This is topic Test results in forum Medical Questions at LymeNet Flash.


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Posted by susanschn (Member # 19352) on :
 
What do you make of the following results? We do not know anything about what this means. Please let us know about any info you have relating to this.
Are these appropriate tests on which to base a diagnosis of Lyme Disease? Should there be other tests? Have any of you had these tests with these kinds of results? If so, what kind of treatment did you receive?
So far, the doctor just emailed these results and no treatment has been started yet. Please help us to understand.
The patient is a 78 year old female who had a tick on her ear for a week near the end of January. She developed a stiff neck at the time of the tick bite which has never gone away completely. She has now begun to develop other symptoms of extreme muscular pain, inablitly to walk, etc.
Thanks!
________________________________________
E.HEMEX FRAG 387
Esoterix Lab in Phoenix, Arizona
ISAC Panel Coag Only
Fibrinogen Activity >800mg/dL

Prothrombin Fragment 1+2 387 pmol/L
(monoclonal)

T/AT Complexes 6.0 ug/L

CD62P*** 41% in gate

CD62P + ADP*** 42%

Platelet Activation Index Abnormal
2+

___________________________________________
E. Bartonella
Fry Lab in Scottsdale, AZ


Moderate (11-20 organisms per total fields observed) coccobacilli adherent to erythrocytes - indicated by yellow arrow(s). This is
suggestive of Hemobartonella(1) or Hemoplasma(2). References: (1)Boulouis HJ, Gang C, Henn J, Kasten R, Chomel BB. Factors
associated with the rapid emergence of zoonotic Bartonella infections. Vet. Res. 36(2005) pgs383-410. Harrison's Principles of
Internal Medicine 15th edition. 2001. Nelson RW, Couto CG. Small Animal Internal Medicine 3rd edition. pg1233. Tilley LP, Smith
FWK. The 5-minute Veterinary Consult 2nd edition. Walker TS, Winkler HH. Bartonella baciliformis: Colonial Types and
Erythrocyte Adherence. Infect immune. 1981 Jan; 31 (1):480-486. Williams and Wilkins 2001 pg750. (2)Outbreaks of Hemotrophic
Mycoplasma Infections in China. Emerg Infect Dis. 2009 Jul. Hu Z, et al. Hemotrophic mycoplasmas (hemoplasmas): a review and
new insights into pathogenic potential. Vet. Clin. Path. 33(2004) pgs2-13 Messick JB. Mycoplasma ovis comb. Nov. (formerly
Eperythrozoon ovis), an epierythrocytic agent of haemolytic anaemia in sheep and goats. Internat J. of Sys and Evol Microbio.
54(2004) pgs365-371 Neimark H, et al. From Haemobartonella to hemoplasma: Molecular methods provide new insights. Vet.
Microbio. 125(2007) pgs197-209 Willi B, et al. (3)Molecular and enrichment studies by Fry Laboratories show that these organisms
could be Protozoal, Phylum unknown.
This stain is not FDA approved and is for research use only.

Special Stains
ANA(Anti Nuclear Antibody) Negative

Anaplasma phagocytophilum IgG Negative

Anaplasma phagocytophilum IgM Negative

Babesia microti IgG Ab Negative

Bartonella IgG Negative

Bartonella IgM Negative

Ehrlichia chaffeensis IgG Negative

Ehrlichia chaffeensis IgM Negative
 
Posted by Lymetoo (Member # 743) on :
 
OK... I think Hemobartonella is different from bartonella. I see the regular bartonella test is negative.

I had neither one, so don't know much about them.

I still don't see a test for Lyme. What gives???
 
Posted by Lymetoo (Member # 743) on :
 
From Tincup:

Susan....

I am NOT a doctor, but it looks like the doctor has indicated hemobartonella. Rather than me explain it.... cause like Ehrlichiosis, its name has changed and it is being reclassified...

http://www.marvistavet.com/html/body_feline_infectious_anemia.html

With this infection, which can come from the tick bite she had, you can have other markers indicated as positives on other tests.

For example, you would expect anemia, possibly. Maybe the throm- whatever it is I can't think right now- would be indicated, etc.

Anyhow.. I do not know Fry Labs at all. Don't use them and don't read their results.. but it appears all other coinfection tests show negative at this time.

The doc said.. "BARTONELLA POSITIVE, HEMEX POSITIVE, EVEN WITH NORMAL CD57, EVERYTHING POINTS TO LYME."

The doc also has a detailed history and the benefit of examination etc... that we don't have access too.

Hemex being positive- clumpy blood basically- would be expected, especially if coinfected (Lyme, Bart).

My GUESS and totally an uneducated GUESS... is like the doc said...

Bart and most likely Lyme. Treatment would be most likely based on using meds that will address both infections.

Often Lyme meds will address Bart and vise versa. Since the bite was less than a year ago, there is a good chance to lick this stuff. At least see some good improvement.

Sorry to hear your mom is feeling so badly Susan, but good to know she has someone who cares and is willing to help her... YOU!
 
Posted by Tincup (Member # 5829) on :
 
Yo Tutu..

You didn't copy the part where I said what a wonderful person you are for helping this new member.

Thanks Tutu... we are lucky to have you here taking care of all of us.

[Big Grin]
 
Posted by treepatrol (Member # 4117) on :
 
My answers here
http://flash.lymenet.org/ubb/ultimatebb.php/topic/1/88544
 
Posted by Lymetoo (Member # 743) on :
 
Thanks, tree and TC!! [Smile]
 
Posted by JamesNYC (Member # 15793) on :
 
This is the usual Fry Labs vagueness.

Fry sees "thingies" in the slides and points to them with arrows. He then equivocates by saying they are "suggestive" of whatever.

Basically it is thought that those thingies are bartonella microbes in the blood, hence "hemo" bartonella. Or mycoplasma or unknown parasite, etc. It's very annoying. If you do a search here, you will see lots of topics on this.

Anyway, take it to mean that Fry actually sees something, probably a bacteria, in the slide that shouldn't be there and that is assumed to be bartonella.

The other bartonella tests look for antibodies and are not necessarily accurate.

I don't see ANY tests for lyme in what you posted.

The Western Blot is the best test for diagnosing lyme. And the best lab is Igenex. If you have that done, the tests need to be interpreted. Since the test is used by the CDC for it's epidemiological survey, and not for diagnosis, a "neg" result by their standard doesn't mean that it's a diagnostic neg.

However, lyme should mostly be a clinical diagnosis, the tests should just confirm, not rule out, a lyme infection. The symptoms along with the tick are pretty strong evidence.

I hope that helps.

James

PS Now I have to go carry bags for my bellboy apprenticeship.
 
Posted by springshowers (Member # 19863) on :
 
It is true that Hemobartonlla is not the same as Bartonella.

That should not be confused.

What is seen in the smears is still being determined and I have heard there is sightings of biofilm clusters that contain bacteria fungal and protozoan infections..

I see this doctor tommorrow and maybe will hear an update..
 
Posted by JamesNYC (Member # 15793) on :
 
Spring,

It would be AWSOME if you could ask him what the difference is. And what he's seeing in those slides. It's very confusing.

Hemo bartoella is different from bartonella? Is it different from haemo bartonella too? Since hemo means blood, why is it called hemo?

I'm going to PM you with this too.
 
Posted by treepatrol (Member # 4117) on :
 
quote:
Originally posted by Lymetoo:
Thanks, tree and TC!! [Smile]

[hi] [kiss]
 
Posted by springshowers (Member # 19863) on :
 
James

Yes I will try to get a better answer.

Tree posts good information too.

Read this about Cats..and Hemobartonella and it might help you gather a visual and some more insight on your questions as well.


Hemobartonella is a type of bacterial "parasite" that infects red blood cells to live and reproduce. For many years, this parasite was thought to be a rickettsial organism, but scientists have recently discovered that Hemobartonella is actually a mycoplasma bacteria. This organism is called Mycoplasma haemofelis, formerly known as Haemobartonella felis.

Mycoplasma organisms lack cell walls and depend on the host (in this case, a cat) to survive and reproduce. Once the cat's immune system finds this foreign invader, destruction of infected red blood cells begins, and anemia results. This is similar, but not the same, as AutoImmune Hemolytic Anemia (AIHA) -- a disease in which the body's immune system mistakenly starts destroying healthy red blood cells. The exact cause of AIHA is not known, though there are several possible triggers.

Transmission
It is not definitively known how Hemobartonella is spread from cat to cat, but blood-sucking insects (fleas, ticks, mosquitoes, etc.) are thought to be the main route of transmission. Blood transfusions and cat fight wounds are other possible routes.

Diagnosis
Diagnosis is made by examining red blood cells under a microscope and finding small dots on the cells. Diagnosis can be difficult; the numbers of Hemobartonella organisms can fluctuate greatly and thus may be difficult to spot on a single smear.

Treatment
Any underlying diseases or stresses must also be addressed, since Hemobartonella can be an opportunistic disease, affecting weakened animals. Antibiotics in the tetracycline family are the treatment of choice for Hemobartonella. Additionally, like AIHA, prednisone may be used to quell the immune system's destruction of red blood cells. In some cats, blood transfusions may be necessary.
 
Posted by springshowers (Member # 19863) on :
 
Here is another link to read

Haemobartonella and Bartonella : Two Very Different Diseases!

Hemobartonella and Bartonella

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6699&O=Generic

There is more information in the Vet World than anywhere on this.

The Fry Test is saying "suggestive" so that means it is as close as they can determine at this point.

But it is the closest thing so reading up on it is the best way to understand it better..
 
Posted by JamesNYC (Member # 15793) on :
 
Hey Spring,

That was VERY helpful. But is Haemo and Hemo the same?

Is there real evidence that humans get it?

And, this disturbs me:

LLMDs are using the Fry slide tests for Bartonella. But if his slides only show Haemobartonella then the test does not mean ANYTHING for Bartonella!

What the heck??? So WHY is it used to dx Bartonella?

Grrrrr
 
Posted by springshowers (Member # 19863) on :
 
James.

Not sure what doctors are using it for DX Bartonella?

And your right. It is not useful for that.

Anyone who has a doctor who used it for that you might want to double check your test results.

The Labs also offer a Bartonella Panel for Bartonella

"Bartonella Panel. This immunofluorescent assay detects both IgG and IgM antibodies to Bartonella henselae and Bartonella quintana."
 
Posted by Pinelady (Member # 18524) on :
 
I'm confused. Did they not do a borrelia titer?
I thought the Ehrlichia was the same as

hemobartenella? Forgive me but I know she has some kind of bug in her blood that is not supposed to be

there. Did he think she was too sick to even bother with a WB? Meaning it might not show up anyway?
 


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