What I see in practice
Two strains of Borrelia are positively identified by
the practice case load, Burgdorferi and Garinii. As to whether there is any
difference in symptomatology I can not comment. The former is the predominant
organism. Further we have Azelii which is known to cause both the
acrodermatitis chronica atrophicans and also a nummular truncal and limb rash
occasionally seen in Lyme disease. Here is an excellent photo of the latter:
There is no arthritic disease as in North America.
Rather we follow a disease pattern of marked neurological symptomatology which
is the European and Asian pattern of the disease. There is also a biotoxin
(refer Burruscano document) produced by the Borrelia which produces sometimes
marked asymmetric muscle spasm and twitching. Cranial nerve involvement
followed by upper cervical nerves accounts for most symptomatology.
It is quite striking the number of cranial nerves
involved by chronic Borellia infection. I find in most patients there are
numbers of 6 to 10 involved. Of particular note are the 9th 10th 11th and 12th nerves in regard to pharyngeal laryngeal and anterior neck musculature.
The number of distinct cranial nerves involved far outweighs the few seen in
MS and from seeking neurological opinion on this, I am advised that the only
other diseases that match this number of cranial nerve involvement are Sarcoid
and neurological autoimmune diseases.
In the same way as AIDS reduces the CD 4 cells there
is a specific marker for Lyme disease CD57 (Burruscano again) which is reduced. Only Lyme
disease suppresses this marker and like AIDS there is a marked propensity to
harbour other important chronic infections in this state.
In practice I am finding Mycoplasma including
mycoplasma fermentans and Chlamydia Pn
infections in a number of patients. I have two with babesia and one with
bartonella. In the US there is quite a long list but I will
just present these latter two here. It is most essential to look for these in every
suspect case of Lyme disease. Even the standard IgG and M markers can be
negative but the PCR's will be positive for Mycoplasma and chlamydia.
These infections are called Co-infections and most
are believed to be transmitted with the tick bite. There is a page on the
Patient site regarding co-infections. It is of
fundamental importance to clear any co-infection early rather than later
because the Borrelia infection just simply wont respond unless these others
have been eradicated. We do not understand why this is so, it is simply