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Headlines: Multiple Diagnoses with Tick-Borne Pathogens (Giant Cell Arteritis, Yezo Virus, Breast Cancer, HLH) * Less Common Symptoms of Tick-Borne Pathogens * Increasing Global Footprint of Relapsing Fever Group Borrelia * More
Multiple Diagnoses
Tick-borne infections themselves sometimes travel together, or multiple diagnoses can accompany tick-borne diseases. The infection may have caused the other diagnoses, or they may just be co-occurring. In any case, concurrent diagnoses can complicate diagnosis and treatment.
Through the Eyes of Uncertainty: Giant Cell Arteritis and Lyme Neuroborreliosis in a Story of Vision Loss by L Wan, A Yan, E Reese, J Thomas & M Kissinger publishing from the West Virginia School of Osteopathic Medicine and Trinity Health System – An 80-year-old woman with sudden vision loss, facial droop, jaw pain, headache and other symptoms had giant cell arteritis. This autoimmune disease affects 1% of women and 0.5% of men in the United States and is most common in elderly people. These were classic symptoms, but was this the whole story?
Before increasing immunosuppression, a comprehensive infectious disease testing panel was ordered and the patient was positive for Lyme disease. Lyme neuroborreliosis could have been detected from a lumbar puncture, but the patient had declined the procedure. This case provides yet another reminder that the first explanation may not be the only disease process, and that multiple diseases may be present at the same time. The authors suggest testing for Lyme disease in cases of acute vision loss.
A Case of Tick-borne Disease with Yezo Virus and Borrelia miyamotoi Coinfection by K Suzuki, S Suzuki, H Yamaguchi & Y Kakinoki publishing from Asahikawa City Hospital and Hokkaido Institute of Public Health – Yezo virus is a tick-borne virus with two previous reported human cases in Japan and one in China. In this third Japanese case, the patient was also infected with Borrelia miyamotoi. Very little is known about Yezo virus symptoms. A dispatch by X Lv et al. published by the US CDC contains an overview.
Evidence for the Presence of Borrelia burgdorferi in Invasive Breast Cancer Tissues by NJ Patel et al. publishing from the Lyme Disease Research Group at the University of New Haven – A study of a commercially available breast cancer tissue array found that 20% of invasive lobular and ductal carcinomas and 14% of intraductal carcinomas tested positive for Borrelia burgdorferi, but none of the normal tissue did. There remains a chicken-and-the-egg question about a variety of pathogenic colonization of tumor tissue, whether the infection influenced the development of the cancer or whether the cancer created a hospitable environment. Either way, the B. burgdorferi-infected tissue had changes to chemokines, which increase inflammation.
Bartonella henselae Related Unilateral Anterior Uveitis and Subsequent Multifocal Retinitis in a Case Under Certolizumab Treatment by M Kayabaşı, I Kefeli, PC Özdal & AO Saatci publishing from Turkey – Patients on anti-tumor necrosis factor treatment are more susceptible to infections, but adverse events involving the eyes from the treatment itself can complicate identifying Bartonella infections involving the eye. A new case report includes a round-up of previously published cases.
Less Common Symptoms
Japanese Spotted Fever Complicated by Acute Sensorineural Hearing Loss by M Shingu, C Fujishima, S Hara & H Nishioka publishing from Kobe City Medical Center General Hospital – Japanese spotted fever (#Rickettsia japonica) patients sometimes have both hearing loss and cutaneous IgM/IgG immune complex vasculitis, symptoms that travel together. In this case study, antibiotic treatment resolved both symptoms.
Lyme-Associated Pericarditis: A Case Report and Literature Review by MA Ameer et al. publishing from Pakistan and the USA – A patient had chest pain, a rash on his back, and ECG changes consistent with Lyme disease. He tested negative, but antibiotic treatment was started based on clinical suspicion and he improved.
Direct detection can overcome delayed antibody response in laboratory confirmation of Lyme disease. Find out more about the Galaxy Diagnostics Lyme Borrelia Nanotrap Antigen Test.
Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases by D Jevtic et al. and a team from the US, Brazil and Serbia – A review of 98 cases of hemophagocytic lymphohistiocytosis (HLH) that were ultimately found to be related to tick-borne disease led researchers to conclude that early antibiotic treatment where HLH is suspected to involve tick-borne disease is life-saving.
Increasing Global Footprint of Relapsing Fever Group Borrelia
The Global Distribution and the Risk Prediction of Relapsing Fever Group Borrelia: A Data Review with Modelling Analysis by T Tang et al. publishing from China, Australia and the USA – In a data study looking at reports on the humans, animals, and vectors interacting with relapsing fever group Borrelia including B. miyamotoi, B. lonestari and more, researchers predicted their habitat will cover regions housing 1.34 billion people.
MORE: Mediterranean Spotted Fever with Photographs * Animal Pathogens Expanding Territories (PE, Theileria, Babesia gibsoni, Avian Influenza) * Dietary Supplement Packaging Safety and Children
Mediterranean Spotted Fever with Photographs
Rickettsia conorii subsp israelensis Infection in a Pediatric Patient Presenting Skin Rash and Abdominal Pain: A Case Report from Southeast Iran by A Hosseininasab & S MoradKasani et al. publishing from Kerman University of Medical Sciences and Pasteur Institute of Iran – This case report is of a child with Rickettsia conorii (Mediterranean spotted fever). The case has useful photographs of MSF skin signs. One of those signs is a black eschar which can occur at the tick bite with certain pathogens. While it is associated with some Rickettsia species, it should be noted that it is much less common with R. rickettsii (Rocky Mountain spotted fever).
Find out more about Galaxy Diagnostics PCR testing for Rickettsia species.
Animal Pathogens Expanding Territory
Climate Determines Transmission Hotspots of Polycystic Echinococcosis, a Life-Threatening Zoonotic Disease, Across Pan-Amazonia by A San-José and a very large team publishing from Spain, UK, Peru, Brasil & France – Changes in climate can alter human and animal behavior, increasing opportunities for zoonotic spillover. Studying the tapeworm disease PE in the Amazon region through El Niño climate shifts is an example of how these changes can be tracked.
Emerging Cattle Disease Found in Missouri – Theileria orientalis is a parasite that causes anemia in cattle. In the US, it is primarily spread by the invasive Asian longhorned tick. It has spread to six counties in Missouri since it was first detected in the state last year.
Second Dog Infected with Rare Parasite Babesia gibsoni – For the first time, Babesia gibsoni was found in New Zealand in one dog. Testing of close contacts of that dog has found one additional infected dog.
Avian Influenza: One Health Surveillance is Key to Prevent Virus Evolving – The European Food Safety Authority has published a news update on avian influenza that encourages One Health management of exposures. The Authority intends to write a scientific opinion with the ECDC by the end of the year.
Dietary Supplement Packaging Safety and Children
Melatonin Industry Asked to Voluntarily Tighten Standards After Dramatic Rise in Childhood ER Visits – With few approved treatments for the symptoms of tick-borne infections, many turn to complementary and alternative medicine (CAM), including the use of dietary supplements. A major trade organization in the supplements industry has recommending better packaging and warnings, with a deadline for implementation. This comes after ER visits are up for children under four from overdoses and other adverse events. While melatonin is the headline here, another important thing to note is that chewable supplements can be a choking hazard for children under four.
In case you missed last week’s Galaxy Radar… Video from Dr. Breitschwerdt discussing the Bartonella 4-Species Serology Panel
Listen to Galaxy Diagnostics Chief Scientific Officer and Cofounder Dr. Edward Breitschwerdt discussing the answers to these questions and more:
– Why is it important to test for antibodies against multiple Bartonella species?
– What symptoms do you see with Bartonella infection?
– Why is Bartonella koehlerae an important species to test for?
