Posted by bleauberry on November 18, 2012, at 8:44:05
In reply to Lyme Disease Recurrences Reinfections Antibiotics, posted by Phillipa on November 16, 2012, at 15:08:52
Interesting. Not that it matters much to the patient, I mean, whether the ongoing suffering is from a chronic resistant strain or a new exposure, the suffering is the same.
The last two paragraphs are false. Overwhelming scientific data do not support the opinions of the writer in those paragraphs. Insurance/medical/political consensus does, but not the data.
This view does serve a purpose however. It profits insurance companies because otherwise they would have to treat approximately 10 tiimes as many patients as now. That is how underestimated the actual cases of infection are, due to the flawed use of CDC monitoring tests for individual clinical diagnosis despite their written disclaimer it is not intended for that purpose. Great for insurance companies. Due to the controversy in the lyme spectrum, doctors who choose to treat patients with longterm antibiotics put their careers at risk, as they are often harrassed or questioned by elites on medical boards and insurance companies. Some have had their licenses stripped from them. But they are the actual ones that get people better.
If someone follows the beliefs of the writer of this article, those patients are likely to stay sick or get worse. A few might spontaneously mysteriously get better. Most will have a grim future. If someone follows the beliefs that longterm ABX works, which all clinical evidence seems to suggest it does, at least a whole lot better than not, those are the patients who are actually getting better in the real world right now today. The others not.
I think a common misconception is that with longterm ABX we are trying to kill off resistant organisms and it takes a long time. Well, the data is grey enough, that we really don't know that. My first LLMD said that his combination of ABX did its healing not by killing the organisms because that already happened, but rather by resetting or remodulating the immune system. His stance was that the symptoms are immune system related and that they can remain even after eradication of the organisms but that longterm ABX of specific kinds gets people better. We don't really know why or how though. Only that that is the only strategy practiced today that actually gets people better. Just as we know minocycline and doxycycline have other mechanisms besides antibiotic, such as anti inflammatory, the others have varying mechanisms too, most of which we probably don't know much about or aren't aware at all. All we know is what works but we might not be able to explain why. And thus the big controversies with establishment on one side and patients on the other side. Somehow, some way, certain longterm ABX just get people better.
There are two clearly distinct sides in the lyme debates. I support the one that favors the best outcome, favors the patient. That is not reflected in the views of this article.
The elites would hopefully adjust closer to reality because since lyme is so widespread, they are already seeing chronic cases of it in their own offices, secretaries, spouses, family members, friends.
Ok so back to the title. If it is a reinfection, where did the reinfection come from? Another tick? Was it deep in bone marrow the whole time, safe? Morphing into a new version while camped out there? Ya know? There's just too much we don't know, and too much assuming going on, and too many articles like this one that can be refuted by data.
And of course, to be fair, in the title the words "may be" are key. We tend to just gloss over that and then continue through the article as if it was undeniable fact.
> Looks like no recurrent lyme's Disease if proper antibiotics taken When first Discovered. Good to know. It's reinfection. Phillipa
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> Medscape Medical News
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> Lyme Disease Recurrences May Be Reinfections, Not Relapses
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> Lara C. Pullen, PhD
> Nov 14, 2012Authors & Disclosures
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> Repeat episodes of Lyme disease (erythema migrans) in antibiotic-treated patients result from reinfection and not relapse, according to a new study. This conclusion was made from genotyping the isolates of Borrelia burgdorferi from paired consecutive episodes of erythema migrans.
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> Skin lesion typical of Lyme disease.
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> Robert B. Nadelman, MD, from New York Medical College in Valhalla, and colleagues published results of their genotyping study in the November 15 issue of the New England Journal of Medicine. The study focused on the ospC genotypes of B burgdorferi. Although 24 paired episodes were initially identified for the study, isolates of B burgdorferi for ospC genotyping were not available from 2 of the culture-positive paired episodes.
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> The study included 22 paired episodes and revealed 12 different ospC genotypes: 8 different ospC genotypes at the initial episode of erythema migrans and 11 different genotypes at the second episode. Notably, not a single patient with recurrent symptoms had the same strain of bacteria in the second episode as they did in the first.
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> The study was not powered to determine whether humans mount type-specific immunity to ospC genotypes.
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> In the first episode, 18 (82%) of 22 of patients had systemic symptoms. Evidence of disseminated infection was present in 13 (59%) of 22 patients. Many patients in the study who were successfully treated with antibiotics in the first episode went on to again be culture positive for B burgdorferi during the second episode.
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> The data are consistent with the clinical and epidemiological evidence, which suggests that the patients had reinfections.
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> Kyle Brizendine, MD, from the Cleveland Clinic in Ohio, reviewed the study and spoke with Medscape Medical News by telephone. He noted that "physicians should feel comfortable that the recommended first-line drugs are extremely effective."
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> In an accompanying editorial also published in the New England Journal of Medicine, Allen C. Steere, MD, from Harvard Medical School in Boston, Massachusetts, writes, "As concluded by the Infectious Disease Society of America, there is no evidence of persistent B burgdorferi infection in human patients after recommended courses of antibiotic therapy. Although B burgdorferi infection may persist for years in untreated patients, the weight of evidence is strongly against persistent infection as the explanation for persistent symptoms in antibiotic-treated patients with Lyme disease."
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> Although evidence points to eradication of the bacteria with appropriate antibiotic treatment, some patients report continued symptoms of pain and fatigue. Dr. Steere acknowledges this in the editorial and writes, "Although most patients with Lyme arthritis have a response to recommended antibiotic therapies, a small percentage of patients have persistent synovitis for months or several years after receiving oral and intravenous antibiotic therapy for 2 to 3 months; this condition is called antibiotic-refractory arthritis. Rather than persistent infection, infection-induced autoimmunity, retained spirochetal antigens, or both may play a role in this outcome."
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poster:bleauberry
thread:1031435
URL: http://www.dr-bob.org/babble/20121113/msgs/1031496.html