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Links: Spirochaetes
Fatal pancarditis .. Demonstration of spirochetes in the myocardium.
Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis. Demonstration of spirochetes in the myocardium.
Marcus LC et al. Ann Intern Med 1985 Sep; 103(3): 374-6.
"A 66-year-old man developed fever, chills, myalgias, three erythematous skin lesions, and transient left eyelid lag. Because of persistent fever, he was hospitalized 4 weeks after the onset of disease; a peripheral blood smear showed Babesia microti in 3% of his erythrocytes. Eighteen hours later, he died unexpectedly. Autopsy showed pancarditis with a diffuse lymphoplasmacytic infiltrate, and spirochetes were found in the myocardium."
Date Added: 17.12.06 Visits: 716
Borrelia spielmanii erythema migrans, Hungary.
Foldvari G, Farkas R, Lakos A. Emerg Infect Dis. 2005 Nov;11(11):1794-5. PMID: 16422006
PDF Picture of patients EM
Comment in: Emerg Infect Dis. 2006 Jul;12(7):1177.
Lyme borreliosis and Borrelia spielmanii.
Emerg Infect Dis. 2006 Jul;12(7):1177.
Maraspin V, Ruzic-Sabljic E, Strle F.
PMID: 16848050
Date Added: 21.02.07 Visits: 647
Generalizability in two clinical trials of Lyme disease (PDF)
Analytic Perspective by Cameron DJ. Epidemiologic review of the generalizability of two trials conducted by Klempner et al. [N Engl J Med. 2001 Jul 12;345(2):85-92. Link]
The author considers whether the results can be generalized to the general Lyme disease population.

Several important flaws has been noted in the Klempner study by Cameron and others; the enrolled patient group were characterized by:
1. had been ill for an average of 4.7 years; a relatively long duration of chronic disease giving a high risk that current symptoms was not caused by active borrelia infection, rather could be caused by permanent damage, or other causes, that antbiotics can not be expected to do anything about!
2. had already undergone average up to three antibiotic treatments; and 1/3 had previously got up to 60 days of IV antibiotic for borreliosis, which is double of what they were offered in the clinical trial - without obtaining a cure so far, hence there was little likelihood aforehand, that the trial treatment would make any difference!
3. furthermore NO patients with proven active Borreliosis (positive antigen test) were enrolled; i.e. the patients most likely to be expected to benefit from the trial treatment, were not enrolled in this trial! - and would also have been unethical to let patients with proven, active borrelia infection draw lot, with risk of getting placebo instead of causal treatment!
4. furthermore, patients were not evaluated for any of the many possible co-infections; an unrecognized, untreated co-infection could readily have explained the persistence of symptoms, not responsive to the previously given treatment(s) for Borrelia.
5. futhermore Klempner et al. claim to give A long-term antibiotic treatment, rather gives TWO DRUGS with different modes of actions after one another, i.e. ceftriaxone for 1 month (a cell wall, bactericidal antibiotic) respectively 2 months of doxycycline 100 mg x 2 (a proteinsynthesis inhibitor, only bacteriostatic); considering the fact that Dotevall & Hagberg PDF - after having measured the CFS concentrations achieved by 200 mg versus 400 mg doxycycline per die, respectively, found that the lower dose did not result in a concentration of doxycycline above MIC for Borrelia burgdorferi in the CSF of all patients, they recommended using the higher dosis of 400 mg / die (2 doses), then the dose of doxycycline given in this trial treatment, could have been UNDERTREATMENT, and explain the poor response to the combined trial treatment!

Cameron states:
"The investigators can only draw conclusions about the 3-month combination of oral and intravenous antibiotic treatment that was chosen for the study and not about longer treatments or simultaneous administration of multiple antibiotics"
... conlusions can only be drawns for patients like those enrolled in the study.

"The quality of life of subjects enrolling in the Klempner et al. trials was worse than that of the average type II diabetic or patient recovering from a heart attack, and as poor as that of subjects suffering from congestive heart failure [14]. In other words, it may be an example of offering patients "too little too late." "

"Subsequent reviews of the trials have discouraged treatment for chronic Lyme disease without addressing their limitations."
- however, considering all the above mentioned flaws, the lack of positive response to treatment in Klempner's trial, should have been expected in the chosen patient population, and can and should therefore NOT be generalized to all chronic Lyme disease patients, and should NOT be used to deny chronically ill patients trial treatment for suspected chronic borreliosis!
Date Added: 25.06.07 Visits: 686
Counterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease
Literature review by Raphael B. Stricker, ILADS. Clinical Infectious Diseases 2007; 45:149–57
"Prolonged antibiotic therapy may be useful and justifiable in patients with persistent symptoms of Lyme disease and coinfection with tickborne agents.
Date Added: 25.06.07 Visits: 671
2007 - symptomdiary & illustrative cases #49 and #50
PowerPoint (PPT) presentation by Marie Kroun, presented in Leicester, UK i July 2007.
Two cases - #49 and #50 - with use of Excel symptom diary before and during antibiotic treatment - measuring both effect and side effect of given treatment, with repeated videomicroscopies of unstained wet (buffy-coat) blood drop (click on light blue links for more information) ....
Date Added: 09.07.07 Visits: 958
"Bell's Palsy of the Gut" and Other Gastrointestinal Manifestations of Lyme and Associ
PRACTICAL GASTROENTEROLOGY April 2006 by Virginia T. Sherr, MD
Date Added: 10.07.07 Visits: 846
Endometriosis and Lyme Borreliosis
Presentation by Gynaecologist Andrew S. Cook, MD
Describes a preliminary study results of Lyme borreliosis PCR testing on endometrial implants:
3 patients with endometriosis in the study were clinically positive for Lyme disease and had positive Western blot IgM and IgG for Bb by both Ma and CDC criteria. The endometrial impants in 2 of these 3 patients tested positive for Borrelia burgdorferi bacteria by PCR techniques!
Date Added: 11.08.07 Visits: 655
Prevalence of Lyme borreliosis
Bela P Bozsik. Letter in The Lancet 2004; 363:901
"Treatment with antibiotics does not always result in eradication of the organism, therefore without follow-up and repeated treatment at recurrence, Lyme borreliosis chronica can develop. Lyme borreliosis is often undetectable by serological techniques. In our practice, the passive haemag glutination method (Diagast, France) failed to detect more than 60% of cases, compared with the newer ELISA (Enzygnost, Behring, Germany). The primary and secondary errors of this passive haemagglutination method were calculated as 1·9% and 6·3%, respectively, from 50000 investigations. The significant difference between these diagnostic techniques highlights the need to assess other factors, especially clinical symptoms, in the evaluation of results and formulation of the definitive diagnosis.
The occurrence of Lyme borreliosis can be estimated from the reported incidence of tick-borne encephalitis (TBE) and the bacterial (1:10) and viral (1:1000) infectivity rate of ticks (http://www.tbe-info.com). The estimated incidence of TBE in Hungary (population 10 million) is 200–400 cases per year, and the infectivity rate of ticks is 100 times higher for Borrelia burgdorferi sensu lato than for the TBE virus. Thus there could be more than 20000 new cases of Lyme borreliosis per year in Hungary. Given the subclinical nature of the disease, the problems with diagnosis, misunderstanding about criteria and diagnosis, and the mean age of patients being 60 years, the number of patients affected at any one time could be as much as 1million—ie, 10% of the population."
Date Added: 20.09.07 Visits: 620
Borrelia - early spread
List under update ... If you know more references please send mail to LymeRICK webmaster!
Date Added: 18.10.07 Visits: 604
Attack of the Chronic Lyme Denialists
Overview over the Lyme controversy war ..
by Steven Gottschalk. November 12, 2007
Date Added: 14.11.07 Visits: 748
Q-RIBb - Lyme borreliosis antigen test by specific immune stain
US-patent # 6,838,247
This Borrelia burgdorferi antigen test, that was developed by Bowen RTI and patented in 2005, is now unavailable, reason being that in February 2007 a modified version of the Bb-specific immune stain, where the quantification is done by computer - i.e. by FLOWCYTOMETRY - instead of by titration as described in the patent, was approved by CLIA; concurrently the research laboratory - formerly named Bowen Research and Training Institute (BRT) was renamed to Central Florida Research Inc. (CFR) which offers the Borrelia antigen test and more serology test for Borrelia burgdorferi commercially. CFR does NOT do microscopic examination of blood smears for coinfection, but plan to offer other tests for coinfections in future!

For more information, see CFRs new website at http://centralfloridaresearch.com CFR
Date Added: 15.11.07 Visits: 583
Studies on the life cycle of spirochetes.
Studies on the life cycle of spirochetes. VIII Summary and comparison of observations on various organisms.
Delamater ED, Haanes M, Wiggall RH, Pillsbury DM. J Invest Dermatol 1951; 16:231-56.

Abstract (OCR): The purpose of the present paper is to draw together and compare the observations made on the nonpathogenic Nichols strain of Treponema pallidum both as it occurs in thioglycollate medium (1) and as it occurs in the embryonated egg (2) under anareobic conditions; the Kazan (3), Reiter (4), and Noguchi (5) strains of nonpathogenic Treponema pallidum as they occur in thioglycollate medium; and the pathogenic Treponema pallidum as it occurs in the experimental syphiloma in rabbit testes (6, 7). Preliminary observations on Borrelia anserinum and Borrelia novyi will also be cited (8, 9). The methods of observation, presented elsewhere (10, 11) have consisted of the use of phase contrast microscopy and a newly developed stain which has proven particularly effective in the study of stained impression smears of infected rabbit testes and in blood films of chickens infected with Borrelia anserinum, and of rats infected with Borrelia novyi.
The current presentation consists of a synthesis and correlation of the observations presented in these previous papers. A brief history of the subject has been presented in conjunction with paper No. V (1), and will not be recapitulated here, as a general review of spirochetes and spirochetal diseases is in preparation (12).

By means of the phase contrast microscope the following general story of development of spirochetes appears to be consistent in those organisms studied. The conditions governing the occurrence of the forms observed and reported are under study. In the current presentation representative plates from several of these organisms will be presented in attempting to present the total picture as it has been observed up to the present time. [abbreviated description below, read full text for more]
Transverse fission. In the organisms so far studied transverse fission appears to be the most important single method of vegetative reproduction in spirochetes, especially as they occur under optimal conditions in their biologic hosts.
Production of gemmae as a means of vegetative reproduction. The production of gemmae has been observed in all of the organisms cited above except Borrelia novyi. This organism has not as yet been adequately studied.
The production of multispirochetal cysts by the aggregation of organisms. The following processes have been clearly observed in the Nichols, Kazan, Reiter and Noguchi strains of nonpathogenic Treponema pallidum, and in the pathogenic Treponema pallidum. Preliminary observations on Borrelia novyi and Borrelia anserinum suggest that under certain conditions similar forms may occur.
The production of multispirochetal cysts by internal reorganization. A second means of formation of these large multispirochetal cysts appears to be by means of reorganization within a single spirochetal body. Continued observation of these structures suggests that this is probably the most important method of their formation.
From comment: "Current studies, including observations on Borrelia novyi and Borrelia anserinum, as well as other saprophytic isolates of Treponema pallidum suggest that so far as these observations have been taken, we are dealing with processes of reproduction which apply at least in some degree in most spirochetes."

Authors used a phase contrast magnification of X4850.
By using a computer equipped with an USB video camera - like Bresser Microocular II - it has become possible to spot moving spirochetes and their alternative structures in an ordinary phase contrast microscope with a maximum magnification of X1000 (oil), after adding further digital magnification in the computer / on the computer screen.
An extra advantage - when the whole microscopy procedure is being videotaped - the video can later be reviewed and the best sequences / snapshots can be extracted and saved as proof for the observed findings; such videos and pictures can be shared with the whole World via Internet, as done here on LymeRICK.net and try a search for "spirochete" or "Borrelia" on YouTube!
Date Added: 29.05.08 Visits: 620
Transmission of Borrelia burgdorferi - vertical and transstadial in Ixodes ticks
Both vertical and transstadial transmission of Borrelia burgdorferi occurs in Ixodes ticks; these articles document Borrelia infection of Ixodes tick larvae varying between 0 to 21% - hence transmission of Borrelia infection via tick larvae IS POSSIBLE, when tick larvae occasionally bite human beings.
I actually have proof for larva biting humans on pictures that I personally took!
A tick larvae bite is usually mistaken as a tiny freckle, since the larvae's 6 legs can only be seen when using a magnifying glass to look at it.
Date Added: 29.09.08 Visits: 664
Medline Plus - Lyme disease
Date Added: 14.12.08 Visits: 1073
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