LymeNet Newsletter Volume 3 Issue 06

Volume: 3
Issue: 06
Date: 24-Apr-95

Table of Contents:

I. Q&A: Experience with Timentin or Cefpodoxime in LD? (A) II. Q&A: Antibiotics for Thrombocytopenia Patients (A) III. Q&A: Combination Therapy (Q) IV. Q&A: Tick Testing (Q) V. POSTGRAD MED: Polymyalgia rheumatica or Lyme disease? How to avoid misdiagnosis in older patients VI. J CLIN MICROBIOL: Distribution of Borrelia burgdorferi in host mice in Pennsylvania VII. About The LymeNet Newsletter

Newsletter:

*********************************************************************** * The National Lyme Disease Network * * LymeNet Newsletter * ***********************************************************************

IDX# Volume 3 - Number 06 - 4/24/95 IDX# INDEX IDX# IDX# I. Q&A: Experience with Timentin or Cefpodoxime in LD? (A) IDX# II. Q&A: Antibiotics for Thrombocytopenia Patients (A) IDX# III. Q&A: Combination Therapy (Q) IDX# IV. Q&A: Tick Testing (Q) IDX# V. POSTGRAD MED: Polymyalgia rheumatica or Lyme disease? IDX# How to avoid misdiagnosis in older patients IDX# VI. J CLIN MICROBIOL: Distribution of Borrelia burgdorferi in IDX# host mice in Pennsylvania IDX# VII. About The LymeNet Newsletter IDX#

QUOTE OF THE WEEK:

"Nevertheless, high isolation rates from counties of the southeastern corner of [Pennsylvania] illustrate well that hemlock habitat is not essential. Evidence suggests that in some areas, transmission between mice is occurring in some way other than through ticks as vectors."

-- Lord et al. (see Section VI)

I. Q&A: Experience with Timentin or Cefpodoxime in LD? (A) ------------------------------------------------------------------- Sender: Phyllis Mervine, Editor, the Lyme Times <[email protected]>

Resistance in Borrelia burgdorferi is not generally considered a problem. The recognized problem is that the bacterium employs various mechanisms to evade the immune system, enabling it also to avoid contact with antibiotics. Sequestration in various types of body cells and long generation time are two of these mechanisms. Throwing the arsenal of the pharmaceutical industry at this bacterium is not the solution. Understanding the microbiology of the organism is the first line of attack.

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II. Q&A: Antibiotics for Thrombocytopenia Patients (A) ------------------------------------------------------------------- Sender: Phyllis Mervine, Editor, the Lyme Times <[email protected]>

The two tick-borne diseases which may affect the platelets are babesiosis and ehrlichiosis. Dr David Persing, Dept of Laboratory Medicine and Pathology, Mayo Clinic, is an authority on this subject.

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III. Q&A: Combination Therapy (Q) --------------------------------------------- Sender: Peter Rohleder <[email protected]> http://zeus.gmd.de/i3/people/peter.rohleder.html

I was diagnosed having Lyme-disease last summer. The Western-Blot test was positive and showed the specific bands.

I had various symptoms like libido loss, muscle weakness, headaches, stiff neck, irritable bladder for which I had no explanation for a long time. After being misdiagnosed about 4 years I was now happy to know the reasons for these different symptoms of my illness.

I got Rocephin I.M. for 15 days, was soon feeling better and thought being cured. But 14 days after the end of the Rocephin therapy, most of the symptoms appeared again. In January '95 I spent four weeks in a hospital again getting Rocephin, now I.V.

But to my surprise it didn't help any more. After the end of the Rocephin-therapy I got Amoxicillin plus Probenecid for about four weeks, but this also didn't help. With one exception: A very short period of time (about 18 hours) when I ended the Rocephin-therapy and started getting Amoxicillin I was feeling better. To me it seems that it was the overlapping time period when both antibiotics were working.

And indeed: In the treatment guide of Dr. Burrascano one can read that in some cases a combination therapy with two different working antibiotics could be the right way.

Now I'm at the point that I need to convince my doctor that this kind of therapy makes sense. He says that he had never heard of this kind of therapy for Borreliose (that the mostly used name for Lyme-disease in Germany). Is there any kind of scientific literature available (preferable electronically) which I can get and which I can show him?

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IV. Q&A: Tick Testing (Q) --------------------------- Sender: <[email protected]>

A child has been bitten by a tick (central Ohio), and the mother has removed the tick and saved it in alcohol. Can this tick be tested? We have been given the name of the Yale Lyme Disease Clinic which will test a tick for $75. Are there any other places which will test a tick for LD?

--

Please send responses to these questions to: [email protected]

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V. POSTGRAD MED: Polymyalgia rheumatica or Lyme disease? How to avoid misdiagnosis in older patients ----------------------------------------------------------- AUTHOR: Paparone PW ORGANIZATION: Lyme Disease Center for South Jersey, Absecon REFERENCE: Postgrad Med 1995 Jan;97(1):161-4, 167-70 ABSTRACT:

This case report demonstrates the need to consider Lyme disease in older patients who present with nonspecific signs and symptoms often seen in polymyalgia rheumatica, particularly a markedly elevated erythrocyte sedimentation rate (ESR). ESRs greater than 100 mm/hr are common in polymyalgia rheumatica, but rates higher than 85 mm/hr are also possible in Borrelia infection. Because positive serologic findings for Lyme disease have been noted in patients with polymyalgia rheumatica who have been exposed to endemic areas, differential diagnosis must be based on clinical manifestations. Response to therapy should be monitored closely to confirm the diagnosis and avoid the adverse consequences of inappropriate treatment. The potentially deleterious effect that corticosteroids can have on Lyme disease must be considered in the decision to treat polymyalgia rheumatica.

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VI. J CLIN MICROBIOL: Distribution of Borrelia burgdorferi in host mice in Pennsylvania --------------------------------------------------------------- AUTHORS: Lord RD, Lord VR, Humphreys JG, McLean RG ORGANIZATION: Biology Department, Indiana University of Pennsylvania REFERENCE: J Clin Microbiol 1994 Oct;32(10):2501-4 ABSTRACT:

Host mice (Peromyscus leucopus and Peromyscus maniculatus) were sampled throughout the state of Pennsylvania to determine the geographical and ecological distribution of the Lyme disease spirochete Borrelia burgdorferi. All 67 counties of the state were sampled. A total of 1,619 mice were captured from a total of 157 sites during the period 1990 to 1993 for an overall capture rate of 29.69%. A total of 112 (6.92%) isolations of B. burgdorferi were made. The distribution of isolations revealed the reason for the correlated distribution of human cases of Lyme disease in the state. Significantly more mice were captured and significantly more isolations were made from hemlock (Tsuga canadensis) habitat than from deciduous species forest.

Nevertheless, high isolation rates from counties of the southeastern corner of the state illustrate well that hemlock habitat is not essential. Evidence suggests that in some areas, transmission between mice is occurring in some way other than through ticks as vectors. Host mice proved useful for determining the geographical and ecological distribution of B. burgdorferi.

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VII. ABOUT THE LYMENET NEWSLETTER ---------------------------------- For the most current information on LymeNet subscriptions, contributions, and other sources of information on Lyme disease, please request the LymeNet Resource Guide. To obtain the Guide, send a blank message to: [email protected] ----------------------------------------------------------------------- The LymeNet Resource Guide is in Revision: 1.10 ----------------------------------------------------------------------- LymeNet - The Internet Lyme Disease Information Source ----------------------------------------------------------------------- Editor-in-Chief: Marc C. Gabriel <[email protected]> FAX: 908-789-0028 Contributing Editors: Carl Brenner <[email protected]> John Setel O'Donnell <[email protected]> Frank Demarest <[email protected]> Advisors: Carol-Jane Stolow, Director <[email protected]> William S. Stolow, President <[email protected]>
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