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(A Microbiology Tutorial)
by, Thomas M. Grier
(An excerpt from the Lyme Disease Survival Manual 2000)
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90-
Western Blot and False Negatives in Children: 1995 Rheumatology Symposia
Abstract # 1254 Dr. Paul Fawcett et al. This abstract showed that under
the old criteria, all of 66 pediatric patients with a history of a tick
bite and, Bull’s Eye rash who were symptomatic, were accepted as
positive under the old Western Blot interpretation. Under the newly proposed
criteria only 20 were now considered positive. That means 46 children
who were all symptomatic, would probably be denied treatment! That’s
a success rate of only 31 %. 66 Children with Bull’s Eye rash Old
W. Blot Criteria 100 % positive New NIH Criteria 31% positive The number
of false positives under both criteria was ZERO %*
Note: A misconception about Western Blots is that they have as many false
positives as false negatives. This is not true. False positives are rare.
The conclusion of the researchers was: “the proposed Western Blot
Reporting Criteria are grossly inadequate, because it excluded 69% of
the infected children.”
91- Abstract # D612- E.L. Logigian - SPECT Scans in LD and reversible CerebralHypoperfusion in Lyme Encephalopathy. SPECT scans in patients with Lyme encephalopathy showed decreased blood flow in the frontal sub-cortical and cortical regions of the brain. After IV Rocephin there was partial improvement, but not total reversal. Abstract #626 - Kenneth Linger, SPECT Scans in Lyme Patients: SPECT scans revealed significant perfusion problems in Chronic Neurologic Lyme Patients, and may offer clinicians another tool to help assess brain function, and neuropathies.
92- Abstract # D647 - P.K. Coyle et al, North American Meningitis. Conclusion: North American Meningitis does not produce the marked inflammatory and immune changes reported in European cases. Lyme Meningitis can occur despite early oral antibiotics.
93- Abstract # D654 - J. Nowakowski, et al. Culture-Confirmed Treatment Failures of Cephalexin Therapy for Erythema Migrans. Two of six patients biopsied had culture confirmed Borrelia burgdorferi infections despite up to 21 days of cephalexin (500 mg TID) antibiotic treatment.
94- Abstract # D655 - Nowakowski, et al, Culture-confirmed infection and reinfection with Borrelia burgdorferi. A patient despite antibiotic therapy had a recurring Erythema Migrans rash on three separate occasions. On each occasion it was biopsied, and revealed the active presence of Borrelia burgdorferi on two separate occasions indicating reinfection had occurred.
95- Abstract # D657 - J. Cimperman, F. Strle, et al, Repeated Isolation of Borrelia burgdorferi from the CSF of two patients treated for Lyme neuroborreliosis. Patient 1, was a twenty year old woman who presented with meningitis but was sero-negative for Borrelia burgdorferi. Subsequently six weeks later, Bb was cultured from her CSF and she was treated with IV Rocephin 2 grams a day for 14 days. Three months later the symptoms returned and Bb was once again isolated from the CSF. Patient 2 was a 51 year old female who developed an EM rash after tick bite. Within two months she had severe neurological symptoms, her serology was negative. She was denied treatment until her CSF was culture positive nine months post tick bite. She was treated with 2 grams of Rocephin for 14 days. Two months post antibiotic treatment Bb was once again cultured from her CSF. In both these cases the patients had negative antibodies, but were culture positive, suggesting that the antibody tests are not reliable predictors of neurological Lyme Disease. Also standard treatment regimens are insufficient when infection of the CNS is established, and Bb can survive in the brain despite Intra venous antibiotic treatment.
96- Abstract # D658 - F. Strle et al. Reinfection with Borrelia burgdorferi in endemic areas. Conclusion: Even despite high antibody titers as seen in ACA patients, 7 % of 2273 patients with previous Lyme disease, became reinfected and present with an EM rash and late symptoms after a recent tick bite.
97- Pachner AR, Itano A. Borrelia burgdorferi infection of the brain: Characterization of the organism and response to antibiotics and immune sera in the mouse model. Neurology 1990;40:1535-1540
98- Bakken LL, Callister SM, Wand PJ, Schell RF. Interlaboratory Comparison of Test Results for the Detection of Lyme Disease by 516 Participants in the Wisconsin State Lab of Hygiene/College of American Pathologists Proficiency Testing Progrm. J Clin Microbiol 1997; Vol 35, No 3:537-54399- Bakken LL, Case KL, Callister SM et al. Performance of 45 Laboratories participating in a proficiency testing program for Lyme disease serology. JAMA 1992;268:891-895 Abstract # 1256 by K.K. McCartney et al : This study showed that the using the newly proposed Western Blot criteria resulted in 60 % false negative results in children with both E.M. Rash, and Bell’s Palsy. A total of 23 patients with both a bull’s-eye Rash and Bell’s Palsy were tested using the new criteria for Western Blot as proposed by the NIH committee. Only nine of the 23 patients were considered positive with the new criteria. This means six out of every ten Lyme Patients would be a false negative. This means flipping a coin is actually more accurate by a healthy margin of 10%. Abstract # D601/D618 - Y.Li et al. Neurborreliosis associated with Guillian-Barre’ Syndrome. - Report of two patients in China who were previously diagnosed with Guillian-Barre’ Syndrome who tested positive for Bb. Their symptoms responded to antibiotic treatment. This means they may have been misdiagnosed, or GBS is triggered by a spirochetal infection. Abstract: # D644 - P.K. Coyle, Rapid Dissemination of Bb from the skin to the CNS. Conclusion: Bb can rapidly seed the CNS from the entry site in the skin, even prior to the formation of a rash. Therefore the traditional staging of Lyme disease based on symptoms, as either early or late stage may be a poor indicator of actual dissemination of the spirochete. Abstract #D646 - P.K. Coyle, et al, Multiple Sclerosis vs. Lyme disease a diagnostic dilemma. Forty-seven patients were identified as possible MS patients. Many had brain lesions on their MRIs, consistent with MS 61%. CSF was constant with MS in 46 % of the patients. The final breakdown of the 47 patients was: 21 MS, 15 LD, 7 had findings constant with both LD and MS. Thirteen patients responded to antibiotics but only those who had CSF findings consistent with LD
page - one - two - three - four - five - six - seven - eight - nine - ten -
91- Abstract # D612- E.L. Logigian - SPECT Scans in LD and reversible CerebralHypoperfusion in Lyme Encephalopathy. SPECT scans in patients with Lyme encephalopathy showed decreased blood flow in the frontal sub-cortical and cortical regions of the brain. After IV Rocephin there was partial improvement, but not total reversal. Abstract #626 - Kenneth Linger, SPECT Scans in Lyme Patients: SPECT scans revealed significant perfusion problems in Chronic Neurologic Lyme Patients, and may offer clinicians another tool to help assess brain function, and neuropathies.
92- Abstract # D647 - P.K. Coyle et al, North American Meningitis. Conclusion: North American Meningitis does not produce the marked inflammatory and immune changes reported in European cases. Lyme Meningitis can occur despite early oral antibiotics.
93- Abstract # D654 - J. Nowakowski, et al. Culture-Confirmed Treatment Failures of Cephalexin Therapy for Erythema Migrans. Two of six patients biopsied had culture confirmed Borrelia burgdorferi infections despite up to 21 days of cephalexin (500 mg TID) antibiotic treatment.
94- Abstract # D655 - Nowakowski, et al, Culture-confirmed infection and reinfection with Borrelia burgdorferi. A patient despite antibiotic therapy had a recurring Erythema Migrans rash on three separate occasions. On each occasion it was biopsied, and revealed the active presence of Borrelia burgdorferi on two separate occasions indicating reinfection had occurred.
95- Abstract # D657 - J. Cimperman, F. Strle, et al, Repeated Isolation of Borrelia burgdorferi from the CSF of two patients treated for Lyme neuroborreliosis. Patient 1, was a twenty year old woman who presented with meningitis but was sero-negative for Borrelia burgdorferi. Subsequently six weeks later, Bb was cultured from her CSF and she was treated with IV Rocephin 2 grams a day for 14 days. Three months later the symptoms returned and Bb was once again isolated from the CSF. Patient 2 was a 51 year old female who developed an EM rash after tick bite. Within two months she had severe neurological symptoms, her serology was negative. She was denied treatment until her CSF was culture positive nine months post tick bite. She was treated with 2 grams of Rocephin for 14 days. Two months post antibiotic treatment Bb was once again cultured from her CSF. In both these cases the patients had negative antibodies, but were culture positive, suggesting that the antibody tests are not reliable predictors of neurological Lyme Disease. Also standard treatment regimens are insufficient when infection of the CNS is established, and Bb can survive in the brain despite Intra venous antibiotic treatment.
96- Abstract # D658 - F. Strle et al. Reinfection with Borrelia burgdorferi in endemic areas. Conclusion: Even despite high antibody titers as seen in ACA patients, 7 % of 2273 patients with previous Lyme disease, became reinfected and present with an EM rash and late symptoms after a recent tick bite.
97- Pachner AR, Itano A. Borrelia burgdorferi infection of the brain: Characterization of the organism and response to antibiotics and immune sera in the mouse model. Neurology 1990;40:1535-1540
98- Bakken LL, Callister SM, Wand PJ, Schell RF. Interlaboratory Comparison of Test Results for the Detection of Lyme Disease by 516 Participants in the Wisconsin State Lab of Hygiene/College of American Pathologists Proficiency Testing Progrm. J Clin Microbiol 1997; Vol 35, No 3:537-54399- Bakken LL, Case KL, Callister SM et al. Performance of 45 Laboratories participating in a proficiency testing program for Lyme disease serology. JAMA 1992;268:891-895 Abstract # 1256 by K.K. McCartney et al : This study showed that the using the newly proposed Western Blot criteria resulted in 60 % false negative results in children with both E.M. Rash, and Bell’s Palsy. A total of 23 patients with both a bull’s-eye Rash and Bell’s Palsy were tested using the new criteria for Western Blot as proposed by the NIH committee. Only nine of the 23 patients were considered positive with the new criteria. This means six out of every ten Lyme Patients would be a false negative. This means flipping a coin is actually more accurate by a healthy margin of 10%. Abstract # D601/D618 - Y.Li et al. Neurborreliosis associated with Guillian-Barre’ Syndrome. - Report of two patients in China who were previously diagnosed with Guillian-Barre’ Syndrome who tested positive for Bb. Their symptoms responded to antibiotic treatment. This means they may have been misdiagnosed, or GBS is triggered by a spirochetal infection. Abstract: # D644 - P.K. Coyle, Rapid Dissemination of Bb from the skin to the CNS. Conclusion: Bb can rapidly seed the CNS from the entry site in the skin, even prior to the formation of a rash. Therefore the traditional staging of Lyme disease based on symptoms, as either early or late stage may be a poor indicator of actual dissemination of the spirochete. Abstract #D646 - P.K. Coyle, et al, Multiple Sclerosis vs. Lyme disease a diagnostic dilemma. Forty-seven patients were identified as possible MS patients. Many had brain lesions on their MRIs, consistent with MS 61%. CSF was constant with MS in 46 % of the patients. The final breakdown of the 47 patients was: 21 MS, 15 LD, 7 had findings constant with both LD and MS. Thirteen patients responded to antibiotics but only those who had CSF findings consistent with LD
page - one - two - three - four - five - six - seven - eight - nine - ten -
Ticks carry more than just
Lyme disease! Including:
0 -Ehrlichia;
o -Bartonella;
0 -Babesia;
o -Q- Fever;
0 -Tularemia;
o -Tick-borne Encephalitis;
0 -Mycoplasma;
o -Relapsing Fever;
0 -Rocky Mountain Spotted Fever and others.
Never WAIT and SEE about a tick bite, please! Quickly and properly treated infections are less likely to progress to later stage or chronic disease.
Sometimes tick bites are
mistaken for spider bites!
Some diseases may be spread by animal bites or scratches and from mosquitoes, fleas or lice.
There is still so much to learn about Lyme disease and related infections.
Sometimes Lyme disease and related infectious diseases are undiagnosed for years, even decades!
Watch closely for symptoms after tick bites. Some never see a tick or a bulls-eye rash.
Don't ignore tick-borne disease symptoms!
If you feel sick, ask a doctor!
SYMPTOMS may include:
0 -Tick bites;
o -Fever; Flu symptoms;
0 -All kinds of Rashes;
o -Muscle; Joint; Neck Pain;
0 -Body Aches; Weakness
o -Light /Sound Sensitivity;
0 -Bells Palsy; Nerve pain;
o -Insomnia; Poor memory
0 -Headaches; Numbness;
o -Mood disorders; Confusion;
0 -Extreme Fatigue; Exhaustion
Never let tick-borne diseases progress!
Lyme and associated diseases are often MISTAKEN FOR OTHER ILLNESSES, Including:
0 -Chronic Fatigue;
o -Fibromyalgia;
0 -Hypochondria;
o -Multiple Sclerosis;
0 -Lupus;
o -Rheumatoid Arthritis;
0 -Lou Gehrig's disease (ALS);
o -Alzheimer's and
0 -Parkinson's disease
******************
Don't be fooled about ticks and their diseases.
******************
Directly affecting humankind, worldwide:
W H A T H A P P E N E D
when the U.S. Senate addressed the Centers for Disease Control regarding Lyme disease?
Consult a good doctor!
Visit ILADS, LDF, LymeNet or LDA to find a specialist in your location.
Protect your children and your family.
Learn about ticks and their many diseases.
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TICK
BYTES:
Tick-borne diseases are spreading rapidly
in many countries across the world including,
UK, Scandinavia, Hungary, Scotland, USA,
France, Germany, China, and Australia.
There is NO 100% accurate Lyme disease
TEST available to detect infection or cure.
Ticks can be found in and around
leaf litter; grass; logs; animal fur;
bird feeders; and deer, mice, squirrel,
and other small animal habitats.
Tick-borne diseases are spreading rapidly
in many countries across the world including,
UK, Scandinavia, Hungary, Scotland, USA,
France, Germany, China, and Australia.
There is NO 100% accurate Lyme disease
TEST available to detect infection or cure.
Ticks can be found in and around
leaf litter; grass; logs; animal fur;
bird feeders; and deer, mice, squirrel,
and other small animal habitats.
How
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Tick-borne diseases can
affect any body part,
organ, and any system
of the body.
Lyme disease and Syphilis are both caused by a type of bacteria called a spirochete.
Tick-borne diseases can KILL!
Ticks travel on mice!
ALWAYS Get Ticks Tested!
Never let tick-borne
infections progress !
Tick-borne diseases can
affect any body part,
organ, and any system
of the body.
Lyme disease and Syphilis are both caused by a type of bacteria called a spirochete.
Tick-borne diseases can KILL!
Ticks travel on mice!
ALWAYS Get Ticks Tested!
Lyme Disease Foundation
Lyme
rashes have been
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mistaken for ring worm!
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travel on birds!
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