Lyme Borreliosis + Morgellons

Lyme diagnostics

Usual Lyme treatments

Prognosis

On suspicion of a Morgellons or Tick infection one may count in most cases also with Lyme exciters, speaks Borreliosis. As well repeatedly with viral and other bacterial exciters as Mycoplasma (respiratory, nerves, organs), Babesia (in red blood cells), Erlichea (in white blood cells) or Rickettsia (Meningo/Encephalitis) and Anaplasma phagocytophilium (intracellular in granulozytes), which are all mostly present after a typical tick bite infection. (See also "Symptoms")

With an infection by the exciter (Bacterium Borrelia Burgdorferi), from the group of the Spirochetes, there may appear after a short time, a local skin reaction which may be followed by neurological and joint complications. (See also Wikipedia and this study)

The Borrelias can spread further through the blood circulatory system and troughout the entire organism, striking each internal organ, the nervous system, all joints and tissues. This illness is also called multi-systemic. At present exists three well-known types of this bacteria kind, “Borrelia sensustricto” which is mainly present in the USA, “Borrelia afzelii” and “Borrelia garinii” are more the European type. The kind of type with an morgellon infection might be common in every country. This should be investigated one day by scientists !!

The above all cause the same illness, but with different complications. B. garinii  e.g. leads to neurological complications and B.afzelii to skin complications. Generally all variants spreads throughout the lymph and circulatory system of the infestated organism. The Borreliose runs quite typically in three phases. The individual`s  patient must not go through to all stages of Lyme, sometimes also quite spontaneous healings can happen.

The illness can sometimes heal completly, prematurely, or it can break out in another stage, since the disease process is dependent on the respective exciter type. Particularly with Lyme/Borreliose depending upon infestation stage, different antibiotic therapies are advised. These antibiotic regiments should begin preventively upon suspicion of the disease or when one sees the bull-eye rash.

1. Stage

Beginning with a bite by a tick, the first stage of illness can last for a few days to several weeks. Surrounding the bite an inflammation appears which turns red on the outside with a clearer lighter center known as a bull-eye" rash. This inflammation continues to spread and may reach several inches daily and will be called “Erythema chronicum migrans”. It can also form a bluish, harder skin (Lymphadenosis cutis benigna).

With a Morgellons infection, a reddish forecourt appears with a pimpel in the center. This inflammation disappears after some time, but the painful pimpel still is visible in which the parasite exists. Following a few days or weeks after the initial lesions, additional infestations areas appear on the body, predominantly near sweating areas.

During the first 6 months of this infection stage, in booth cases most suffer a general weakness and reducingness, headaches and pains of the joints and repeatedly from bouts of fever. In addition to a Morgellons type infection, scabies like skin symptoms appear.

2. Stage

The second stage that arises after several weeks to months is characterized by neurological complaints. For example by inflammations of the brain skins (Meningitis), the brain itself (Encephalitis) or the nerve strands within the range of the spinal column (Radiculitis).

Also face paralyses (Facialisparesis) can occur and in the later process also the “Garin Bujadoux syndrome”. Which represents a painful inflammation of nerves and brain skins (Meningopolyneuritis).

In most cases there arise asymmetrical paralyses, as well partly as sensitivity disturbances and swollen lymph nodes. Completely rarely there may also be inflammatory changes in the heart, with palpitations and common arise of the heart frequency.

3. Stage

In the third stage of the Borreliose, which occurs only after months and years, one can determine a slow fall of certain skin areas, which is called “Acrodermatitis chronica atrophicans. This occours on the arms, hands, legs and feet and perhaps the muscles can be involved in a later stage too.. The skin is very thinned out at the stretching sides anyway.

In the later process in thrusts are formed chronic joint inflammations. This is called Lyme Arthritis and strikes predominantly the large jump joints, elbows, as well as the joints of finger and toes. In the later disease process also chronic inflammations of the brain and the brain skin can be formed, which can cause a paralysis of the legs and arms.

Borreliosis diagnostics

After a detailed anamnesis before the actual diagnosis, in order to exclude other possible basic illnesses, one should ask the patient, not only their symptoms which they are complaining about, but also over the possible infection causes. With a bite by ticks, the reasons are obvious, as well confirmed after a physical and neurological investigation (reflexes, muscle movement, sensitivity) and a CT of the lymph nodes.

With a Morgellons infection, sexual contact or an indirect infection could have occurred over public ranges (see Epidemiology).

In both cases one may note a rigidity of the neck, a tighten type of headache and sometimes an accompaniment of an inflammation of the facial nerves and the brain skins. There may be swollen lymph at the ears, nipples or the scrotum and pain in the heart area. Later inflammations of the joint in particular in the knees, which can feel swollen or hot. With AIDS-patients repeatedly also an infestation of the central nervous system is to be determined.

With both kinds of parasite, on suspicion a laboratory test on antigens against Borrelias in the blood or brain fluid should take place. Under normal conditions with a bite by ticks, the usual investigations with a PCR test, a IgM Antigen test or Elisa could furnish a proof of the exciters. Normal microscopic investigations can confirm proof of the Borrelias too.

In the case for a Morgellons infection, evident clinical findings are rarely appropriate (See "Diagnosis"), sometime even by a tick infection. Therefore it would be advisable not only with a Morgellons infection to introduce and use the new American Igenex test. Generally that test far exceeds the older test procedures. But more effective is sometime the new intercellular measuring test LTT-Melisa (Lymphozyt-transformation-test) which is more indicating an infection with borrelia.

For being 95 % sure of a borrelia infection, the newest German test called T-Cellspot is actually the best on market. The T-Cellspot test with the Elispot-Assay is based on the research of antigene-specific zytokinsecretion through reactive Lymphozyts. The T-Cellspot test is actually 200 time more sensitive than the older elisa test (Enzyme Linked Immuno spot Assay). As well it can show pretty soon after an infection a seropositive result and therefore an earlier medical treatment can be started to prevent usual damage, due to a lack of quick recognition of borrelia.

Usual Borreliosis treatments

Generally one should begin in the initial stage with Doxycyclin during the first 2-3 weeks, alternatively with Amoxicillin and Erythromycin. If the joints are already implicated, then one should extend the therapy. With simultaneous skin features in the initial stage, one can also take additionally Ampicillin or Macrolids, as Roxithromycin (throat/nasal/urinary/respiratory-system/clamydia) or also Azytromycin.

Those that have experienced heart involvement or palpitations and those with an already longer existing illness, one may treat also with Cephalosporins (Penicillin based) . After 2-3 months one should accomplish an antigen measurement against certain components of the exciters. During the therapy one should be able to determine a decrease of the antigens.

These newer medicines (Amoxicillin, Azythromycin, Cephalosporins), are third generation antibiotics and can prevent also a disease outbreak. After a longer time of chronic lyme (2-4 years), sometimes only a treatment with newer antibiotics like Ketek or Zyvox are still effectful. Former liver complications can cause severe problems using then those antibiotics. At present vaccines are developed, which unfortunately, still can not ensure 100% protection. Since January 2006 the University of Wuerzburg (Germany) had success in developing from genetically changed tobacco plants (by transgene) a vaccine which already showed very good results with mice. The former vaccine from N.Y (USA, 1999) was also very promising but taken off suddenly from market and this vaccine may be now only used for animals.

Starting 4 weeks with Cefuroxim 2 x daily 500mg. (against lyme and related bacteria)
Then 4 weeks Clarythromycin (Clerimed) 2 x daily 500 mg. or Azithromycin or Roxytromycin or zyvox. (against lyme bacteria)
At least 2 weeks Metronidazol (Flagyl) 2 x daily 400 mg. (against related protozoa)

Prognosis

The Borreliose-Lymphozytom and the Erythema migrans mostly heal with an antibiotic therapy, without consequences. With the advanced Acrodermatitis chronica atrophicans, a therapy does not always arrive at a complete restitution. The Arthritis heals approximately 80% of the cases after 3 months. Another 20% is to be expected after some years. In the case of 5% of the patients with a Facialisparese, lasting residues (arrears) can result.

With an acute Neuro-borreliosis, the symptoms can be repaired relatively fast with antibiotics. With chronic Neuro-borreliosis, healing occours after months or may not occur at all or will be incomplete. Even after successful treatment of the symptoms, some patient can develop a depressive syndrome or chronic fatigue syndrome or also complaints of a Fibromyalgy, which hardly responds then to a renewed antibiotic treatment.

This is not a typical subsequent illness after a Borreliosis, but reactions which can develop also with other heavy illnesses with an appropriate arrangement. After an appropriate differential diagnosis, one can introduce also a therapy with certain tricyclic anti-depressives.

Then 2 weeks with Metronidazol 2 X daily 400 mg.