Dempsey: Bartonella is a stealth multi-systemic infection transmitted by fleas, biting flies, body louse, mosquitoes and possibly ticks #ILADS2022 ImageImage
2/Dempsey: Objective findings of #Bartonella include fever, rash, swollen lymph nodes, uveitis #ILADS2022 Image
3/Dempsey: #Bartonella is multisystemic and can involve every organ. #ILADS2022 Image
4/Dempsey: #Bartonella can impact the eyes (#uveitis) heart (#pericarditis #myocarditis), joints, vascular system, brain and more #ILADS2022 Image
6/Dempsey: Molecular testing for #Bartonella will be the best option in the future. Serology tests may miss strains not tested for; PCR currently lacks sensitivity (qPCR is better). #ILADS2022 ImageImageImage
7/Dempsey: #Bartonella is an intracellular pathogen may be widely distributed within tissues. Oral antibiotics work, intravenous therapy not usually needed #ILADS2022
8/Dempsey: Antibiotics are bacteriostatic, not bactericidal: it takes time for the immune system to clear #Bartonella infection. Slow replication cycle, biofilms and tissue cysts may play a role in persistence of infection #ILADS2022
9/Dempsey: Recent practice patterns emerging: Azithromycin or Clarithromycin in combination with Rifampin for #Bartonella treatment. However, beware of drug effects on CYP systems and metabolism of sterol hormones (cortisol, others) when using Clarithromycin / Rifampin #ILADS2022
10/Dempsey: Botanicals such as J. nigra, C. sanguinolenta, and P. cuspidatum have been shown do be effective against stationary phase #Bartonella henselae in vitro. Methylene blue is also showing promise #ILADS2022
11/Dempsey: Ongoing recruiting for #Bartonella tissue study #ILADS2022 Image

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More from @ilads_lyme

Sep 22, 2022
Samuel Shor, MD - Treating Lyme & Chronic Lyme
ILADS defines #chronicLymedisease (CLD) as a multisystem illness with a wide range of symptoms and/or signs that are either continuously or intermittently present for a minimum of six months #ILADS2022
2/Shor:
Only 18% of 1770 children with #Lyme disease
remember being bitten
Nigrovic LE, et al A minority of children diagnosed with Lyme disease recall a preceding tick bite 2019, Vol.10(3), p.694 #ILADS2022
3/Shor: The CDC acknowledges that its #Lyme case definition was developed for surveillance purposes. It is NOT to be used as an absolute criteria for clinical diagnosis. #ILADS2022
Read 4 tweets
Sep 22, 2022
Joseph Burrascano, MD - Diagnostic Tools
#Lyme Clinical Presentation: nonspecific, viral-like symptoms that persist, & new ones appear. Then symptoms more focused on musculoskeletal, peripheral and central nervous systems, heart and skin. Muti-systemic & migratory. #ILADS2022 Image
2/Burrascano: Sorting out the co-infections #NotJustLyme #Bartonella #Babesia #Ehrlichia #Anaplasma #Mycoplasma #ILADS2022 ImageImageImageImage
3/Burrascano: Types of tests
SEROLOGIES are indirect, B-cell based tests:
B-cells create antibodies and serologies measure these antibodies #ILADS2022
Read 19 tweets
Sep 22, 2022
Robert Bransfield, MD: Thousands of peer-reviewed journal articles demonstrate the causal association between infections and #mentalillness 400+ peer reviewed scientific articles demonstrate the causal association between tick-borne disease and mental illness. #ILADS2022 #Lyme
2/Bransfield: Up to 40% of patients w/ #Lyme develop peripheral or central nervous system involvement. Psychiatric reactions include: #paranoia #dementia #schizophrenia #bipolar #panicattacks #depression #anorexianervosa, and #ODC #ILADS2022
3/Bransfield: Lyme is over represented in psychiatric patients. #ILADS2022
Read 15 tweets
Sep 22, 2022
Joseph Burrascano, Jr. MD: Ticks are "Nature’s Dirty Needle." In addition to #Lyme, ticks may be infected with #Babesia #Bartonella #Ehrlichia #Anaplasma #Chlamydia #Mycoplasma #WestNileVirus #Nematodes #candida and viruses. #ILADS2022
2/Burrascano: B. microti and B. duncani (also known as WA-1) are the predominant cause of Babesiosis in the United States #Babesiosis has been detected in all 50 states #ILADS2022
3/Burrascano: #Babesia odocoilei has been found in ticks across N America, but not human samples, perhaps due to defective primers. Immunoblot data shows significant % of Babesia species in human patients are not microti or duncani. Could be divergens and/or odocoilei? #ILADS2022
Read 8 tweets
Sep 22, 2022
Amy Offutt, MD: Rickettsial & Related Diseases
#RMSF Rocky Mountain Spotted Fever
#Ehrlichiosis
#Anaplasmosis
#Qfever
#Scrubtyphus
#ILADS2022 ImageImage
2/Offutt Ticks are the primary vectors for spotted fevers; some species may be spread by fleas and mites #ILADS2022 #RMSF #Richettsia
3/Offutt: #RMSF is the most severe rickettsial illness in the US with risk of death. Early treatment with #doxycycline is critical, regardless of age #ILADS2022 Image
Read 10 tweets

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