Comments and Co-infections

Comments

We would like to point out that laboratory values as much as imaging methods (ultrasound, CT, MRT, etc.) should be considered as supporting methods for a diagnosis. There are important factors that a laboratory cannot detect and that an imaging process cannot reveal, despite an important advance in the technical development. After all, a MRI is not a microscope yet.

In general, all scientists (including us) should be careful affirming that everything that we cannot prove does not exist. Together, we should conduct research and look out. This is what we stand and campaign for.

Otherwise, patients will continue to go to several doctors and clinics (involving repeated diagnostics, unsatisfactory symptomatic therapies, long work incapacities, invalidities, etc.). It is also an economical factor as patients will have to undergo many further tests until the correct diagnosis is met and an efficient therapy is found.

Surely, there are studies that can be interpreted incorrectly or even show methodological weaknesses.  This can always happen; especially when it comes to a statistical evaluation of a study (we all know that). However, we do not think that all cited studies, especially the ones taken from renowned journals, are incorrectly interpreted and evaluated. We believe that there is a big and interesting field of very complex interdependencies that is yet to be studied. Just because there is only little literature about co-infections and mixed infections does not mean that they do not exist. This should be an incentive for doing more research about it (see below and in the chapter “symptoms”). We are not alone with this opinion. Also the Entomological Society of America and Dr. John Aucott from the Johns Hopkins University see these problems and ask for more research and a factual discussion.

 

Unknown borrelia strains

In fact, a new borrelia strain has been discovered as human-pathogenic and was found at first in the Pacific region, the Borrelia miyamotoi (see: General Information). We surely do not have yet adequate testing methods to detect it. Therefore, those patients can still be negative in an antibody test for borreliosis, even though they are positive. And maybe there are many more of these unknown and human-pathogenic strains.

 

Let us not generalise

The general medical opinion affirms that a spontaneous healing of borreliosis is possible. Maybe these persons are infected but not sick? PD Dr. Hassler states the contrary in his studies.

The general medical opinion likes to quote Klempner’s study (from 2001) when affirming that a long term antibiotic treatment does not bring “meaningful medical benefit”. However, this study included also patients with “seronegative” borreliosis, which is said to be “inexistent” in the late stadium (or chronic stadium). There is therefore a contradiction. However, such contradictions can be found on both sides; the Embers’ study can be discussed just as well.

 

Is Ceftriaxon adequate or enough?

From own experience, we are able to confirm the Klempner’s new study (from 2013). A mono-therapy (using only one substance) with ceftriaxon does not lead to any improvements or disappearing of the patient’s symptoms, not even in the long term. It is effective against the native spiral form of borrelias. But the therapy must also tackle persister forms of borrelias and from other pathogens, as well as co-infections and biofilms. This is the reason that the therapy should include a combination of antibiotics (see: Antibiotic Treatment, literature (1) and General Information, literature (2) and below). In the same way, even doxycycline as a mono-therapy may not be efficient enough.

The treatment with ceftriaxon should be reconsidered, since it does not attack persistent forms of borrelias or other pathogens, nor does it help against co-infections and biofilms (see: Antibiotic Treatment).  A combination of distinct antibiotic substances must be employed in order to achieve this. These substances must have reduced risks and side effects, thus better metabolised by the body as the ones used currently (ceftriaxon and doxycycline). This way, we get a better risk/success relation during the therapy.

 

Conclusion

We believe that it is not correct (in a factual discussion) to state that one “opinion” has exclusively good and scientifically correct studies, and that the opposite “opinion” has exclusively wrong and scientifically incorrect studies. However, it is definitely wrong to state that there is no literature available regarding either of those “opinions” on borrelia and co-infections. Also other infections and tick-borne diseases can cause complaints. It is not always Lyme disease. A patient can also have two or more infections at the same time.

 

Co-infections:

Sugdan K et al: Is Toxoplasma Gondii Infection Related to Brain and Behavior Impairments in Humans? Evidence from a Population-Representative Birth Cohort; 2016, PLOS ONE, DOI:10.1371/journal.pone.0148435 February 17, 2016

A new study from France: Vayssier-Taussat Muriel et al: Identification of Novel Zoonotic Activity of Bartonella spp., France; Emerg Infect Dis. 2015 Mar [date cited]. http://dx.doi.org/10.3201/eid2203.150269

New case reports: Ahmad Ameilia et.al.: “Cat scratch disease presenting as increased intracranial pressure and aseptic meningitis”, Asian Pac J Trop Dis 2015; 5(6): 500-501; doi:10.1016/S2222-1808(15)60823-4

Gary P. Wormser et. al.: ” Neutropenia in Congenital and Adult Babesiosis”, Am J Clin Pathol 2015; 144: 94-96, doi: 10.1309/AJCPHH4HBVHZFS

Mirouse G. et al: “Bartonella henselae osteoarthritis of the upper cervical spine in a 14-year-old boy”, Orthop Traumatol Surg Res (2015), http://dx.doi.org/10.1016/j.otsr.2015.02.007

Charles A. Kallick et.al: “Could ehrlichial infection cause some of the changes associated with leukemia, myelodysplastic diseases and autoimmune disorders, and offer antibiotic treatment options?”, Medical Hypothesis 85 (2015) 891-893

 

Further reading about Co-Infections:

Jen-Wei Lin et.al: “Unknown Fever and Back Pain caused by Bartonella henselae in a Vetenarian after a Needle Puncture: A Case Report and Literature Review”, Vector-Borne and Zoonotic Diseases, Volume 11, Number 5, 2011; doi: 10.1089/vbz.2009.0217

Philippe Parola et al: “Update on Tick-Borne Rickettsioses around the World: a Geographic Approach”, Clinical Microbiology Reviews, October 2013, Volume 26, Number 4, p. 657-702; http://cmr.asm.org

Edouard Vannier, Ph.D., and Peter J., Krause, M.D.: ‘Human Babesiosis’, The New England Journal of Medicine 366;25; June 21,2012; 2397-407

Marion Blaschitz et al.: ‘Babesia Species Occurring in Austrian Ixodes ricinus Ticks’, Applied and environmental Microbiology, Aug. 2008, Vol. 74, No. 15, p. 4841-4846

Todd A. Florin et al.: ‘Beyond Cat Scratch Disease: Widening Spectrum of Bartonella henselae Infection’, PEDIATRICS 2008, Volume 121, Number 5, May 2005, e1413-e1542

Massimo Accorinti: ‘Ocular Bartonellosis’ International Journal of Medical Sciences; 2009; 6(3):131-132

Cari J Stek et al.: ‘Neuralgic amyotrophy associated with Bartonella henselae infection’; J Neurol Neurosurg Psychiatry published online Aug. 14, 2010; doi: 10.1136/jnnp.2009.191940

An overwiew about ehrlichia-infection from Bogdan, Christian et.al. ‘Ehrlichien: Durch Zecken übertragbare Erreger’, Dtsch. Ärzteblatt 2000; 97 (38): A-2450, B-2007, C-1985

N. Kevin Wade et. al.“Optik disk edema associated with perpapillary serous detachment: an early sign of systemic Bartonella henselae infection, American Journal of Ophthalmology Vol. 130, Issue 3, September 2000, Pages 327-334

James L. Schaller et.al.” Do Bartonella Infections Cause Agitation, Panic Disorder and Treatment Resistant Depression? “; MedGenMed. 2007; 9(3): 54, published online Sep. 13, 2007

Andrea Gaito et.al. „ Comparative analysis of the infectivity rate of both Borrelia burgdorferi and Anaplasma phagocytophilum in humans and dogs in a New Jersey community, Infection and Drug Resistance, 2014: 7, 199-201

Bakken JS, Dumler JS: Clinical diagnosis and treatment of human granulcytotropic anaplasmosis; Ann N Y Acad Sci. 2006 Oct: 1078:236-47.

Breitschwerdt E.B. et al.: Koch’s Postulates and the Pathogenesis of Comparative Infectious Disease Causation Associated with Bartonella species; J. Comp. Path. 2013, Vol. 148, 115-125.

Siamer S, Dehio C: New insights into the role of Bartonella effector proteins in pathogenensis; Current Opinion in Microbiology 2015, 23:80-85.

Wojcik-Fatla A et al.: Leptospirosis as a tick-borne disease? Detection of Leptospira spp. in Ixodes ricinus ticks in eastern Poland; Annals of Agricultural and Environmental Medicine 2012, Vol 19, Nr 4, 656-659.

Jia-Fu Jiang et.al. “Babesiosis in China, an emerging threat”, Lancet Infect Dis., Dez 2014, http//dx.doi.org/10.1016/S1473-3099(19)71062-X

Croxatto,A,et.al., “Presence of Chlamydiales DNA in ticks and fleas suggests that ticks are carriers of Chlamydiae.”,  Ticks and Tick-borne Dis (2014), http//dx.doi.org/10.1016/j.ttbdis.2013.11.009

Nicolson GL, Gan R, Haier J. Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms. APMIS 2003;111:557–66.

Mariconti, Mara et. al. “Humans parasitized by the hard tick Ixodes ricinus are seropositive to Midichloria mitochondrii: is Midichloria a novel pathogen, or just a marker of tick bite?”, Pathogens and global Health 2012, Vol. 106 No. 7 pp 391 ff

 

Informations also here: www.erlebnishaft.de –diagnostik—pro contra.pdf