FREE: Chronic Lyme Disease Summit Online July 27-Aug 2

July 5, 2020

https://chroniclymediseasesummit4.com/

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Don’t miss The Chronic Lyme Disease Summit 4

Now considered to be a dysfunction of the immune system, Lyme disease can mimic other chronic conditions; it can manifest in autoimmunity… along with other misunderstood chronic conditions, Lyme disease has destroyed people’s lives. 

Lyme disease can be a devastating (and sometimes hidden) condition, but it doesn’t have to be! Known as “The Great Imitator,” Lyme disease may mimic other chronic health conditions: arthritis, fibromyalgia, chronic fatigue syndrome, MS, depression…

But the sooner it’s detected, the easier it is to address!

—>>Gain a deeper understanding of Lyme disease when you attend this complimentary, online event!

Lyme disease is difficult to diagnose and treat and has over 150 different possible symptoms: fatigue, mood problems, insomnia, neurological impairments, brain fog, migraines, gut issues, neuropathy, joint pain and others. If not properly treated, over time Lyme disease becomes chronic and can manifest in autoimmunity or a number of other degenerative, debilitating health issues.

Some people live in a cycle of symptom management while remaining extremely ill.
Many doctors don’t know which medications to give people, so many have to find their own solutions.

The fact is: if you don’t know the root cause of your health issues, it’s so much harder to heal.

WHY ATTEND?
Your host, Dr. Jay Davidson, nearly lost his wife to chronic Lyme disease, which prompted him to undergo years of research to help her heal. He’ll share that wisdom with you during this summit.

Lean on the wisdom of our health experts to help with:
+ Testing methods and treatment protocols
+ Steps to take before addressing Lyme
+ Staying empowered in the doctor/patient relationship
+ Supporting mitochondrial health and drainage
+ Detox and diet protocols
+ Nutrition, exercise and mindset strategies
+ And so much more!

Register for free

or

Order Presentation to gift someone else or watch at your own convenience.

If you’ve been diagnosed with or suspect you’ve been misdiagnosed, it’s time to gain a deeper understanding of Lyme disease!

Join us at this important event to discover current research and novel approaches to testing and treating chronic Lyme disease and what you can do to boost your immune system health.

You’re not alone. There are answers. We can heal together.

P.S. When you register for The Chronic Lyme Disease Summit 4k, you’ll also unlock early-access interviews, complimentary guides and helpful eBooksabout living your most resilient life!

 

___________________

**Comment**

Just for clarification: ALL disease is basically due to an impaired immune system from the standpoint of if the immune system was working at 100% it would be able to fight off disease.  Tick-borne illness by nature causes immune dysfunction as these are pathogens who work synergistically together and literally feast upon the human body, depriving it of vital nutrients.  Of course replacing those nutrients and building blocks is essential but in my opinion only one prong of treatment.  Detoxification is another prong, and antimicrobial treatment is the third important prong.

When we only focus on the immune system we miss a key of the puzzle and that is the pathogens themselves – which typically means antimicrobial treatment of one form or another.

From my experience, when the pathogens are dealt with, many if not most symptoms just disappear.

There’s always exceptions.  I’ve personally heard stories of people getting well on nothing but supportive things like diet and supplements; however, they are in the minority.  I get excited over each and every person who finds wholeness – no matter how it comes, but at the end of the day we all must make informed choices and nobody knows your body better than you do. You must gather all the information you can and choose for yourself your course of action.  All I can say is “God speed” on whatever you choose and may you reach the other side.

For more on treatment:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

https://madisonarealymesupportgroup.com/2020/06/26/new-treatments-for-lyme-disease-on-the-horizon/

https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/ This article is based upon an important video Dr. Burrascano did where he shares nuances of successful treatment. Blood levels of antimicrobials are important (dosage) as well as cycling (going off treatment when you’ve been symptom-free for 2-3 months and then hitting it hard with antimicrobials if and when you relapse.  He’s found that doing 3-4 cycles has brought people to remission).

Some of the sickest patients I’ve seen are 1) those who have had it for decades 2) used antimicrobials (typically antibiotics) indiscriminately.  It takes a trained eye and know-how to treat this.  You can NOT just throw more and more doxycycline at this.  It takes many antimicrobials and varying dosages (depending upon the person) in a layered fashion.  You have to deal with all forms of Bb (borrelia or Lyme) as well as every coinfection, which can include worms.

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Happy 4th of July!

July 4, 2020

iu-66

https://www.archives.gov/founding-docs/declaration-transcript

In Congress, July 4, 1776.

The unanimous Declaration of the thirteen united States of America, When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.–That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, –That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.–Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

He has refused his Assent to Laws, the most wholesome and necessary for the public good.

He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.

He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.

He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures.

He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.

He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.

He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.

He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.

He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.

He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance.

He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures.

He has affected to render the Military independent of and superior to the Civil power.

He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:

For Quartering large bodies of armed troops among us:

For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States:

For cutting off our Trade with all parts of the world:

For imposing Taxes on us without our Consent:

For depriving us in many cases, of the benefits of Trial by Jury:

For transporting us beyond Seas to be tried for pretended offences

For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:

For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:

For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.

He has abdicated Government here, by declaring us out of his Protection and waging War against us.

He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people.

He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.

He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.

He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.

In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people.

Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.

We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.

__________________

**Comment**

Never were the words in this document more important than today.

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ACT Now: Tell Your Officials To Make Mask-Wearing Voluntary

July 3, 2020

https://standforhealthfreedom.com/action/act-now-mandatory-masks-endanger-your-health/?

ACT NOW: Mandatory Masks Endanger Your Health and Your Liberties. Tell Your State and Local Officials To Make Mask-Wearing Voluntary.

OUR STAND

  • As the United States begins to re-open from lockdowns, jurisdictions are instituting measures that dictate how people are able to participate in society. One of the most common is compulsory mask-wearing.
  • Officials throughout the country are seeking policy guidance on masks from the Centers for Disease Control and Prevention (CDC), which has flip-flopped its position on face coverings several times since March but is now recommending that everyone wear a mask in public.
  • State and local authorities are taking varying approaches in what their emergency mask orders stipulate and how they will be enforced. Rules differ by state and are constantly changing. However, to date, only a handful of states don’t have any mandatory mask measures.
  • Though CDC’s policy guidance encourages the use of face masks, there is substantial evidence showing that masks are harmful and a lack of evidence showing they are effective in preventing the spread of coronavirus. Studies show that wearing a face covering reduces blood and tissue oxygenation — which can be deadly — while increasing carbon dioxide levels. Mask-wearing can also increase the risk of infection and the spread of viral illness, hinder detoxification that occurs via exhalation, impair the immune system and cause many other ailments, both physical and emotional. Moreover, some masks have been found to contain known carcinogens, which put people at risk from inhaling toxic chemicals and having them come into contact with their skin.
  • Lawsuits are now being filed throughout the country to challenge mandatory masks. Despite evidence of harm and questionable evidence of benefit, fall 2020 school guidelines across the country are calling for mandatory masks. Public school systems (e.g., San Diego, California) are concerned that mask requirements in the classroom will spark even more legal battles.
  • It is unethical and unconstitutional to force healthy citizens to abide by measures that can result in physical and emotional harm and that impinge on their ability to move freely throughout society without discrimination. For those with deeply held religious beliefs, mask mandates violate their ability to abide by natural law and follow their convictions to walk in faith, not fear. As such, the decision to wear a mask is a highly personal one and should not be universally mandated; measures that are meant to protect the community as a whole are ineffective if they hurt individuals in that community. Please email and tweet your lawmakers now and urge them to do their part to make sure that mask-wearing is voluntary, not mandatory.

Your home address information is required from the legislative offices to ensure you are reaching out to your designated representatives. Your email and your phone number are used to establish connection with your designated representatives. Messages from non-constituents don’t have the same impact on a legislator as messages from verified constituents, who can vote for that officeholder. We do not share your name and contact information with any third parties unless legally required to do so.

Have a question or need help?

VIEW OUR FAQS

CALL TO ACTION

Do I have to wear a mask? Should I just wear a mask to avoid being heckled or harassed? What if wearing a mask makes me feel unwell? These are just a few of the questions that people are grappling with as a growing number of jurisdictions nationwide institute mandatory mask measures.

At present, all but a handful of states call for mandatory mask-wearing, and many cities have their own mask ordinances.[1]However, Stand for Health Freedom believes that wearing a mask should be an individual’s choice. A growing contingent of individuals are concerned that mandatory mask policies jeopardize bodily, civil and constitutional rights.

Mandatory Masks Can Cause Considerable Harm and Are Not Proven Effective

Evidence that face masks reduce the transmission of viral respiratory infections within community settings is equivocal at best. A recent meta-analysis of scientific literature, including 11 randomized, controlled trials and 10 observational studies, found that there was no clear clinical or laboratory-confirmed evidence that masks prevent infection.[2] To the contrary, the study warned that facemasks “…may even increase transmission if they act as fomites [objects or materials that are likely to carry infection] or prompt other behaviours that transmit the virus such as face touching.”

This echoes World Health Organization (WHO) guidance published on January 29, 2020 entitled, “Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (‎‎‎‎‎2019-nCoV)‎‎‎‎‎ outbreak.”[3] In it, the WHO says, “Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices.”  Furthermore, the January 2020 WHO guidance stated that “Cloth (e.g., cotton or gauze) masks are not recommended under any circumstance.”

Cloth masks have been found to be particularly problematic.[4] A British Medical Journal (BMJ) study published in April 2020 cautions against the use of cloth masks, citing “Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.”[5] The WHO affirms increased infection risk with cloth masks in its latest June 5, 2020 guidance.[6] It based its guidance on an earlier BMJ study that found the penetration of particles to be 97% in the cloth mask group, with significantly higher rates of infection and influenza-like illness.[7]

A study on the CDC website that reviewed 10 different randomized clinical trials worldwide on highly infectious respiratory virus transmission found “no significant reduction” in “transmission with the use of face masks.”[8]

Given the lack of evidence for their use,[9] and flip-flopping advice both against and for their use by authoritative health agencies like the WHO, the increasing pressure to wear masks in public — and to be able to access basic services required to maintain one’s health, liberty and livelihood — constitutes an unnecessary power grab and means of controlling the population.

Fear Is Driving Violence And Aggression

Nonstop media coverage of coronavirus has generated unprecedented levels of fear and anxiety.[10] On June 30, Dr. Anthony Fauci warned lawmakers that we could easily see 100,000 new cases of coronavirus each day.[11] Fauci stated that he is unable to accurately predict the incidence and mortality that the US will eventually see, but he declared, “It’s going to be very disturbing, I will guarantee you that.”[12]

Some individuals are now fraught with so much panic and worry that they are becoming violent toward anyone they believe is a threat to their personal safety. Aggression toward those who don’t wear masks is becoming is increasingly common and ranges from verbal threats, to assault and battery, to murder.

In March, an 86-year-old dementia patient was killed in a Brooklyn emergency room after she lost her bearings and grabbed onto another patient’s IV pole to steady herself.[13] The patient, 32-year-old Cassandra Lundy, became irate that the elderly woman, Janie Marshall, had broken social distancing guidelines and then knocked her to the floor. Ms. Marshall — who initially went to the ER for severe abdominal pains — struck her head on the floor, lost consciousness and died hours later. According to reports, Ms. Lundy, who has been charged with manslaughter, told detectives that she shoved Ms. Marshall because the elderly woman “got into the defendant’s space.”[14]

The Great Mask Divide

Masks have become one of the most controversial issues of our time. Those who are seen in public without a mask are often judged and discriminated against, even if they have a condition that precludes compliance. Harassment and discrimination have become rampant,[15] and fellow citizens are policing each other with very little to no knowledge of why someone may or may not be wearing a mask.[16]

Even in communities that have mask exceptions for certain members of the population, those individuals are no longer allowed to fully participate in society because businesses are barring them or won’t provide services to them without a mask. It’s a breach of an individual’s privacy and autonomy to not be able to go into public without being discriminated against, and banning people from entering or participating in society because they don’t wear a mask violates their constitutional rights.[17]

These types of breaches have sparked lawsuits nationwide from individuals claiming they have been personally or financially harmed from mandatory mask measures.[18][19] Some also contend that forcing people with medical conditions to wear masks violates Title III of the Americans with Disabilities Act,[20] which prohibits discrimination on the basis of disability of “enjoyment of services, facilities, privileges, advantages or accommodations by any person who … operates a place of public accommodation.”[21]

Individual Health Is The Responsibility Of The Individual, Not The State 

With unbridled governmental control throughout much of 2020 — under the guise of emergency orders needed to curb coronavirus — citizens from coast to coast have seen their civil, constitutional and religious rights trampled upon. An onslaught of executive orders have shaped nearly every aspect of our personal lives, from where we can go and what activities we’re allowed to engage in, to how we educate our children, to how we earn a living, to how we worship. They have also dictated which medical philosophies we embrace and which medical treatments we can receive. In doing so, we’ve been extremely restricted in how we’ve been able to care for ourselves and support our immune systems — and we’ve been asked to follow guidelines that are not evidence-based “for the greater good.”

Although the government plays a role in controlling the spread of infectious illness, adults are responsible for their own health; each person has the right to responsibly make choices about what precautions and perceived risks they take. It’s not incumbent on government officials to direct individual health decisions, and granting them this power is dangerous. Individuals are much more qualified than public servants to weigh the risks and benefits of their own personal actions.

Public officials should not impose mandates to seek compliance. Mandates perpetuate the idea that individuals lack the moral or intellectual capacity to make sound decisions for themselves and their children, so the state needs to do it for them. Individuals are capable of making responsible decisions, and those decisions must take a person’s whole health into account. The health of the individual cannot be forsaken or sacrificed for the collective. We can only have a healthy society when that society is made up of healthy individuals. Health is a personal right and responsibility. It is not something that we should look to the government to bestow on us or guarantee.

Masks as “Submission Signaling” 

There is no compelling scientific evidence to justify the widespread push to mandate universal mask-wearing. The demonstrated risks far outweigh the purported benefits. Whereas those who wear masks believe they are “virtue signaling” their concern for the weakest and most vulnerable among us, those who refuse to submit to authoritarian decrees do so because they believe that health is a personal responsibility — and that it is up to them to decide what precautionary measures they implement to avoid a virus with an estimated case fatality rate of .1% to .26%.[22]

At-risk populations and those who are sick can self-quarantine, and society should take the best care of them possible. However, healthy, law-abiding citizens should not be forced to take any precaution that can result in physical and emotional harm and that impinges on their constitutional rights; this includes the right to bodily autonomy, the right to move about freely, the right to participate in society and connect with others, and the right to be free from unreasonable government intrusion.

It’s Time to Stand – Urge Your Lawmakers To Make Face Coverings Voluntary

Never before has it been so important for you to stand up for your rights! Mandatory medicine and mandated interventions such as social distancing and mask-wearing have no place in a free society; citizens have the right to make responsible decisions about what is best for themselves and their children based on their own unique circumstances.

Please stand up against medical tyranny by sending your state and local officials a pre-drafted email and tweet urging them to protect everyone in the community by ensuring that masks are voluntary, not mandatory. When you are finished, please share this vital campaign with your friends, family, neighbors and co-workers. Remind them that constitutional rights don’t stop being important in times of emergency; they become more important.

SEND YOUR LETTER NOW

References

  1. https://www.littler.com/publication-press/publication/facing-your-face-mask-duties-list-statewide-orders
  2. https://www.qeios.com/read/1SC5L4
  3. https://apps.who.int/iris/handle/10665/330987
  4. https://bmjopen.bmj.com/content/5/4/e006577
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/#__ffn_sectitle
  6. https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420971/#__ffn_sectitle
  8. https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article
  9. https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data
  10. https://qz.com/1812664/the-psychology-of-coronavirus-fear-and-how-to-overcome-it/
  11. https://www.nytimes.com/2020/06/30/us/politics/fauci-coronavirus.html
  12. https://www.cnn.com/2020/06/30/politics/fauci-redford-testimony-senate-coronavirus/index.html
  13. https://www.nytimes.com/2020/04/08/nyregion/coronavirus-brooklyn-janie-marshall-cassandra-lundy.html
  14. https://patch.com/new-york/bed-stuy/social-distancing-death-suspect-held-coronavirus-packed-rikers
  15. https://www.facebook.com/photo.php?fbid=1143163319383637&set=gm.4087336354647037&type=3&theater
  16. https://www.nytimes.com/2020/05/04/us/social-distancing-rules-coronavirus.html
  17. LawCornell.edu
  18. https://www.miamiherald.com/news/coronavirus/article243643797.html
  19. https://www.nytimes.com/2020/05/04/us/social-distancing-rules-coronavirus.html
  20. https://pittsburgh.cbslocal.com/2020/06/22/lawsuits-against-giant-eagle-mask-policy/
  21. ADA.gov
  22. https://www.nejm.org/doi/pdf/10.1056/NEJMe2002387?articleTools=true

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Case of Cerebral Vasculitis Due to Neurobartonellosis

https://nn.neurology.org/content/7/5/e791

September 2020; 7 (5) CLINICAL/SCIENTIFIC NOTESOPEN ACCESS

A case of cerebral vasculitis due to neurobartonellosis

Meryim Poursheykhi, Farhan Mithani, Tanu Garg, Christian Cajavilca, Siraya Jaijakul, Steve Fung, Richard Klucznik, Rajan Gadhia
First published June 4, 2020, DOI: https://doi.org/10.1212/NXI.0000000000000791

We report a case of a 60-year-old right-handed woman with hypertension, hyperlipidemia, and hypothyroidism who presented with a three-week history of:

  • recurrent thunderclap headaches 
  • photophobia (aversion to light)
  • phonophobi (aversion to sound)
  • nausea
  • vomiting

She reported one brief episode of:

  • slurred speech
  • expressive aphasia (inability to understand and formulate language)
  • right facial droop
  • right hemiparesis suggestive of a TIA

Family history was remarkable for primary angiitis of the CNS (PACNS) in the mother. Neurologic examination was unremarkable. CT of the head was negative; CT angiography (CTA) of the head and neck suggested fibromuscular dysplasia in bilateral cervical internal carotid arteries and distal right vertebral artery. MRI of the brain showed no correlating abnormalities. A digital subtraction angiography (DSA) revealed multivessel intracranial medium and large vessel narrowing and fusiform dilatations, suggestive of reversible cerebral vasoconstriction syndrome (RCVS) vs vasculitis. Subsequent MR intracranial vessel wall imaging (IVWI) showed multifocal concentric vessel wall thickening and enhancement consistent with vasculitis (figure). Transcranial Doppler showed no evidence of elevated intracranial velocities. CSF studies were unremarkable with an opening pressure of 10 cm H2O, 2 white blood cells (normal 0–5/mm3), 2 red blood cells (normal 0–1/mm3), 58 mg/dL glucose (normal 40–70, serum glucose 87), 41 mg/dL protein (normal 15–45), normal Q-albumin ratio, normal IgG synthetic rate, and IgG index. Serum inflammatory and infectious studies had been negative thus far. Empiric high-dose IV steroids lead to complete symptom resolution.

Final infectious workup revealed strongly positive serum Bartonella IgM titer of 1:256 and negative IgG, consistent with her reported cat exposure.

She was started on an outpatient two-week course of doxycycline, rifampin, and oral steroids. Four weeks later, repeat vessel wall MRI and Bartonella serologies (IgM titer 1:80) showed improvement.

Figure
FigureVessel imaging

(A) Angiogram of the left internal carotid artery showing multifocal narrowing and fusiform dilatations (arrows) pretreatment. (B) Intracranial vessel wall MRI showing multifocal concentric vessel wall thickening and enhancement (arrows) pretreatment. (C) Intracranial vessel wall MRI showing reduction in vessel wall enhancement (arrows) posttreatment. (D) Magnetic resonance angiography (MRA) head showing multifocal stenoses (arrows) pretreatment. (E) MRA head showing improvement of stenoses (arrows) posttreatment.

Discussion

We present an individual with symptoms initially concerning for RCVS vs vasculitis who was subsequently found to have secondary CNS vasculitis due to cat-scratch disease (CSD). To our knowledge, this is the first adult case of Bartonella henselae-associated CNS vasculitis, particularly without encephalopathy as the presenting symptom.

CSD typically presents with self-limited regional lymphadenopathy and fever.1 Neurologic complications are rare, occurring in 2% of cases with encephalopathy as the most common manifestation.2 Neuroretinitis, seizures, coma, myelopathies, and cranial and peripheral nerve involvement have also been reported. CNS vasculitis associated with CSD, however, has only been reported in 2 pediatric cases which presented with strokes.3,4

Diagnostically, identifying primary and secondary CNS vasculitis can be challenging both clinically and radiographically. No specific studies in serum or CSF are available for the diagnosis of CNS vasculitis. As in neurobartonellosis, CSF may be unremarkable or reveal nonspecific mild lymphocytic pleocytosis. Cerebral vasculopathies can present with similar luminal patterns, and therefore, imaging modalities such as DSA, magnetic resonance angiography (MRA), and CTA provide nonspecific results leading to difficulties identifying and differentiating between common etiologies of intracranial disease including vasospasm, atherosclerosis, and inflammation. Although DSA remains the gold standard for vessel imaging, it is an invasive study that provides information limited to the vessel lumen. Conversely, IVWI allows direct visualization of the vessel wall by subtracting the signal of blood in the vessel lumen and has shown to improve diagnostic specificity.5 In CNS vasculitis, IVWI shows multifocal concentric vessel wall enhancement and thickening as seen in our patient. In RCVS, vessel wall thickening may be present but with minimal or no enhancement.5

At this time, there is no clear evidence-based treatment regimen or duration for neurologic manifestations of CSD including CNS vasculitis.1 We recommend concomitant treatment of the infection with antibiotics and secondary vasculitis with high-dose steroids. Our patient received a 2-week combination of doxycycline 100 mg and rifampin 300 mg twice daily per current expert opinion.6 In addition, we initiated 5 days of high-dose IV steroids, followed by a 1-week oral steroid taper. To avoid recurrent invasive testing, we repeated IVWI 4 weeks later for treatment monitoring and found significant reduction in vessel wall enhancement (figure).

Our case reiterates the importance of ruling out rare causes of CNS vasculitis including assessing animal exposure before diagnosing PACNS. Detection of the etiology of vasculitis is essential to guide treatment and for prognostication. Noninvasive imaging such as an IVWI provides valuable diagnostic information and can be useful in assessing the treatment response over time by minimizing the need for repeat invasive DSA.

Study funding

No targeted funding reported.

Disclosure

M. Poursheykhi, F. Mithani, T. Garg, C. Cajavilca, S. Jaijakul, S. Fung, R. Klucznik, and R. Gadhia report no disclosures. Go to Neurology.org/NN for full disclosures.

Acknowledgment

The authors thank Dr. Gadhia for his mentorship.

_____________________

**Comment**

Since Bartonella is a vascular disease, it follows that it will cause vasculitis pretty much anywhere in the body.  https://madisonarealymesupportgroup.com/2020/01/05/bartonella-endocarditis-masquerading-as-systemic-vasculitis-with-rapidly-progressive-glomerulonephritis/

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

It also creates tumors, many neurological manifestations including PANS and other mental health issues.

The concern with their treatment is it wasn’t long enough and she could relapse, which is common.  Bartonella, in my opinion, is as bad if not worse than Lyme disease and together it’s a one, two punch – you are out.

Marna Ericson’s work has demonstrated it to survive right along side a PICC line with antibiotics being pumped directly into the body:  https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/  The subject is her son who has chronic bartonellosis.

 

 

 

Category:

Bartonella, research, Treatment

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RMSF Rare in NJ But Spreading Elsewhere

https://www.sciencedaily.com/releases/2020/06/200625124939.htm

Dangerous tick-borne bacterium extremely rare in New Jersey

The mystery behind the rise in spotted fever cases continues

Date:  June 25, 2020
Source:  Rutgers University
Summary:
There’s some good news in New Jersey about a potentially deadly tick-borne bacterium. Researchers examined more than 3,000 ticks in the Garden State and found only one carrying Rickettsia rickettsii, the bacterium that causes Rocky Mountain spotted fever. But cases of tick-borne spotted fevers have increased east of the Mississippi River, and more research is needed to understand why.  (See link for article)

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**Comment**

Important quote:  

“CDC researchers recently found that the invasive Asian longhorned tick, like the American dog tick and lone star tick, is an efficient vector of Rickettsia rickettsii in the lab,” said senior author Dina M. Fonseca.

I’m surprised they didn’t mention that the brown dog tick has outbreaks in Mexico.

This is worrisome because the brown dog tick is more likely to bite people and it adapts easily to living in a house.. Researchers worry it may be spreading to California and the Southern U.S.  It also appears to transmit a more virulent form of RMSF: https://madisonarealymesupportgroup.com/2018/08/16/new-tick-causes-epidemic-of-rmsf/

For more:  https://madisonarealymesupportgroup.com/2020/05/05/asian-longhorned-tick-able-to-transmit-rmsf-in-lab-setting-also-transmitted-within-ticks-through-ova/

https://madisonarealymesupportgroup.com/2019/07/25/kentucky-more-than-two-dozen-rocky-mountain-spotted-fever-cases-reported-in-grayson-county/

https://madisonarealymesupportgroup.com/2020/06/30/rocky-mountain-spotted-fever-can-be-deadly-how-to-prevent-diagnose-treat-it/

Category:

research, Rocky Mountain Spotted Fever, Testing, Ticks, Transmission

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