https://www.ncbi.nlm.nih.gov/m/pubmed/29936799/

Cat Scratch Disease in a 1.5-year-old girl – Case report.

Karski J, et al. Ann Agric Environ Med. 2018.

Abstract
INTRODUCTION: The paper is a case report presenting Cat Scratch Disease (CSD) in a 1.5-year- old girl. Bartoneloses, including CSD, are a group of infectious diseases which are rarely detected, therefore there are no statistical data concerning the aetiology, and the incidence of CSD noted in Poland is low in comparison with other European countries.

OBJECTIVE: The purpose of the paper is to discuss several problems related to CSD.

MATERIAL AND METHODS: A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling. X-rays showed osteolytic lesions which radiologists described as multi-ocular cyst or infection. As neither clinical examination nor laboratory investigations found pathological signs, the patient was followed-up on an ambulant basis. Repeated x-ray taken 4 weeks later showed increased periosteal proliferation accompanied by pain. The baby was admitted to the Clinic but additional investigations found no pathologies. The baby was consulted by a rheumatologist and haematologist; however, they did not facilitate a definitive diagnosis. As the baby developed, because of a thickening of the soft tissues on the dorsal side of the distal epiphisis in the forearm the doctors decided to inspect the condition operatively. Macroscopic examination found brownish granulated tissue. Suction drainage was inserted and a tissue sample was tested for aerobic and anaerobic bacteria, tuberculosis and borelliosis. The test results were negative. The baby was in good condition, was not pyrexial and suffered from less pain. The diagnostics was further expanded and the baby tested for yersinia, chlamydia, tuberculosis and bartonella, i.e. CSD. The postoperative wound healed soon and radiological bony lesions began to resolve. After a month, we received a positive bartonella test result, the baby tested positively for Bartonella henselae IgG class, which confirmed past or active infection of CSD. A repeated test for B. henselae taken 6 months later showed a lower level of antibodies.

CONCLUSIONS: It should be remembered that CSD, which is an extremely rare infection, can be diagnosed despite mediocre clinical and radiological manifestations. Thus, in the case of infections of unexplained aetiology and mediocre manifestations diagnostics should include testing for Bartonella henselae.

PMID 29936799 [ – in process]

_______________

**Comment**

There is little to no statistical data on Bartonella, that’s for sure, but it’s far from a rare infection & it is far from benign, in fact I would go as far to state it is prolific and devastating.  

Please note the finding of granulated tissue.  Bartonella is primarily a vascular disease and causes all sorts of bizarre symptoms – including nodules on the shins and painful soles of the feet; however, please do not underestimate the cognitive/psychological symptoms of this disease (anxiety, anger, suicidal thoughts).  It can also cause:  aseptic meningitis, neuroretinitis & other vision problems, lymphadenopathy (swollen lymph nodes), headaches, seizures, heartburn, abdominal pain, skin rash, gastritis, duodentis, mesenteric adenitis, myocarditis & endocarditis, and cysts.  

Authorities are still squabbling over whether ticks transmit this or not, but we know for sure spiders and other arachnids do as well as cat scratches, biting flies, fleas, needle stick transmission in veterinarians as well as drug users.  And just because something can’t be seen/proven in ticks, doesn’t mean it doesn’t happen.  Frankly, all it shows is the science is lagging and this is a fastidious organism which is hard to detect.  All I know is that nearly every Lyme/MSIDS patient I work with has Bart.  So either the tick transmits directly OR a previously asymptomatic case is triggered upon getting a tick bite.  Either way, WE GOT IT and it needs to be considered in each and every Lyme/MSIDS patient.

For more on Bartonella:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/  (Checklist and treatment options within this link)

Fifteen species of gram-negative aerobic Bartonella are known to infect humans; however Dr. Ricardo Maggi’s statement is quite telling, “This case reinforces the hypothesis that any Bartonella species can cause human infection.”

Dr. Mozayeni talks about Bartonella as one of the major co-infections of Lyme disease. It’s more prevalent than Lyme, as there are many more ways to contract the disease (eg. flees, cats). In a study, that Dr. Breitschwerdt and Mozayeni published in The Journal of Emerging Diseases, about 60% of Lyme patients tested positive for Bartonella. Dr. Mozayeni also talks about the importance of looking at Biofilm when treating Lyme, Bartonella etc. as biofilm can harbor many of these microbes and be the cause of many symptoms.

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

https://madisonarealymesupportgroup.com/2016/08/09/a-bartonella-story/

https://madisonarealymesupportgroup.com/2018/06/12/osteomyelitis-in-cat-scratch-disease-a-never-ending-dilemma-a-case-report-literature-review/

https://madisonarealymesupportgroup.com/2018/04/03/encephalopathy-in-adult-with-cat-scratch-disease/

https://madisonarealymesupportgroup.com/2018/05/09/rheumatological-presentation-of-bartonella-koehlerae-henselae-a-case-report-chiropractors-please-read/  Please note the joint popping with each articulation and continual joint subluxation issue.
Chiropractors need to be told about this. Please educate! Send them this article.  I too had this bizarre popping of the joints with a lot of instability in the knees. Treatment completely ameliorated this issue so treatment is primo important.

https://madisonarealymesupportgroup.com/2018/06/15/fleas-harbor-bartonella-13-days-post-infection-continuously-excrete-bartonella-dna/

https://madisonarealymesupportgroup.com/2018/06/20/northern-southern-ca-cats-have-bartonella-and-rickettsia-proven-by-16s-rrna-next-gen-sequencing/

https://madisonarealymesupportgroup.com/2016/12/29/cardinal-state-bartonella/

 

 

 

 

https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciy510/5039131?redirectedFrom=fulltext

Insights from the Geographic Spread of the Lyme Disease Epidemic

Taylor Eddens, Ph.D Daniel J Kaplan, M.D Alyce J M Anderson, Ph.D Andrew J Nowalk, M.D.,Ph.D Brian T Campfield, M.D
Clinical Infectious Diseases, ciy510, https://doi.org/10.1093/cid/ciy510
Published: 16 June 2018

Reproduced by permission of Oxford University Press on behalf of the Infectious Diseases Society of America. 9c) The Author(s) 2018. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. Please visit: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy510/5039131

Abstract
Background
Lyme disease is the most common reportable zoonotic infection in the United States. Recent data suggests spread of the Ixodes tick vector and increasing incidence of Lyme disease in several states, including Pennsylvania. We sought to determine the clinical presentation and healthcare utilization patterns for pediatric Lyme disease in western Pennsylvania.

Methods
The electronic medical records of all patients with an ICD9 diagnosis of Lyme disease between 2003-2013 at Children’s Hospital of Pittsburgh were individually reviewed for cases meeting the 2011 CDC case definition for Lyme disease. 773 patients meeting these criteria were retrospectively analyzed for patient demographics, disease manifestations, and healthcare utilization.

Results
An exponential increase in Lyme disease occurred in the pediatric population of western Pennsylvania. There was a southwestward migration of Lyme cases, with a shift in concentration from rural to non-rural zip codes. Healthcare provider involvement also changed from subspecialists to primary care pediatricians(PCP) and emergency departments(ED). Patients from non-rural zip codes more commonly presented to the ED, while patients from rural zip codes utilized PCPs and EDs similarly.

Conclusions
The current study details the conversion of western Pennsylvania from a Lyme-naïve to a Lyme-epidemic area, highlighting changes in clinical presentation and healthcare utilization as the epidemic evolved. Presenting symptoms and provider-type differed between those from rural and non-rural zip codes. By understanding the temporospatial epidemiology, disease presentation and healthcare utilization of Lyme, the current study may inform future public health initiatives regionally while serving as an archetype for other areas at-risk for Lyme epidemics.

 

 

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984262/#__ffn_sectitle

Lyme Meningoencephalitis Masquerading as Normal Pressure Hydrocephalus

Monitoring Editor: Alexander Muacevic and John R Adler
Aakash Desai, Gaurav Manek, Anand M Krishnan, Corina Iorgoveanu, Ahmed Zaghloul

Abstract
Lyme disease is a tick-borne illness caused primarily by the spirochete Borrelia burgdorferi. The disease is most prevalent in forested areas endemic for Ixodes tick, which transmits the spirochete. Here, we describe a case of Lyme meningoencephalitis masquerading as normal pressure hydrocephalus (NPH) which initially presented with urinary incontinence, gait instability, and neurological decline. Due to its non-specific symptoms and low incidence, Lyme meningoencephalitis causing NPH like syndrome poses a diagnostic conundrum for clinicians. Awareness of this disease entity is key for prompt diagnosis and treatment.

____________

**Comment**

Normal Pressure Hydrocephalus (NPH), which normally affects older people, is a brain disorder where there’s too much cerebrospinal fluid in the brain’s ventricle which causes trouble reasoning, thinking and walking, as well as loss of bladder control.  There can also be personality & behavior changes, and apathy.  Brain imaging to detect enlarged ventricles as well as MRI’s help with diagnosis.  Causes include hemorrhages, inflammation, and infections, and unknown reasons.

In this case, the patient appeared to have NPH but was rather infected with Lyme.

I know many patients who have excruciating headaches that they would describe as meningal, including myself.  The entire lining of the head hurts.  Some even receive a Chiari diagnosis as the swelling can force the brain to go through the opening of the skull.  For me the best antibiotics were those like minocycline which cross the blood/brain barrier.  I honestly wondered if I’d ever have a day without this head pain.  Good, effective treatment eradicated this but doctors are woefully unprepared.  Please contact your local Lyme support group if you have symptoms for a list of ILADS trained doctors who understand the complexity of this disease and will treat accordingly.

For more:  https://madisonarealymesupportgroup.com/2016/04/02/chiari/

https://madisonarealymesupportgroup.com/2017/06/04/minocycline-for-ms-and-much-more/

 

https://www.ncbi.nlm.nih.gov/m/pubmed/29859885/

Integrated control of juvenile Ixodes scapularis parasitizing Peromyscus leucopus in residential settings in Connecticut, United States.

Williams SC, et al. Ticks Tick Borne Dis. 2018.

Abstract
Lyme disease continues to be the most common vector-borne disease in the United States with an estimated 330,000 human cases annually. In the eastern United States, the blacklegged tick, Ixodes scapularis, is the primary vector of the Lyme disease spirochete, Borrelia burgdorferi, and the white-footed mouse, Peromyscus leucopus, is a primary reservoir host. In four residential neighborhoods in Connecticut over three years, we tested the effectiveness of different low-toxicity integrated tick management approaches to control larval and nymphal I. scapularis parasitizing P. leucopus.

  • Combinations of white-tailed deer, Odocoileus virginianus, reduction,
  • broadcast application of the entomopathogenic fungus Metarhizium anisopliae,
  • distribution of fipronil-based rodent-targeted bait boxes were evaluated against an
  • experimental control

Deer reduction with no other intervention likely forced juvenile I. scapularis to obtain blood meals from available reservoir hosts, resulting in increased exposure of P. leucopus to B. burgdorferi compared to control sites. The M. anisopliae/bait box and the deer reduction/M. anisopliae/bait box treatment combinations resulted in 94% and 85% reductions in larvae parasitizing P. leucopus that tested positive for B. burgdorferi, respectively, compared to control. Deer reduction alone resulted in only a 3% reduction, likely because parasitizing juvenile I. scapularis were not targeted by bait box-delivered fipronil. Unless there is community support to reduce and maintain deer at very low densities (<5 deer/km2), it is clear that a combination of M. anisopliae/fipronil-based bait boxes offers an effective, localized, low-toxicity option for reducing I. scapularis parasitizing P. leucopus without complications from host switching.

_______________

For more on successful tick reduction methods:  https://madisonarealymesupportgroup.com/2018/04/03/fire-good-news-for-tick-reduction/

https://madisonarealymesupportgroup.com/2018/06/06/mc-bugg-z/

https://madisonarealymesupportgroup.com/2017/05/11/tick-prevention-and-removal-2017/

https://madisonarealymesupportgroup.com/2018/05/27/study-conforms-permethrin-causes-ticks-to-drop-off-clothing/

 

https://www.sciencedirect.com/science/article/pii/S1877959X17303333?via%3Dihub

Splenic rupture from babesiosis, an emerging concern? A systematic review of current literature

Shuo Li, Bobby Goyal, Joseph D.Cooper, Ahmed Abdelbaki, Nishant Gupta, Yogesh Kumara

Abstract
Babesiosis is a relatively common tick-borne parasitic infection of erythrocytes primarily affecting the northeastern United States. Babesiosis’ prevalence and presentation have earned it the monikers “malaria of the northeast” and “Nantucket fever”. Clinical presentation ranges from asymptomatic infection to severe infection including acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulopathy (DIC) or death. Since 2008, there have been a number of reports of splenic rupture in patients with the disease. We seek to provide a further understanding of this process, with the report of a case of splenic rupture followed by a systematic review of the current literature. We found that 87% of splenic rupture secondary to babesiosis occurred in male patients who are otherwise healthy, with an average of 56 years. Computed tomography is a reliable mode of diagnosis, and hemoperitoneum is the most common imaging finding. Patients with splenic rupture due to human babesiosis were successfully treated by various management strategies, such as conservative non-operative approach, splenic artery embolization, and splenectomy. The modality of treatment depends on patient’s clinical course and hemodynamic stability, although spleen conserving strategy should be considered first whenever possible.

______________

For more:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

https://madisonarealymesupportgroup.com/2018/01/24/phase-ii-malaria-meds-100-cured-good-for-babesia/

https://madisonarealymesupportgroup.com/2016/12/05/babesia-cure-update/

https://madisonarealymesupportgroup.com/2018/06/08/two-cases-of-babesia/

https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

https://madisonarealymesupportgroup.com/2018/05/31/widespread-babesiosis-in-canada/

https://madisonarealymesupportgroup.com/2018/03/07/babesia-tests-approved-by-fda-for-screening-purposes/

https://madisonarealymesupportgroup.com/2017/08/08/transfusion-transmitted-babesiosis-in-nonendemic-areas/