I'm doing a search now....but i'll ask as well. How accurate is a skin (or tissue)culture for Bb. Isn't this done only at the site of an EM?? Or can this be done at any time, and from any location.
Posted by blueskyfaith (Member # 8723) on :
According to the paper:
Narayan K, Dail D, Li LB, et al. The nervous system as ectopic germinal center: CXCL13 and IgG in lyme neuroborreliosis ANNALS OF NEUROLOGY 57 (6): 813-823 JUN 2005
Skin has the highest Bb load followed by nerves, muscle, spinal cord and brain.
The culture may take months to complete.
But PCR is more sensitive, and can be finished within a day.
My question is why they don't used skin biopsy to do PCR to detect lyme disease,
Rather using blood where in most cases there may be no Bb in the blood.
Posted by pattiecake (Member # 6424) on :
I had a tisseue biopsy done to check for bb and it came up neg. where the blood tests came back Pos.
pattiecake
Posted by lou (Member # 81) on :
The Johns Hopkins testing paper seems to be saying not any of these methods are totally productive:
I recently developed a round, red ring on my abdomen. This occured after starting IM Bicillin.
I am certain that this was part of my "herx" response to the Bicillin. (I also spent 5 hours in the ER with tachycardia due to the herx...that was fun.)
I was fortunate enough to get into a dermatologist who did a biopsy on the rash. It was examined locally and the findings were "non-specific." The dermatologist had never seen a rash like it before, and is quite interested to see what will come of further studies. She knows I have lyme disease.
We will be sending it back east for further studies....PCR, specifically. We are actually seeking a doctor who specializes in that...and are waiting to hear back from him.
If that doesn't work out...what labs do you all suggest? MDL? or what?
I hope this comes back PCR positive for Bb. I've heard that the yield is very low. BUT, if it does, it will be evidence that someone can be on massive amounts of antibiotics and still have Bb in their body.
Timaca
Posted by lou (Member # 81) on :
Good luck, timaca. If yours comes back positive, it would be joining other such results showing Bb can survive heavy doses of abx. This has been shown in people, horses, and dogs. Aparently, the opposition doesn't really believe in evidence based medicine. They just talk about it a lot.
Posted by blueskyfaith (Member # 8723) on :
PCR test is very simple. A regular molecular biology lab can do it.
But contact the expert first:
Dr Pachner, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 185 S. Orange Avenue, Newark, NJ 07103. E-mail: [email protected]
They just published a paper on Bb last year: "The Nervous System as Ectopic Germinal Center: CXCL13 and IgG in Lyme Neuroborreliosis" Ann Neurol 2005;57:813-823.
They have the PCR technique to detect Bb. They may want do it and for free or they may suggest other lab to do it.
Good luck
Posted by lou (Member # 81) on :
I would not trust Dr. Pachner or that NJ med school. Do a search of pubmed and you will find that they are card carrying members of camp A. They are not going to want to show that Bb survives abx.
Think IGeneX or MDL could do this. Ask em.
Here is an abstract for a study that used skin pcr:
I know that MDL does it...and my biopsy may end up there.
But, we are seeking someone else first. A doctor well known in this area was suggested by my LLMD. He is "winding down" and would prefer to not do it, but is checking around with his colleagues to see if someone will take it on. We are waiting to hear back. Two dermatologists in my hometown are following this quite closely.
If it comes back positive, you can bet I'll be knocking on some doors and writing to some doctors concerning the results.
I have totally convinced my "somewhat skeptical" PCP and cardiologist that I had a herxheimer response this past month with what happened to me (tachycardia and ER visit). They had heard me say in the past that I have "significant issues" 10-12 days after starting an antibiotic. They were floored when this happened to me on day 10.
I would love to share my medical history and hopefully positive skin biopsy to any doctor who will listen (especially an ID doctor).
That is the key there, huh? A doctor who is willing to listen and learn.
Timaca
Posted by timaca (Member # 6911) on :
thanks for the article, lou....it states what my LLMD states...the chances of finding the spirochete are much lower because I've been on antibiotics.
But, what the hey?! I got a rash, let's biopsy the thing!
Posted by lou (Member # 81) on :
Good luck. Lettuce know the outcome.
Posted by blueskyfaith (Member # 8723) on :
Clin Microbiol Infect. 2001 Sep;7(9):461-9.
Routine diagnosis of Borrelia burgdorferi (sensu lato) infections using a real-time PCR assay.
Schwaiger M, Peter O, Cassinotti P.
Institute for Clinical Microbiology and Immunology, St Gallen, Switzerland.
OBJECTIVE: To establish a one-tube fluorogenic real-time PCR assay for routine detection of Borrelia burgdorferi (sensu lato) DNA in various clinical specimens.
METHODS: A fragment of the flagellin gene sequence was amplified with the TaqMan chemistry using primers and a probe common to Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii and Borrelia valaisiana.
A recombinant plasmid containing the chromosomal gene coding for the flagellin protein was used as standard. RESULTS: The specificity of the assay was documented with 48 different clinically relevant Borrelia burgdorferi strains.
No cross-reaction occurred with unrelated bacteria, viruses and fungi.
At an analytic sensitivity of 10 copies, excellent precision within runs and between runs was observed.
The potential presence of inhibitors of the Taq DNA polymerase was monitored by spiking aliquots of each sample with a plasmid containing the target sequence.
Among 56 cerebrospinal fluid samples taken from 54 patients with clinical suspicion of neuroborreliosis, one (1.8%) tested positive for Borrelia burgdorferi sensu lato DNA.
Borrelia burgdorferi DNA was also detected in five (17.9%) of 28 synovial fluid specimens and in one (20%) of five synovial membrane biopsies obtained from 31 patients with arthropathies.
In order to test for the absence of false-positive results, 84 samples from 83 patients without evidence of Lyme disease were investigated.
None of these samples showed measurable amounts of Borrelia burgdorferi DNA.
CONCLUSION: By its established features, such as speed, reliability, sensitivity, specificity, the inclusion of carryover prevention and the monitoring of inhibitors in individual test tubes, this real-time PCR assay has proved to be a potent tool for the detection of Borrelia burgdorferi DNA under routine conditions in diagnostic laboratories.