Archive for February, 2011

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21117376&retmode=ref&cmd=prlinks

Excerpt:

Lyme disease is rare in the U.K. but there is evidence of an increase in
both prevalence of, and patient concern about, the infection. There are no
published data characterising Lyme disease as it is seen in the U.K. The
clinical and laboratory features of 65 patients diagnosed with the disease
between 2002 and
2007 were recorded and their clinical presentation and response to treatment
documented. In total, 34% of patients acquired the infection in the UK, 20%
in North America and 46% in Europe. Exposure to ticks was reported by 58% of
patients. Erythema migrans was seen in 91%, systemic upset in 62%, headaches
in 31%, arthralgia or arthritis in 28%, radiculitis in 11% and cranial nerve
palsies in 4.6%. Screening enzyme immunoassay tests were negative in 39% and
reference laboratory immunoblots were negative in 31% of patients,
principally those with early infection. The majority of patients were cured
with one course of antibiotic treatment, three patients had evidence of
persistent infection after treatment and two required intravenous therapy.
No cases of chronic Lyme disease were seen.

Link: http://www.biomedcentral.com/content/pdf/1471-2334-10-352.pdf

Excerpt:

Background

Skin erythemas of unknown origin are a frequent reason for consulting the general practitioner or dermatologist.

Case presentation

Here we report a case of an erythema resembling the erythema migrans manifestation of Lyme disease, but with atypical symptoms like persistent pruritus. The patient had no history of a recent tick-bite but displayed a positive serology for an advanced stage of Lyme borreliosis, which stood in contrast to the clinical manifestation of erythema migrans as a symptom of early Lyme disease. Three skin swabs and soil samples, collected in the area where the patient possibly acquired the infection, were examined by bacterial and fungal culture methods. Microorganisms were identified by using 16S rRNA gene sequencing and bioinformatics. The patient and soil isolates were compared by employing RAPD analysis. The serum samples of the patient were examined by immunoblotting. Arthrobacter mysorens, a soil bacterium, was isolated from the collected skin and soil samples. The identity of both isolates was determined by molecular fingerprinting methods. A.mysorens was proven to be causative for the erythema by direct isolation from the affected skin and a positive serology, thus explaining the atypical appearance of the erythema compared to erythema migrans caused by Borrelia infection.

Conclusions

Infections with A.mysorens might be underreported and microbiological diagnostic techniques should be applied in cases of patients with unclear erythemas, resembling erythema migrans, without a history of tick bites.

Implementing Advanced Healing Through Patient Participation and Financing

Join us for a Webinar on February 15

Space is limited.
Reserve your Webinar seat now at:
https://www2.gotomeeting.com/register/188983082
Dr. Garry Gordon, Gordon Research Institute, and Mike Bianco, Renua Medical, discuss further the benefits of Pulsed Electro Magnetic Field Therapy and how you can affordably incorporate this into your personal therapy or practice.
Title:   Implementing Advanced Healing Through Patient Participation and Financing
Date:  Tuesday, February 15, 2011
Time:  4:00 PM – 5:00 PM MST
After registering you will receive a confirmation email containing information about joining the Webinar.
System Requirements
PC-based attendees
Required: Windows® 7, Vista, XP or 2003 Server
Macintosh®-based attendees
Required: Mac OS® X 10.4.11 (Tiger®) or newer

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21113897&retmode=ref&cmd=prlinks

Excerpt:

Infectious diseases can affect the previously healthy adolescent as well as
severely immuno-compromised intensive care unit patients. The effects may be
merely annoying, but in many cases they can become life-threatening. The
immediate impact of infectious diseases on everyday life can be seen with
Helicobacter pylori, which infects more than 50% of the global population,
or Borrelia burgdorferi, which causes a major tick-borne disease in Europe
and America. On the other hand, in less-developed countries, infections
causing diarrhea are still among the most important causes of death –
especially in children. Research in Medical Microbiology ranges from
attempts to better understand the physiology and ecology of the causative
agents to epidemiological typing of clinical isolates. It covers the mutual
interactions of pathogenic microbes as well as the interplay between
microorganism and host. Among the most pressing problems in medical
microbiology is the emerging of antibiotic resistances. In recent years,
both Gram-positive bacteria – with the first description of vancomycin
resistant Staphylococcus aureus – as well as Gram-negative species – e.g.
with the emergence of extended spectrum beta-lactamases – have seen new and
dramatic occurrences of resistance.
Consequently, the detection and characterization of new antimicrobial
compounds is, more than ever, an important task. All these topics are
covered by the research articles compiled in this Special Issue of the
Journal of Basic Microbiology. Further, the publication of this Special
Issue should underline the importance of “Basic Microbiology” for “Medical
Microbiology”: The sometimes existing gap between basic research and
application needs to be bridged urgently and in a time-saving manner as
often as possible. We are convinced that only combined efforts of experts in
both areas will allow us to tackle future’s problems in infectious diseases
efficiently ((c) 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21114956&retmode=ref&cmd=prlinks

Excerpt:

Artificial baits constitute important tools for the detection and sampling
of blood-sucking arthropods, in particular those that are vectors of
parasites affecting human health. At present, many different devices have
been proposed to attract blood-sucking arthropods, mostly based on the
attractiveness of particular chemicals or blends. However, most of them
revealed themselves as unpractical (e.g. they require an electrical supply),
expensive (e.g. gas
bottles) or not efficient enough. On the other hand, the use of living baits
is as effective but it has practical constraints and/or raises ethical
questions.
We present here a multimodal lure to attract blood-sucking arthropods
designed taking into account both practical constraints and costs. The main
characteristics of our bait are: 1) artificiality (no living-host); 2)
multimodality (it associates heat, carbon dioxide and chemical attractants);
3) independency from any energy source; 4) no need for gas bottles; 5) easy
to prepare and use in the field; 6) low cost. We tested the ability of the
bait to attract blood-sucking arthropods in the laboratory and in the field,
using capture sticky-traps. Our bait evinced to be almost as efficient as
live hosts
(mice) for the capture of Chagas disease and Borrelia vectors in Bolivia.
The multimodal lure here presented is a generalist bait, i.e., effective for
attracting different haematophagous species. Copyright (c) 2010 Elsevier
B.V.

Excerpt:

BACKGROUND AND PURPOSE

Neuroborreliosis is a rare cause of stroke in children. We aim here to demonstrate the diagnostic value of gadolinium-enhanced magnetic resonance imaging (MRI) for demonstrating vessel wall abnormality in a child with brainstem stroke.

RESULTS

We report here the case of an 8-year-old boy with cerebral vasculitis and stroke due to Lyme neuroborreliosis. Imaging studies revealed the presence of ischemic lesions in the pons and cerebellum, with focal stenosis of the basilar artery on magnetic resonance angiography and focal gadolinium enhancement of the basilar artery wall. Nine months after treatment, clinical outcome was favorable, with no enhancement of the basilar artery.

CONCLUSIONS

Gadolinium-enhanced MRI provided additional information facilitating the diagnosis of vasculitis in a child with Lyme neuroborreliosis and stroke. The location of vessel wall enhancement was correlated with the topography of the acute infarct, and the lack of vessel lumen obstruction supported the diagnosis of vasculitis rather than any other cause.

Link: http://www.ncbi.nlm.nih.gov/pubmed/21051675

Excerpt:

Morgellons disease is a controversial and poorly defined symptom cluster of skin lesions and somatic symptoms, most notably ‘fibers’ in the skin. Because of widespread coverage in the media and on the Internet, there are an increasing number of patients presenting to dermatologists. We present three patients who believed that they had fibers in their skin. We offer a discussion of delusions of parasitosis to demonstrate similarities between these conditions. It has been suggested by a limited number of healthcare providers that an unknown infectious agent underlies this symptom complex yet no available evidence supports this assertion. Laboratory values that would be reflective of an infectious process (e.g. elevated white blood cells, sedimentation rate, C reactive protein) are routinely normal and biopsies often reflect only nonspecific findings such as acute and chronic inflammation with erosion or ulceration. Patients with Morgellons disease generally lack insight into their disease and reject the need for psychiatric help. The goal is to build trust and refrain from minimizing what the patient experiences. Attentive examination of the patient’s skin and fragments they present is necessary to rule out a true underlying pathologic process and to establish a trusting relationship. A supportive, non-confrontational approach is ideal. The patient is best treated by a team of practitioners of several specialties, including dermatologists, psychiatrists, and counselors.

Link:

Excerpt:

CD14 is a glycosylphosphatidylinositol-anchored protein expressed primarily
on myeloid cells (eg, neutrophils, macrophages, and dendritic cells).
CD14(-/-) mice infected with Borrelia burgdorferi, the causative agent of
Lyme disease, produce more proinflammatory cytokines and present with
greater disease and bacterial burden in infected tissues. Recently, we
uncovered a novel mechanism whereby CD14(-/-) macrophages mount a
hyperinflammatory response, resulting from their inability to be tolerized
by B. burgdorferi. Paradoxically, CD14 deficiency is associated with greater
bacterial burden despite the presence of highly activated neutrophils and
macrophages and elevated levels of cytokines with potent antimicrobial
activities. Killing and clearance of Borrelia, especially in the joints,
depend on the recruitment of neutrophils. Neutrophils can migrate in
response to chemotactic gradients established through the action of
gelatinases (eg, matrix metalloproteinase 9), which degrade collagen
components of the extracellular matrix to generate tripeptide fragments of
proline-glycine-proline. Using a mouse model of Lyme arthritis, we
demonstrate that CD14 deficiency leads to decreased activation of matrix
metalloproteinase 9, reduced degradation of collagen, and diminished
recruitment of neutrophils.
This reduction in neutrophil numbers is associated with greater numbers of
Borrelia in infected tissues. Variation in the efficiency of
neutrophil-mediated clearance of B. burgdorferi may underlie differences in
the severity of Lyme arthritis observed in the patient population and
suggests avenues for development of adjunctive therapy designed to augment
host immunity.

Link: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=21079313&retmode=ref&cmd=prlinks

Excerpt:

Bacillary angiomatosis is a recently described infectious disease that
usually affects immunosupressed hosts with a previous history of contact
with cats. We report a rare case of bacillary angiomatosis in an
immunocompetent 59-year-old woman with no history of previous exposure to
cats, and atypical clinical features (fever and subcutaneous nodules with
ulceration on the left ankle).
Histopathology of the lesion showed extensive ulceration and reactive
tumor-like vascular proliferation of the blood vessels with swollen
endothelial cells and an inflammatory infiltrate including neutrophils and
lymphocytes in the dermis and subcutis. Staining with the Warthin-Starry
method demonstrated the presence of clustered bacilli located in the
extracellular matrix adjacent to the proliferating endothelial cells.
Diagnosis was confirmed with the detection of Bartonella spp. DNA in the
affected skin and in bone marrow using polymerase chain reaction.

Link: http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1001144

Excerpt:

If insufficiently treated, Lyme borreliosis can evolve into an
inflammatory disorder affecting skin, joints, and the CNS. Early
innate immunity may determine host responses targeting infection.
Thus, we sought to characterize the immediate cytokine storm
associated with exposure of PBMC to moderate levels of live
Borrelia burgdorferi. Since
Th17 cytokines are connected to host defense against
extracellular bacteria, we focused on interleukin (IL)-17 and
IL-22. Here, we report that, despite induction of inflammatory
cytokines including IL-23, IL-17 remained barely detectable in
response to B. burgdorferi. In contrast, T cell-dependent
expression of IL-22 became evident within 10 h of exposure to the
spirochetes. This dichotomy was unrelated to interferon-? but to
a large part dependent on caspase-1 and IL-1 bioactivity derived
from monocytes. In fact, IL-1? as a single stimulus induced IL-22
but not IL-17. Neutrophils display antibacterial activity against
B. burgdorferi, particularly when opsonized by antibodies. Since
neutrophilic inflammation, indicative of IL-17 bioactivity, is
scarcely observed in Erythema migrans, a manifestation of skin
inflammation after infection, protective and antibacterial
properties of IL-22 may close this gap and serve essential
functions in the initial phase of spirochete infection.