EM is diagnostic for Bb - IDSA

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Girlie
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Date Joined May 2014
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   Posted 8/12/2017 12:12 PM (GMT -6)   
Occasionally on this forum, I will read posts with members saying 'wait' to treat when the person has presented with an EM. (wait until symptoms appear)

EM IS a sign/symptom of LD.

Having an EM is diagnostic for Lyme disease - ILADS guidelines say this, but here it is from the IDSA as well.




EM RASH IS DIAGNOSTIC FOR BORRELIA INFECTION
Erythema migrans is the only manifestation of Lyme disease in the United States that is sufficiently distinctive to allow clinical diagnosis in the absence of laboratory confirmation.”
Clin Infect Dis 2006; 43:1101
(2006 IDSA Guidelines)

/txlda.com/pdfs/FACTS_for_Physicians_12_1_15.pdf
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Traveler
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Date Joined May 2007
Total Posts : 35853
   Posted 8/12/2017 1:11 PM (GMT -6)   
It's actually something I see a lot in a lot of places - and yet we shouldn't wait. Why? Let's use a less important situation to understand this. If someone had a splinter - would a person leave it in and wait for it to fester and cause a major infection situation before ever pulling the splinter out? Or would it be better to pull the splinter and not wait and see if it will cause a major infection? I think we all know the answer to that one.

All ticks/mosquitoes and other bugs do not pass on these infections, but enough do and enough doctors don't know what they are looking at for Lyme to become a major health issue in many, many countries now. This should be raising alarms - a lot more than have been raised.

So, since both ILADS and the IDSA have stated that the EM is diagnostic of having contracted Lyme, why would we wait?? This is like pulling the splinter out! Catching a Lyme infection in the earliest of stages is the ONLY way to have a chance of eliminating the infection from the body - the rest of us may have to be content to only be in remission with an understanding that if we aren't very careful (and sometimes even when we are) we may relapse at any point in time.

My husband and I are good examples of this. We have been together for going on 18 years now. He's been by my side in many aspects - but I was the one that was always getting more bug bites. He did end up getting Lyme disease though, and I set out to make sure that he got the treatment needed - one way or another. We were really lucky that his doctor listened to me. I walked in to that appointment armed with 14 or so studies and reports about what a Lyme infection was and the proper treatments. She never wanted to see a single one of them, she listened closely to what I had to say and found a way to get him the treatment I was saying (and prepared to show) was needed. Guess what? Three years later, and one knee replacement surgery and a neck fusion surgery (3 vertebrae were fused) later, and he's still not showing any symptoms of Lyme again. He healed because he got early and proper treatments.

The EM rash is the first sign of an infection for many people. We should NOT ignore this or promote ignoring this - especially if the IDSA and ILADS can agree on this!!

Girlie posted the link to the IDSA statement, which says:
"EM RASH IS DIAGNOSTIC FOR BORRELIA INFECTION
“Erythema migrans is the only manifestation of Lyme disease in the United States that is
sufficiently distinctive to allow clinical diagnosis in the absence of laboratory confirmation.”
Clin Infect Dis 2006; 43:1101 (2006 IDSA Guidelines)"


And here is the ILADS statement:
/goo.gl/HRiUqH

"ERYTHEMA MIGRANS

Erythema migrans (EM) is diagnostic of Bb infection, but is present in fewer than half. Even if present, it may go unnoticed by the patient. It is an erythematous, centrifugally expanding lesion that is raised and warm. Sometimes there is mild stinging or pruritus. The EM rash will begin four days to several weeks after the bite, and may be associated with constitutional symptoms. Multiple lesions are present less than 10% of the time, but do represent disseminated disease. Some lesions have an atypical appearance and skin biopsy specimens may be helpful. When an ulcerated or vesicular center is seen, this may represent a mixed infection, involving other organisms besides B. burgdorferi.

After a tick bite, serologic tests (ELISA. IFA, western blots, etc.) are not expected to become positive until several weeks have passed. Therefore, if EM is present, treatment must begin immediately, and one should not wait for results of Borrelia tests. You should not miss the chance to treat early disease, for this is when the success rate is the highest. Indeed, many knowledgeable clinicians will not even order a Borrelia test in this circumstance."
Herb only treatment for Lyme & Bart ended 12/11 - no active symptoms for 2 yrs -Herb only treatment for Babesia ended 12/12
www.healingwell.com/community/default.aspx?f=30&m=2977364
Had Lyme, Bart, Babs, RMSF, Ehrlichia, Myco, Anaplasmosis, EBV
New set of infections 8/2014 - still treating.
Come visit me: dogwoodtraditionals.freeforums.net/

Girlie
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Date Joined May 2014
Total Posts : 26270
   Posted 8/12/2017 1:18 PM (GMT -6)   
Thanks, Traveler!


"After a tick bite, serologic tests (ELISA. IFA, western blots, etc.) are not expected to become positive until several weeks have passed. Therefore, if EM is present, treatment must begin immediately, and one should not wait for results of Borrelia tests. You should not miss the chance to treat early disease, for this is when the success rate is the highest. Indeed, many knowledgeable clinicians will not even order a Borrelia test in this circumstance."

YES! Why risk it?
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Traveler
Forum Moderator


Date Joined May 2007
Total Posts : 35853
   Posted 8/12/2017 1:22 PM (GMT -6)   
This isn't quite the same as being diagnosed by an EM rash, but is along the lines of it because it's talking about testing: abcnews.go.com/GMA/video/cdc-advises-multiple-lyme-disease-tests-tick-bite-48364357

It shows that the EM rash may be the only sign some get in the early stages of the infection, and testing could still be negative even though a person may have tested several times.

Even without an EM rash, the CDC spokesperson states that if a person keeps getting a negative test and has symptoms of Lyme, they should pursue treatment anyway.
Herb only treatment for Lyme & Bart ended 12/11 - no active symptoms for 2 yrs -Herb only treatment for Babesia ended 12/12
www.healingwell.com/community/default.aspx?f=30&m=2977364
Had Lyme, Bart, Babs, RMSF, Ehrlichia, Myco, Anaplasmosis, EBV
New set of infections 8/2014 - still treating.
Come visit me: dogwoodtraditionals.freeforums.net/

Jinna
Veteran Member


Date Joined May 2017
Total Posts : 692
   Posted 8/13/2017 2:33 PM (GMT -6)   
The EM rash is a sign that Bb is in the body and that your body is fighting it.

EM rash exists for very long here in Europe, and it is documented in old MEDICAL texts.

EM rashes were associated with tick bites more than 100 years ago in Germany.

Did lyme disease existed then? The answer seems to be NO.

Well, the EM rash existed, but no one was treated for the severe condition we call lyme.

No one got treatments for EM rash, that I know, in the past, because no one developed severe health diseases. Old papers talk about the EM rash after tick bites, but do not talk about lyme disease, if you see what I mean.

The same way that EM rash means that the person had contact with Bb and that the body is fighting it back, you'll find that POSITIVE WESTERNBLOTs are not = diagnosis of lyme disease.

A positive Westernblot means simply that the patient shows immune reactions against Bb.

Many lyme patients do not show immune reactions to lyme, as their immune system cannot recognize Bb!!

In the past, EM rash was an EM rash and was not treated because no one developed lyme, neuro lyme, lyme carditis, etc like we do now.

It's a bit like getting bitten by a mosquito, developing an allergy, and that was it. The allergy disappears after a while.

Only recently, lyme became a bigger problem.

The same way that dengue, in Brazil, was NOT a problem in the past, even though the pathogen was already there for so many decades!!

It only started to kill sometime in the last decades, and only in one area of Brazil. Then we heard about hospitalizations, severe symptoms etc. Before, the pathogen that caused dengue did not cause the disease we call dengue today!

In other areas, the presence of dengue in the population did nothing to them (only mild symptoms, if they had even any symptom...).

Same as Bb and the EM rash!


Of course, if I had an EM rash, I would take my herbs and do my photon treatment.

Of course, if anyone has an EM rash, they'd rather get treated.

But I would NOT say that taking an antibiotic would be the best solution, because the body is trying to fight Bb on its own, and giving the antibiotic will help some Bb go into cyst forms, ..

... and on top, it will LOWER the ability of the body to fight on its own, because it destroys beneficial bacteria and increases the amount of toxins.

But that is just my opinion.

In the past, there were some MDs saying that people showing EM rashes had better immune systems than the ones who never developed EM rashes.

Here on TV, there are more documentaries on lyme disease (Switzerland). There are amazing cases of forest workers that get bitten the whole time, show EM rashes, some in many parts of the body, and never develop lyme. I mean, lyme symptoms!

They never treat either, and are used to see the rash. And there are people working in the forest who get very ill, like us, and have to stop working, with or without EM rashes.

I guess, that is what dr. Rau says:

1- some people get often bitten and do not EVEN show any immune reaction (no Igg, Igm).
It means, that Bb has no chance to develop in such people.

2- Some people get bitten and develop Igg or Igm. But not all will develop lyme.

3- Only a small percentage of people would develop lyme.
I suppose if you get an EM rash, you'll get some positive antibodies.
But antibodies are not the SAME as lyme disease!

4- many people do not show even any immune response to the presence of Bb, because their bodies do not even recognize the pathogen!! They won't have EM rashes, then.


Of course, treat the EM rash, if you got one (or many)!

But I would say, treat it by SUPPORTING your immune system, that is showing signs of fight (immune responses).

Some people treating lyme never had the rash but may DEVELOP a rash AFTER starting treatment.

I, personally, think this is a positive development, because Bb is trying to find some place to reproduce on the skin surface, as it is likely having trouble to reproduce DEEP INSIDE the body.


I sincerely REGRET having taken antibiotics for my EM rash. I knew nothing about lyme back then.

If I could rewind the time, I would NEVER take doxy or any antibiotic for an EM rash.

I would jump into treatments that reinforced my immune system, and avoid taking treatments that lowered it and still caused Bb to turn into cysts!

But that is just me, talking today, 7 years + after lyme went into remission.

7 years still being bitten and not falling ill with lyme any more.

I do believe TODAY that the only way out, if you are bitten the whole time like I am, is to reinforce the immune system. Anything else, is only palliative and a temporary solution.

I'm not against antimicrobials: they are very useful, and also help the immune system to recover. But only temporarily, until the next reinfection.

Traveler
Forum Moderator


Date Joined May 2007
Total Posts : 35853
   Posted 8/13/2017 2:57 PM (GMT -6)   
Jinna said: "EM rashes were associated with tick bites more than 100 years ago in Germany.

Did lyme disease existed then? The answer seems to be NO."

Oh, it was around back then too. "Ötzi the Tyrolean iceman died in middle age some 5,300 years ago, most likely after sustaining a head injury and taking an arrow to the shoulder..."

"Zink and his team also identified traces of the bacterium responsible for Lyme disease, a tick-borne infection first described in 1975 but thought to have affected humans for thousands of years...."
www.history.com/news/iceman-frozen-for-millennia-had-lyme-disease-blocked-arteries-sardinian-relatives

Even though some days I 'feel' that old, obviously I'm not - but, I did have Neuro Lyme back in 1970 - long before "Lyme" was recognized - so I'm not so sure we can say that this is new. More prevalent, yes. More cases, yes - but not new. It's been around a lot longer than most of us. And those that were dying a hundred years ago - most of them or their families would have never known what it really was that was the contributing factors to their loved one's death - if we can't test for it, how do we know we have it without a list of symptoms?? We can't - so many people were dying from ordinary things, like a brain aneurysm, or atherosclerosis or whatever and no one knew it if you go back into history far enough. Why? Because it was before we had the ability to diagnose it. Just like with Lyme disease.

I do have to complete disagree with you on a positive Western Blot not being diagnostic of Lyme though. While it's only diagnosing a small percentage of those that actually have the Borrelia bacteria, if you test positive for it, it's in your body and even if it's not 'active' at the moment, most of us know that all it takes is a bit of stress or an illness to lower the immune system and the person ends up with a ton of symptoms.....and chronic Lyme. Waiting only ensures that a person will not have the opportunity to catch it in it's earliest stages.

"In the past, there were some MDs saying that people showing EM rashes had better immune systems than the ones who never developed EM rashes. " And yet, now we know that that's not the case at all, it's strain specific, not up to the person's immune system.

If I didn't have access to my herbs, I would be taking an abx for Lyme any time I had a bulls eye rash - I can take care of the imbalance it would cause for the short time I would be on the abx with plenty of probiotics. It far out weighs the bleak future of not treating - as you said, you would turn to herbs. So would I if I had them, but I wouldn't poo-poo abx if I couldn't get to them for some reason. Chronic Lyme is a LOT worse than taking abx for 6 weeks and supplementing with probiotics.

But, I do agree with your premise of treating naturally - but that's our choice. I use astragalus daily, and of course do all of the tick checks and that, but I was reinfected after developing Addison's due to way too much family stress (that couldn't be avoided - FIL was dying and had no where to live and so on). I also am using other immune modulators to help me recover, as well as other herbs.
Herb only treatment for Lyme & Bart ended 12/11 - no active symptoms for 2 yrs -Herb only treatment for Babesia ended 12/12
www.healingwell.com/community/default.aspx?f=30&m=2977364
Had Lyme, Bart, Babs, RMSF, Ehrlichia, Myco, Anaplasmosis, EBV
New set of infections 8/2014 - still treating.
Come visit me: dogwoodtraditionals.freeforums.net/

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 26270
   Posted 8/13/2017 2:59 PM (GMT -6)   
^^^^ great post, Traveler.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi

Jinna
Veteran Member


Date Joined May 2017
Total Posts : 692
   Posted 8/14/2017 9:34 AM (GMT -6)   
Taking abx for 5 weeks is what my daughter did, the first time she got bitten by a tick.

It only worsened her condition, and our lyme dr forced me to pull her out (as I wanted to give her up to 6 weeks, as most lyme sufferers believe).

Her chronic lyme developed DURING abx intake (she was only 2 years old), and then she still had her gut to heal from abx damage.

You can still believe that a couple of probiotic strains will do the job of hundreds of strains that got damaged, and that may happen for stronger and healthier people.

You can bet my daughter was on the best probiotics I could afford, and that did not prevent severe gut problems, that took her about 6 months to heal.

It's for me a myth that probiotics will prevent severe gut damage because I saw what happened to my child.

So while I agree on fast treatments for an EM rash, I cannot agree on fast treatments meaning massive doses of ABX, just because of own experience.

I truly regret my intake of doxy and my daughter's intake of amoxy immediately after tick bite.

That is just MY experience.



I believed the 6 weeks mark of abx immediately after bite would help, and it did not work.

The imbalance children and adults get after few doses of abx is long lasting.

It's not something to be regarded lightly.

Chronic lyme can be developed in spite of early treatment, with or without abx.

Dr. K recently (2017, lyme summit) said that: I now prescribe only short term abx after a fresh tick bite (which probably means 3-6 weeks). If abx doesn't work (which means they are NOT always working), I stop the abx and move into other treatments.

He doesn't even try to prescribe abx for chronic lyme anymore. So he said!!

Whatever we discuss, abx or not, fast treatment or not, chronic lyme can install even after you treat a fresh bite, and that is already happening in many cases, according to dr. K.

My daughter's case are also a proof that early treatment can fail.

Even I was treated early, so to say. I took doxy 2 weeks, added some more for more 2 weeks sometime later, then added amoxy, then Riamet, then found medical help about 10 months later.

I was already by then, the worst patient my lyme dr had ever seen, fully 'chronic', neuro, arthritic.

My daughter took abx from the DAY we found the attached tick.

5 weeks, and she only got worse and was forced to stop by the 5th week. She developed arthritis and had to be confined to a wheel chair.

In my opinion, abx is not to be taken lightly, SPECIALLY for children.

for those who believe the damage is only short term, there are some studies showing the damage is much worse than that!

Some studies say that even short doses of abx can cause PERMANENT damage.

"Unfortunately, even a single course of antibiotics can permanently alter the gut flora."

https://chriskresser.com/the-high-price-of-antibiotic-use-can-our-guts-ever-fully-recover/

Clostridium difficile, that most people that treated with abx suffer, can be a direct result from abx!

"Another study demonstrated that a short course of the antibiotic ciprofloxacin reduced the diversity of the intestinal microbiota, with significant effects on roughly one-third of the bacterial species. "

"Somewhere between 300[9] and 1000 different species live in the gut,[10] with most estimates at about 500" (wikipedia).

That means that about ONE SINGLE course of Cipro would wipe out about 200 SPECIES of the intestinal flora!!

How many species of probiotics are you guys taking? 2? 3?? Even if you take 10 different species in great amount of numbers to try to recolonize your flora gain, that is just like NOTHING compared to 200 wiped out species!

"Infancy is a critical time where the development of a healthy gut microbiota is essential for the long term health of your child."

https://www.sciencedaily.com/releases/2010/11/101101083144.htm

https://med.stanford.edu/news/all-news/2010/09/repeated-antibiotic-use-alters-guts-composition-of-beneficial-microbes-study-shows.html

Girlie
Forum Moderator


Date Joined May 2014
Total Posts : 26270
   Posted 8/14/2017 11:06 AM (GMT -6)   
Jinna said...
Taking abx for 5 weeks is what my daughter did, the first time she got bitten by a tick.

It only worsened her condition, and our lyme dr forced me to pull her out (as I wanted to give her up to 6 weeks, as most lyme sufferers believe).

Her chronic lyme developed DURING abx intake (she was only 2 years old), and then she still had her gut to heal from abx damage.

You can still believe that a couple of probiotic strains will do the job of hundreds of strains that got damaged, and that may happen for stronger and healthier people.

You can bet my daughter was on the best probiotics I could afford, and that did not prevent severe gut problems, that took her about 6 months to heal.

It's for me a myth that probiotics will prevent severe gut damage because I saw what happened to my child.

So while I agree on fast treatments for an EM rash, I cannot agree on fast treatments meaning massive doses of ABX, just because of own experience.

I truly regret my intake of doxy and my daughter's intake of amoxy immediately after tick bite.

That is just MY experience.

I believed the 6 weeks mark of abx immediately after bite would help, and it did not work.



This thread is about the EM being diagnostic for Bb. It is a manifestation of Lyme disease.
Now, the IDSA also has 'come around' to what ILADS stance has been for many years.

How you decide to treat - whether herbally or with abx is another discussion - separate from this.

When an EM presents - the patient should be treated until sign/symptom free PLUS another 4 weeks.
Moderator, Lyme Forum
Symp started April/2013; Buhner's Lyme May 15-July24/14; Igenex pos. July 3/14
Doxy: July 4-Aug.24/14;Zithro July26-Aug24/14; Amox + Proben. Aug. 29/14;
added biaxin Sept. 26/14
Disc. amox,added Ceftin Nov. 20th.;
Disc. biaxin added Buhner bart herbs Dec/14;Jan/15 pulsing Tinda (w/ Ceftin);
Abx/herb break Apr-July/15; July-mino; Aug. added Rif;
Nov./15 mino - to biaxi
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