Fry Labs obviously have changed their minds about what they find in the blood smears. Since some weeks now, positive blood smears that earlier would have been labelled as ``Bartonella ssp'' are now diagnosed as ``Hemobartonella/Mycoplasma''.
Hemobartonella are NOT Bartonella! They belong to the Mycoplasma family and they need a DIFFERENT abx approach.
I called the lab and they said that on a blood smear the two different bugs look the same and without any further testing such as serology or DNA-testing one cannot say what it is.
I recommend everyone with a ``Bartonella-positive'' Fry blood smear to call the Lab and ask them what their diagnosis would be, if they would have to check your blood smear again today: would they call it Bartonella or Hemobartonella/Mycoplasma?
I had no response to Levaquin and Mino. This could be the explanation.
Gabrielle
[ 17. June 2008, 04:04 PM: Message edited by: Gabrielle ]
Posts: 767 | From Germany | Registered: Feb 2004
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Let me just add that if people- having followed your advice and conclude that they may have had a questionable interpretation of their smears- that they take a look at the Hemobartonella/mycoplasma spp discussion.
They might have valuable information to add to the quest.
Gale
Posts: 268 | From europe | Registered: May 2008
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posted
I just got my results back from Fry, and it said "suggestive of hemobartonella or mycoplasma", yet the paper with the results of all my tests [including the smears] said negative. Talk about covering your bases. So if it is "suggestive" of either one, how can my test be concluded as negative?
-------------------- Craig Posts: 207 | From Tallahassee, Florida | Registered: Nov 2007
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djf2005
Frequent Contributor (1K+ posts)
Member # 11449
posted
thats the sad thing about this disease, the testing is useless to this point.
its one big guessing game of treating and response.
i personally would not waste any more money on any testing until some more definitive testing became available, or, i needed it for documentation for IV coverage which ins will try to deny anyway...
bart and myco are sometimes both treated by the same drugs, levaquin will target both, as will mino.
hope things start working for you all soon.
i can certainly understand, ive been trying to treat what i suspect is bart/myco and it is very difficult.
derek
-------------------- "Experience is not what happens to you; it is what you do with what happens to you."
posted
You say now that Lev and Mino did nothing for you, yet I've read in your previous posts that you had to limit the Lev to half dose, as well as pulse it. Plus you were so tired on it that you stopped it for a week or two at least once or twice.
It sounds like it was working for you, and it would have worked much better if you had taken it at full dose.
The Tx for Myco is the same as for Bart, and Lev is one of the most effective drugs against it.
Posts: 132 | Registered: Jul 2005
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
lev helped me and i have positive blood smear of bart at fry labs, but i also have myco pnumoniae.
like derek says testing is pathetic really.
Anyone know if zithro is good for myco, im due to go on that next for babs treatment.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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Clarissa
Frequent Contributor (1K+ posts)
Member # 4715
posted
Truly unbelievable.
I had Bartonella spp and so did BOTH of my dogs.
I'll ask my LLMD about this "issue" during phone consult tomorrow and let you know what he says.
posted
Please Clarisa let us know...as I and My son have the same thing going on....but we also have VEGF paterns as Your Doctor exsplain...maybe we have them both....as that is what muscle testing comes up.
For me and my son comes up as BARTand Mucoplasma....is that a diferent kind of bug--mutated somehow and playes and shows symtoms of both of them....I am so confused right now... Do not know what to think anymore
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Clarissa
Frequent Contributor (1K+ posts)
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That's the question: did it work or was it only the side effects of Levaquin? Other people who take it for something else also get fatigued. Do they all have Mycoplasma?
If I had taken it at full dose (and who decides what is the full dose for a 115 lbs person?) I would have lost my job and at least I felt like I would have lost my life, too.
Clarissa,
Right, I meant spp.
Gabrielle
Posts: 767 | From Germany | Registered: Feb 2004
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
gabrielle i weigh 100 and took 500mg, it didnt knock me down, BUT back in 2006 I couldnt tolerate this drug at all.
We are all just so different at each stage of this illness!
Maybe this is why my LLMD wasnt to concearned about the pos fry bart test and is moving on to babs treatment.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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The dose of Lev is not decided upon from the weight of an individual, but by infection. The min dose for any adult without considering renal or liver problems is listed at 500 mg a day for this type of Tx. Some Dr's believe that 750 mg is needed for Bart and Myco.
So first, you cut the dose in half, and then you further mutilate the Tx protocol by only taking it 4 days on at 1/2 dose, and then 3 days off completely for each week.
Then you take a full week off after 1 month of taking it, and then you repeat this protocol for the following month or two. I look at what you wrote before, and it seems very clear to me that it was still working for you inspite of the giant reduction in dosing.
I can understand about work, but that has nothing to do with the untrue and misleading remark that you made in the first post that "it did nothing for me."
Maybe people do need to reconsider their Dx, but regardless, the Tx with Lev is still one of the best ones available against Mycoplasmas and Bart.
Posts: 132 | Registered: Jul 2005
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posted
This is so important to clear up. Bartonella or Haemobartonella? Obviously because of new DNA testing things have changed but what does that mean in terms of older Fry findings of Bartonella. Was it really Haemobartonella Mycoplasma? that they were looking at all along? Should the treatment plan then be changed if based on the new findings?
Everyone with Fry tests should be asking these questions. I think that they are advanced enough in their testing to be able to tell you if this is Bartonella or Haemobartonella mycoplasma esp. if they are using DNA tests to find it.
A new study relating to the Quinolones, Levaquin and Bartonella suggests mutations with this drug and advises not using it to treat Bartonella.
Articles by Angelakis, E. Articles by Rolain, J.-M.
� The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: [email protected]
Heterogeneity of susceptibility to fluoroquinolones in Bartonella isolates from Australia reveals a natural mutation in gyrA Emmanouil Angelakis1, Silpak Biswas1, Carmel Taylor2, Didier Raoult1 and Jean-Marc Rolain1,* 1 Unit� des Rickettsies, CNRS UMR 6020, IFR 48, Facult� de M�decine et de Pharmacie Universit� de la M�diterran�e, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France 2 Public Health Virology, Forensic and Scientific Services, 39 Kessels Road, Coopers Plains Q 4108, Australia
Received 24 October 2007; returned 17 December 2007; revised 29 January 2008; accepted 16 February 2008
-------------------------------------------------------------------------------- * Corresponding author. Tel:+33-491-38-55-17; Fax: +33-491-83-03-90; E-mail: [email protected] Objectives: Bartonella sp. are intracellular bacteria associated with an increasing number of clinical manifestations but with few published data on in vitro susceptibility testing of antibiotics. Our objective was to evaluate in vitro antibiotic susceptibilities of 20 new Bartonella isolates from animals in Australia.
Methods: MICs were determined using Etest assay on Columbia agar supplemented with 5% horse blood. The presence of mutations in the quinolone-resistance-determining region (QRDR) of gyrA was searched for after PCR amplification and DNA sequencing using specific oligonucleotide primers.
Results: Bartonella isolates from Australia were susceptible to rifampicin, tetracyclines, β-lactam and macrolide compounds but were resistant to vancomycin. We found heterogeneity of susceptibility for fluoroquinolones with ciprofloxacin being more effective (MICs from 0.06 to 0.5 mg/L) than ofloxacin (MICs from 0.5 to 4 mg/L). This heterogeneity was linked to a natural mutation Ser-83Ala (Escherichia coli numbering) in the QRDR. Surprisingly, this mutation was also present in the QRDR of Bartonella henselae, Bartonella quintana and Bartonella bacilliformis.
Conclusions: Etest is a sensitive and reliable assay for evaluation of antibiotic susceptibility in the genus Bartonella. The higher sensitivity of this method allowed us to detect heterogeneity of susceptibility among fluoroquinolones that was associated with natural mutation in the QRDR of the DNA gyrase. Because a high level of resistance to fluoroquinolones due to a second mutation may be obtained easily in vitro, we believe that fluoroquinolone compounds should be avoided for the treatment of any Bartonella-related diseases.
Keywords: DNA gyrase , Etest diffusion assay , resistance
Posts: 465 | From New York, NY | Registered: Aug 2005
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posted
Tosho, Thank for that, the book looks great.
But no mention of the Haemobartonella findings.
Maybe one of his patients can ask him to clear up the mystery of this new finding.
Posts: 465 | From New York, NY | Registered: Aug 2005
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Boomerang
Frequent Contributor (1K+ posts)
Member # 7979
posted
Hubby just had a positive test from Fry at the end of April. It says: Moderate number of coccobacilli adherent to erythrocytes indicated with arrows. This is suggestive of Bartonella spp.
Test was ordered by a local doc, not LLMD. I asked LLMD about test results during phone consult last week. He said that Fry Lab was considered to be one of the best, and hubby's test indicated we should continue with levaquin and doxy with tindi pulses.
FYI, levaquin dose is 750 mg per day.
Posts: 1366 | From Southeast | Registered: Sep 2005
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bettyg
Unregistered
posted
interesting thread; thx for posting!
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Alv
Unregistered
posted
I was wondering is that what we have coobacillis :
quote:Originally posted by Porsche: I look at what you wrote before, and it seems very clear to me that it was still working for you inspite of the giant reduction in dosing.
I can understand about work, but that has nothing to do with the untrue and misleading remark that you made in the first post that "it did nothing for me."
Porsche,
I'm glad that you are so certain. So can I take this as your medical advice to go back on Levaquin and to take the "full" dose of 500 mgs daily for several months? Can you guarantee me that it won't harm me and that it will make me better?
Just asking because after 3 weeks of being off I'm still fatigued. My husband who took the full dose last year for 3 months (some weeks he even took 1.000 mgs) was fighting fatigue and exhaustion for several months after stopping the Levaquin).
Gabrielle
Posts: 767 | From Germany | Registered: Feb 2004
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
THE PET HEALTH LIBRARY By Wendy C. Brooks, DVM, DipABVP Educational Director, VeterinaryPartner.com
Feline Infectious Anemia
(also called feline hemotropic mycoplasmosis, infection by Hemobartonella felis, or infection by Mycoplasma haemofelis)
Parasitic organisms survive by attaching themselves to a host and using the host's body to thrive, generally at the host's expense. Parasites find themselves protected from the harsh temperature and moisture changes of the external world when they live within the rich, warm body of their host. The parasites this article concerns is a bacterium that attaches itself to the red blood cell membranes of its host, happily riding around, feeding and reproducing until the host's immune system sees it and begins destroying red blood cells in an attempt to remove it.
The agent of what has traditionally been called feline infectious anemia is an organism called (until recently) Hemobartonella felis. This creature is technically a bacterium but it's a member of a group of bacteria called mycoplasma. Mycoplasmas are different from other bacteria because they do not have a cell wall surrounding and protecting their microscopic bodies. They cannot be cultured in the lab like normal bacteria because they require living hosts.
Hemobartonella felis was first discovered in Africa in 1942 but it was not recognized as a mycoplasma until gene sequencing was possible recently. This has led to renaming Hemobartonella felis to Mycoplasma haemophilus, though after decades of celebrity we shall see if they new name becomes commonly used. Complicating matters further, gene sequencing has revealed a second species, previously thought to be another variant of Hemobartonella felis. This one, which is smaller, has been named Candidatus M haemominutum. This smaller mycoplasma seems to only be a problem for cats infected with the feline leukemia virus. The discussion that follows largely concerns Mycoplasma haemophilus.
The term feline infectious anemia has also recently felt to be inaccurate as there are many infectious organisms that might cause an anemia (lack of red blood cells). For this reason the disease itself has been re-named feline hemotropic mycoplasmosis, which literally means a blood infection of mycoplasma organisms in cats.
What Happens to the Infected Cat?
The infected cat's immune system is busy coating infected red blood cells with antibodies. Coated red blood cells are removed from the circulation by the spleen. This kills the organism, and the iron is harvested and recycled into new red blood cells. The problem is that so many red blood cells are being destroyed that the cat becomes anemic.
The infected sick cat is pale (sometimes even jaundiced) and weak. Anemic cats often eat dirt or litter in an attempt to consume iron. They may have a fever. The initial blood tests show not just red cell loss but a very responsive bone marrow (the source of new red blood cells), which means that the cat knows it is losing red cells and is trying to make more as quickly as possible to keep up. Cats with concurrent feline leukemia virus infection tend to have more severe anemias as the virus does not permit the bone marrow to respond.
When a cat is newly infected, it can take up to one month before adequate numbers of parasites are present to actually make the cat sick. Mortality is highest during the month following this initial stage. If the cat recovers, it becomes a carrier, though stress can re-activate the infection.
How is Diagnosis Confirmed?
Confirmation of diagnosis has been problematic since the discovery of the organism. Because it lacks a cell wall, Mycoplasma haemophilus cannot be cultured, which means one cannot simply culture a blood sample and isolate the organism the way one might isolate the organism causing something like a urinary tract infection.
Most reference labs scan all feline blood samples under the microscope looking for the characteristic appearance of infected red blood cells (see graphic at the top of the page). Unfortunately, the number of organisms cycles in a matter of hours such that the number of infected cells can change from 90% to 1% in a matter of 3 hours. This makes it very easy to miss infected cells, even in a grossly infected cat.
Luckily, PCR technology has made diagnosis easier, though carrier cats can still slip by. Unless organisms are actually seen on a blood smear, the PCR test is the type of test to request.
What Cats are at Risk?
The cats at highest risk are those that roam outside in the spring and summer (obviously these cats have the highest risk for flea infestation). Cats that are statistically likely to be infected are male cats younger than age 4 to 6 years, with a history of cat fights, and incomplete vaccination histories (in short, cats who've had somewhat casual care). Infection with the feline leukemia virus is also a factor in diagnosis. This may be because this immune-suppressive virus allows proliferation of the organism that is not possible in normal hosts or perhaps the anemia associated with the virus directly leads to a sicker cat who is thus more likely to see the veterinarian and be tested. Making matters worse, the presence of the mycoplasma seems to enhance the ability of the feline leukemia virus to create bone marrow cancers.
An abnormal immune system is absolutely not a necessity in infection with hemotropic mycoplasmas; normal cats are infected as well. Further, infection with feline immunodeficiency virus does not enhance the severity of hemotropic mycoplasma infection.
Blood sucking parasites such as fleas, ticks, lice, and mosquitoes are the leading candidates for spread of the organism. This makes flea control paramount in protection.
Cats can become infected by blood transfusion, though animal blood banks routinely screen donors so this is an unlikely route.
Infected mother cats appear to be able to infect their unborn or newly born kittens. Oral transmission is definitely possible.
Treatment
If hemotropic mycoplasma infection is suspected, initiating treatment is probably a good idea as treatment is much easier than diagnosis. All mycoplasma infections are susceptible to the use of tetracycline. In cats, the derivative doxycycline tends to be most easily dosed as it comes in an oral suspension. Tablets must be used with caution as they can stick in a cat's esophagus, cause irritation, and scarring. The quinolone class of antibiotics (enrofloxacin, etc.) is also effective against hemotropic mycoplasmas. Three weeks of medication is needed to adequately suppress the organism.
Killing the mycoplasma is only part of the therapy, however; it's the host's own immune system that is removing the red blood cells and this must be stopped. Prednisone or a similar steroid hormone is typically used to suppress this part of the immune system so that the red blood cells are not removed as quickly. Very sick cats will probably require blood transfusions to get through the brunt of the infection. Happily, prognosis is fair if the diagnosis is made in time as cats generally respond well and quickly to treatment.
Carrier cats are generally not treated.
Can Dogs be Infected?
There is an organism previously called Hemobartonella canis (now renamed Mycoplasma haemocanis). It's not generally considered to be a problem except in dogs who have lost their spleens and thus cannot effectively remove infected red blood cells. Gene sequencing suggests that Mycoplasma haemophilus may be able to disguise itself slightly when it lives in a dog's body. Blood from infected dogs, however, will not infect cats. It's not clear at this time what the relationship is between these two types of mycoplasma, but it appears that cats cannot infect dogs and dogs cannot infect cats. There is a hemotropic mycoplasma disease in dogs but it is separate from the kind in cats.
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
posted
So do you suggest a new type of mycoplasma?
Mathias, who has a lot of knowledge on "regular" mycoplasma posted these treatment guides;
might be interesting regarding treatment of this new kind of myco. I have tried to find if myco can be treated with rifampin but cannot find any info on that.
Mycoplasma pneumoniae Azithromycin (Zithromax) Clarithromycin (Biaxin) Erythromycin Telithromycin (Ketek) Dirithromycin (Dynabac) Doxycycline or Minocycline or Tetracycline
posted
Why not try some clindamycin instead of the flox-family? Combined with zith for instance, what I see that would cover the mycoplasma groups on Mathias chart.
(I must say it is just soooo interesting that Dr. J in SC says on hois homepage that he has patients that do not respond on "normal" treatment for neuroborreliosis and he gives them IV CLINDAMYCIN and the response is great in 11/12 cases.)
Posts: 347 | From sweden | Registered: Feb 2008
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posted
I have previously tested positive by pcr for Mycoplasma fermentans, and recently by blood smear for hemobartonella/mycoplasma. So, does that mean I have/had two different mycoplasma species?
Was on a floroquinolone for three weeks several years ago which caused tendon damage. The hemobartonella/mycoplasma positive was long after that treatment, so it did not wipe out the germ.
Interesting (very) that clindamycin works well for some people, because it does for me. In fact, the combo of clindamycin + zithromax reversed a nearly disabling lower back condition, and in a pretty short time. It is still a good drug for me. Guess we are really just operating in a black box, trial and error, with drugs and suspected infections that may or may not have adequate tests or positive IDs.
Posts: 8430 | From Not available | Registered: Oct 2000
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So can I take this as your medical advice to go back on Levaquin and to take the "full" dose of 500 mgs daily for several months? Can you guarantee me that it won't harm me and that it will make me better?
You know that there are never any gaurantees with these drugs...there's too many variables that change with each individual.
I'm not saying that you should have ever taken Lev in the first place, or that it would be my choice agaist Bart and Myco.
All I am saying is that it appears to have still worked for you from your previous posts, even though you mutilated the treatment protocol so drastically. This is why we have such a problem with resistant and mutating bacteria in the world today IMO.
Posts: 132 | Registered: Jul 2005
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posted
Does anyone who has been diagnosed with hemobartonella have a picture of their Fry slide to post? I would be really curious if it looked any different. Or do any people with a very very recent Fry diagnosis of bartonella have a slide to post?
Posts: 929 | From Massachusetts | Registered: Oct 2007
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posted
I hope people with the Hemobartonella/Mycoplasma finding will post their smears in the other thread " to everybody with a....". Technically one has to scan the picture, send it to "photobucket" or the like and load it from there.
Gale
Posts: 268 | From europe | Registered: May 2008
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posted
I have previously tested positive by pcr for Mycoplasma fermentans, and recently by blood smear for hemobartonella/mycoplasma. So, does that mean I have/had two different mycoplasma species? -------------
Lou, yes most definitely two different species. Both species may need similar long term treatment to eradicate those bad boys from your blood. Did you see Dr Nicolson's article in the Townsend letters about treatment of mycoplasmas? If not, let me know...I can fax them to you...
I had/have Bb, mycoplasma pneumonia (real nasty strain from some devious lab) but the MP has got back to normalcy.
Treepatrol, excellent post...as usual.
-------------------- My biofilm film: www.whyamistillsick.com 2004 Mycoplasma Pneumonia 2006 Positive after 2 years of hell 2006-08 Marshall Protocol. Killed many bug species 2009 - Beating candida, doing better Lahey Clinic in Mass: what a racquet! Posts: 830 | From Mass. | Registered: Aug 2006
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