Info about (mainly) B Afzelii

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
Margarita
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Re: Info about (mainly) B Afzelii

Post by Margarita » Thu 12 Jan 2012 16:53

Carina,
Since it takes so long for the skin symptoms to appear, how do doctors know that it is B. afzelii rather than B. garinii for example? Western Blot bands usually don't differ that much for different B. strains, right? So it's mostly from other (neurological) symptoms, or from culture tests?

Carina said (in another thread):
It was really hard to find any good info about ACA in english!

So, I have to give some swedish info to you instead:

http://www.janusinfo.se/v/Behandlingsri ... r-i-huden/

Akrodermatit

Symtom
Akrodermatit är en kronisk hudinflammation som drabbar perifera/akrala delar, framför allt fötter och underben. Inkubationstiden är lång, månader till år, och akrodermatit kan därför diagnostiseras året runt. Akrodermatit ses företrädesvis hos äldre kvinnor. Förloppet är långsamt och smygande med blåröd missfärgning och svullnad av huden. Så småningom utvecklas en hudatrofi. Sensorisk neuropati och/eller artropati i angripna områden kan uppkomma.
Not a perfect translation (with google translate):
Acrodermatitis

Symptoms
Acrodermatit is a chronic skin inflammation that affects peripheral / akrala parts, especially feet and lower legs. The incubation period is long, months to years, and acrodermatit can be diagnosed throughout the year. Acrodermatit seen predominantly in elderly women. The process is slow and insidious with purplish discoloration and swelling of the skin. Eventually a skin atrophy develop. Sensory neuropathy and / or arthropathy in contaminated areas may occur.
I read (in another info) that it can take up to 8 years until those skin changes occur, and in my case my treatment started when I have had borreliosis for 8 years. So, maybe I got treatment in time?

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Re: Info about (mainly) B Afzelii

Post by X-member » Thu 12 Jan 2012 17:52

Margarita, you wrote:
Since it takes so long for the skin symptoms to appear, how do doctors know that it is B. afzelii rather than B. garinii for example? Western Blot bands usually don't differ that much for different B. strains, right? So it's mostly from other (neurological) symptoms, or from culture tests?
They don't know for sure, but since a B Garinii-neuroborreliosis (in most cases) give more serious symptoms early, it is in most cases diagnosed early.

A B Afzelii-infection is more often diagnosed in a later stage. (see earlier posts about this in this topic).

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Re: Info about (mainly) B Afzelii

Post by X-member » Tue 28 Feb 2012 13:45

ChuckG gave us more info about B Afzelii in this topic below:

http://www.lymeneteurope.org/forum/view ... 511#p27230

A quote:
it should be considered that "Ca. Neoehrlichia mikurensis" appears to be the second most common pathogen in I. ricinus ticks. In our survey, only Borrelia afzelii appears to infect Central European vector ticks more frequently.
This many people don't know, and they often only talk about some studies from US.
Or only about studies on B Garinii (-neuroborreliosis).

The problem in Europe (at least when it comes chronic borreliosis) is (if I understand it correct) mainly B Afzelii!

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Re: Info about (mainly) B Afzelii

Post by X-member » Fri 1 Jun 2012 4:45

"WHY IS CHRONIC LYME BORRELIOSIS CHRONIC?"

http://www.lymeneteurope.org/forum/view ... ?f=6&t=379

About ACA.

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Re: Info about (mainly) B Afzelii

Post by X-member » Tue 24 Jul 2012 1:04

From Dr Marie Kroun, Denmark:

http://lymerick.net/Borrelia-culture.html
Since patients with Borrelia afzelii infection may be just as sick and may have Borrelia afzelii in their CSF and or blood - whether they express the usual laboratory signs of "certain neuroborreliosis" or not, it should be clear to all that the patients infected with Borrelia afzelii also deserve to get the correct diagnosis and treatment for their Borrelia infection!

It seems that Borrelia afzelii is apparently less immunogenic / more stealth in its nature than Borrelia garinii, so correct diagnosis is not made by the conventional test methods, are not made early at the time when there is great chance of cure by short term antibiotic treatment - because the patients are not diagnosed and treated as early they have a worse long term prognosis and are not cured by conventional treatment for Borrelia, resulting in long term debilitating sickness, and inability of patients to work etc. etc ... the impact on the society of undiagnosed Borrelia afzelii infection with or without sign of neuroborreliosis is probably much more common than hitherto beleived, because usual tests failed to give the correct diagnosis, a much larger proportion of chronic illness could be due to undetected and untreated Borrelia afzelii infection, compared to typical Borrelia garinii neuroborreliosis infection, that usually raise a quick and high immune response in its victims ... leading to fast diagnosis and treatment and good chance of cure by early treatment!?
And this (the above) is what I so often try to explain to people.

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Re: Info about (mainly) B Afzelii

Post by X-member » Thu 6 Sep 2012 15:15

"Success and failure in the treatment of acrodermatitis chronica atrophicans.

Aberer E, Breier F, Stanek G, Schmidt B."

http://www.ncbi.nlm.nih.gov/pubmed/8852478

A quote:
Two out of five patients who were monitored for Borrelia burgdorferi DNA excretion were still positive after 12 months as compared to none of six patients who were treated orally for 20-30 days. Six out of 11 patients treated orally for only 20 days needed retreatment after 6 months because of continuing skin manifestations, neuropathy or arthralgia. A 30-day duration of treatment with oral antibiotics and not the chosen antibiotic is crucial for curing acrodermatitis chronica atrophicans. The duration of treatment with ceftriaxone needed for eradication of Borrelia in acrodermatitis chronica atrophicans has yet to be determined in future studies.

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Re: Info about (mainly) B Afzelii

Post by X-member » Thu 6 Sep 2012 15:19

"Cutaneous manifestations of Lyme borreliosis"

http://derma.akademos.de/pdfdown/akadem ... 731428.pdf

A quote (page 7):
Therapy

Some authors have suggested that ACA may be adequately
treated with oral therapies such as doxycycline. In our opinion,
ACA should be viewed instead as »the tip of the iceberg
«
in chronic borreliosis
and one should reckon with
additional lesions in less accessible connective tissue structures.

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Re: Info about (mainly) B Afzelii

Post by X-member » Fri 5 Apr 2013 16:31

Norway:
Ticks Tick Borne Dis. 2013 Apr;4(3):218-21. doi: 10.1016/j.ttbdis.2012.11.006. Epub 2012 Dec 20.
Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum in Ixodes ricinus ticks in Brønnøysund in northern Norway.
Soleng A, Kjelland V.
Norwegian Institute of Public Health, Department of Pest Control, PO-Box 4404 Nydalen, NO-0403 Oslo, Norway.

Abstract
Ticks are important vectors of disease for both humans and animals. In Europe, Lyme borreliosis is the most abundant tick-borne human disease, whereas anaplasmosis, or tick-borne fever, is the most widespread tick-borne infection in domestic animals. However, knowledge about the prevalence of the causative disease agents in questing ticks in the northern range of their distribution in Norway is missing. Ixodes ricinus ticks were therefore collected by flagging vegetation in Brønnøysund, an area near the Arctic Circle in Norway where ticks have been abundant for decades. Ticks were analysed for infection with Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum by real-time PCR amplification of the 16S rRNA gene of B. burgdorferi and the msp2 gene of A. phagocytophilum. B. burgdorferi s.l. were subsequently genotyped by conducting a melt curve analysis of the PCR-amplified hbb gene or by directly sequencing the PCR-amplified rrs (16S)-rrl (23S) intergenetic spacer. A. phagocytophilum was genotyped by msp2 gene sequencing. B. burgdorferi s.l. isolates were detected in 11.3% (15/133) of the nymphal ticks and in 33.3% (29/87) of the adult ticks. Of the 44 Borrelia-infected ticks collected, B. afzelii was identified in 42 ticks (95.5%), whereas B. garinii was detected in only 2 ticks (4.5%). A. phagocytophilum was detected in 0.8% of nymphal ticks (1/133) and in 4.6% of adult ticks (4/87). Mixed infections of more than one B. burgdorferi genospecies were not observed. One adult tick was co-infected with B. afzelii and A. phagocytophilum.

http://www.ncbi.nlm.nih.gov/pubmed/23333106

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Re: Info about (mainly) B Afzelii

Post by X-member » Fri 5 Apr 2013 16:35

Poland:
Ann Agric Environ Med. 2013 Mar 25;20(1):21-9.
Assessment of the frequency of different Borrelia burgdorferi sensu lato species in patients with Lyme borreliosis from north-east Poland by studying preferential serologic response and DNA isolates.
Grygorczuk S, Peter O, Kondrusik M, Moniuszko A, Zajkowska J, Dunaj J, Zukiewicz-Sobczak W, Pancewicz S.
Source
Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Poland.

Abstract
Introduction and objective. Several Borrelia burgdorferi sensu lato species cause Lyme borreliosis throughout Europe and their geographic distribution may influence clinical manifestations of the disease. In Poland, Lyme borreliosis presents mainly with neurologic and cutaneous symptoms, while clinically overt arthritis is rare. The presented study investigates the prevalence of B. burgdorferi s.l. genospecies in a group of patients with different clinical forms and stages of Lyme borreliosis in north-east of Poland. This has not previously been studied. Material and methods. Preferential reactivity towards different B.burgdorferi s.l. species was investigated with a previously validated immunoblot assay in sera of 33 patients with disseminated Lyme borreliosis: 10 with neuroborreliosis, 6 with acrodermatitis chronica atrophicans and 17 with osteoarticular symptoms. Also typed were B.burgdorferi s.l. DNA isolated from the skin and synovial fluid of 7 patients with erythema migrans, acrodermatitis chronic atrophicans and arthritis. Results. Preferential reactivity was detected in 30 out of 33 serum samples. Of these, 25 reacted preferentially with B.afzelii, 3 with B. garinii and 2 with B. burgdorferi ss. B.burgdorferi DNA was isolated from all studied samples and typed as B.afzelii in 5. In a patient with acrodermatitis chronica atrophicans studied with both methods simultaneously, B.afzelii was identified by both genotyping and serotyping. Conclusions. Both methods gave consistent results, indicating B.afzelii as the main agent of all the clinical forms of the Lyme borreliosis in the study area.
http://www.ncbi.nlm.nih.gov/pubmed/23540208

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Re: Info about (mainly) B Afzelii

Post by X-member » Thu 20 Feb 2014 4:01

Information from Norway (guidelines for borreliosis) about the studies that the treatment for chronic (Lyme) borreliosis, (in this case chronic B Afzelii infection) is based on:

http://helsedirektoratet.no/sites/antib ... fault.aspx

Det finnes ingen prospektive randomiserte studier eller systematiske oversikter.
(There are no prospective randomized trials or systematic overviews.)
Det foreligger ingen studier av høy kvalitet som omtaler antibiotikabehandling av ACA og som underbygger anbefalingene. Det er heller ingen studier som sier noe om lengden av behandlingen. Det finnes ingen studier som sier noe om oral versus parenteral behandling.
(There are no good quality studies to review antibiotic treatment of ACA and underpinning the recommendations. There are no studies that say something about the length of treatment. There are no studies that say something about oral versus parenteral therapy.)

I have used google translate so the translation is maybe not perfect.


Edit to add:

Recommended treatment: 3 weeks oral abx

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