posted
I had never heard stretch marks being related to co infections. This is very interesting. Altho my son is very heavy he has huge red stretch marks on his body. My mother even commented on them last year which I found odd because my father is heavy too. She said she had never seen stretch marks like this before. Where can I find more info on this as my son also tested negative for Bart. Thanks Eileen
Posts: 127 | From Rock Tavern, New York | Registered: May 2005
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Dr. Martin Fried, Pediatric Gastroenterology and Nutrition Department of Pediatrics at the Jersey Shore University Medical Center in Neptune, NJ presented a session on Unique dermatologic manifestations of tick-borne diseases at the LDA conference on Friday, Oct. 28th in Philadelpia, PA.
Dr. Fried's talk mostly centered on the infection of Bartonella Henselae which is the most common form of Bartonella seen. It can be caused by a cat scratch, and thus is often called "cat scratch fever" but recently has become more and more common in conjuntion with Lyme Disease and infected by a Tick bite. (You can have Bartonella alone as well.)
Dr. Fried said that there are several common rashes that are seen in Bartonella.
1. maculopaplar or flat 2. hibes-urticarial 3. erythema nodosun- hard tender raised area often on the heals. 4. Ringworm- granuloma annulaire 5. Thrombocytic 6. Vascular
The one he concentrated most of his talk on is the vascular rash often mistaken as stretch marks. This Rash is caused by Interleuken 6 and is a a vasculitis with the result of a new blood vessel formation secondary to the inflammatory process. The marks are Deep reddish purple lillines that appear snake like. They look remarkably like stretch marks but Dr. Fried gave a few tips that the cause is infection and not stretch marks. You can suspect a Coinfection cause for the rash if:
1. Bartonella or Mycoplasma infection 2. No steroid use (which can cause rash) 3. No abrupt weight gain 4. Not obese, BMI over 30
Another tipoff to it being caused by an infection is where it is on the body:
1. Breast- circling the breast little red lines 2. Back- distribution important: looks like a Christmas tree going up back and distributed on both sides of the backbone. 3. Groin 4. Back of knee (atypical-may go straight up and down the leg pointing up or down the leg) 5. Periumbilical only (Belly button) May be just one line or many 6. Inner thigh 7. Buttocks 8. Shoulder (rare) -very rare to see in weight gain so seeing it on the shoulder is a Big tip off to infection.
Dr. Fried said it is more common for stretch marks to follow connective tissue planes where in an infection it can or it can follow other planes. Lines that are all horizontal are infections. This rash can come and go. If it goes away the patient may still be fatigued and have cognitive issues and if this is the case treatment needs to be continued.
Dr. Fried said that if you have blood drawn for titers to Bartonella it is rare to get a positive IgM titer, and IgG may only be >1:64. He also said that if the lymph nodes are greater than 1 cm. in diameter and not obese or on steroids this should alert you to an infection as the cause.
He also discussed Mycoplasma infections briefly.
1. Intracellular infection with no cell wall 2. Rarely found in the blood 3. Coinfection in patients with Lyme and Bartonella MAY PERSIST DESPITE TREATMENT May cause CFS.
Dr. Fried said that with Striae (rash) or Neovascularization:
1. May be a sign of ongoing infection 2. Consider all possible etiologies (Cushing Syndrome, Obesity, Rapid Weight Changes, Pregnancy, Steroid use) 3. Deserves evaluation of etiology of rash 4. Consider treatment for tic infection when accompanied by multiple organ system involvement
His Conclusions:
1. Consider multiple infections especially in complicated or non responsive cases 2. Evaluate for Multiple infections such as Lyme, Bartonella, Mycoplasma, EBV, Helicobactor 3. Use treatments that will cover multiple infections if suspected or proven.
Posts: 55 | From USA | Registered: Sep 2005
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lyme_suz
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Thanks everyone!
My daughter starts picc end of this month, but given this bart info; we are going to lyme dr. on Monday to see about switching her oral antibiotics to treat Bart now.
I learn so much on this site. The drs. get a little surprised with the questions and ideas I have.
posted
Thanks for the link to photo's of Bart Rash. My son's look exactly like these although he is quite heavy I was always stumped at the bright red stretch marks he has and have had comments made by family members who have stretch marks themselves and are heavy but they never looked like his.
Posts: 127 | From Rock Tavern, New York | Registered: May 2005
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