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Clinical determinants of Lyme borreliosis, babesiosis, bartonellosis, anaplasmosis, and ehrlichiosis in an Australian cohort

Just published in IJGM


Though the title suggests this may be about the pecularities of Lyme disease in Australia the paper also contains extensive material about clinical diagnosis of Lyme, babesia and bartonella. In particular it raises these issues:


 

Peer review acceptance of certain specific bartonella and babesia symptoms. Very little of this information is available on Pubmed. Refs 15-18 in the paper.

Arthropathy. Aside from the swollen large joint of lyme arthropathy other arthropathies are sometimes incorrectly attributed to Lyme. This paper explores:

  1. Mycoplasma pn, fermentans and incognitans - a cause of polyarthropathy

  2. Chlamydia pneumonia and trachomatis – a cause of polyarthropathy and monoarthropathy

  3. 68% mono and 32% polyarthropathy. 

  4. 11% of patients pre­sented with small joint arthropathy

Cranial nerves 5, 8, 10, and 11 were involved in at least 50% of respondents. A definite scaling down of Bells palsy as an expected component of cranial radiculopathy (Banwarth syndrome) is demonstrated by these figures

Crucial jump in numbers of clinically diagnosable  Lyme disease above 3 cranial nerves

Does bartonella cause POTS at a central level??

Skin problems were reported in 11% of the cohort; they were usually widespread and often presented with itching. In 6% of patients, Morgellons could be demonstrated by skin microscopy. There was no previous report of the incidence of Morgellons in a large borreliosis population cohort.

Combined symptomatology of the two coinfections, babesia and bartonella, was found in 307 (61%) individuals. Finally, by aligning the data for clinical and laboratory factors for all three infections, only 50 (10%) individuals in the entire cohort had no diagnosis (clinical or laboratory supported)

The value of carefully interpreted MRI and SPECT scans to support a diagnosis of Lyme disease.