fetus.
2.) Two years later, in 1983, was described the suspicion of infection in pregnant women, and in 1985 it was found the first clinical manifestations in pregnant women and fetuses, highlighting congenital malformations and fetal death.
3.) We demonstrate scientifically that definitely Lyme disease, in addition to its multiple organic manifestations, its causative agent Borrelia Burgdorferi, crosses the placenta and reaches the fetus in pregnant women, producing the side effects already described.
4.) All pregnant women living in endemic areas of Lyme disease should take the tests to rule out Borreliosis of pregnancy, to establish immediate treatment in case of being positive.
5.) In addition to establishing adequate treatment, we alert the population to defend against the bite of possibly infected ticks.
6.) We urge the World Health Organization to recognize all the codes and classification of Lyme disease in ICD-11 (International Classification of Diseases year 2.018).
ACKNOWLEDGMENTS
To the community of patients affected by Lyme disease.
To the organizations that fight for the recognition of this pathology as a public health problem World.
__________________
**Comment**
The Lyme community owes a debt of gratitude to the doctors Lapenta. You will see many of their articles on my website as they have painstakingly combed through the research and condensed it for laypeople to clearly see the ramifications of Lyme and other tick borne illnesses.
This article makes plain that Lyme can be passed congenitally to infants.
For more on pregnancy with Lyme:
https://madisonarealymesupportgroup.com/2017/10/15/pregnancy-in-lyme-dr-ann-corson/
