Trigeminal Neuralgia As the Principal Manifestation of Anaplasmosis: A Case Report

LeDonne, Michaela J; Ahmed, Sultan; Keeney, Scott; Nadworny, Howard

doi:10.7759/cureus.21668

Cited by 5 publications

(4 citation statements)

References 18 publications

(21 reference statements)

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“…Many of these overlapping factors on the MSIDS map were increasing underlying symptomatology, apart from her tick-borne infections since hypoglycemia, Candida, POTS, low adrenal function, chronic insomnia, depression, low glutathione levels, vitamin and mineral deficiencies, heavy metal toxicity, and possible mitochondrial dysfunction can all increase underlying fatigue and affect mood [170][171][172][173][174][175][176][177][178][179]. Similarly, infections with Borrelia, Bartonella, and Anaplasma, heavy metal toxicity, i.e., mercury (Hg), lead (Pb), and arsenic (As), mold toxicity, vitamin B deficiency, and mitochondrial dysfunction can all cause neurological symptoms and increase neuropathy [180][181][182][183][184][185][186], which is why a full MSIDS evaluation in CLD/PTLDS is highly important for diagnosing and treating all potential overlapping etiologies. A laboratory clue that Bartonella was also playing a significant role in her chronic illness was that she had an indeterminate Bartonella Western blot and evidence of prior exposure to Bartonella vinsonii sub spp.…”

Section: Discussionmentioning

confidence: 99%

Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella: A Report of 3 Cases and a Literature Review

Horowitz,

Fallon,

Freeman

2024

Microorganisms

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Three patients with relapsing and remitting borreliosis, babesiosis, and bartonellosis, despite extended anti-infective therapy, were prescribed double-dose dapsone combination therapy (DDDCT) for 8 weeks, followed by one or several two-week courses of pulsed high-dose dapsone combination therapy (HDDCT). We discuss these patients’ cases to illustrate three important variables required for long-term remission. First, diagnosing and treating active co-infections, including Babesia and Bartonella were important. Babesia required rotations of multiple anti-malarial drug combinations and herbal therapies, and Bartonella required one or several 6-day HDDCT pulses to achieve clinical remission. Second, all prior oral, intramuscular (IM), and/or intravenous (IV) antibiotics used for chronic Lyme disease (CLD)/post-treatment Lyme disease syndrome (PTLDS), irrespective of the length of administration, were inferior in efficacy to short-term pulsed biofilm/persister drug combination therapy i.e., dapsone, rifampin, methylene blue, and pyrazinamide, which improved resistant fatigue, pain, headaches, insomnia, and neuropsychiatric symptoms. Lastly, addressing multiple factors on the 16-point multiple systemic infectious disease syndrome (MSIDS) model was important in achieving remission. In conclusion, DDDCT with one or several 6–7-day pulses of HDDCT, while addressing abnormalities on the 16-point MSIDS map, could represent a novel effective clinical and anti-infective strategy in CLD/PTLDS and associated co-infections including Bartonella.

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Section: Discussionmentioning

confidence: 99%

Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella: A Report of 3 Cases and a Literature Review

Horowitz,

Fallon,

Freeman

2024

Microorganisms

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“…In addition to CNS, the peripheral nerves can be damaged in patients with anaplasmosis. Cases of trigeminal neuralgia [ 14 ], brachial plexopathy [ 15 ], transient hearing loss [ 16 ], and bilateral facial nerve paralysis [ 17 ] have been reported. A recent systematic review of published cases on anaplasmosis also reported cases of peripheral neuropathy at the site of the tick bite [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Anaplasma phagocytophilum Encephalitis: A Case Report and Literature Review of Neurologic Manifestations of Anaplasmosis

Cosiquien,

Stojiljkovic,

Nordstrom

et al. 2023

Infectious Disease Reports

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Anaplasma phagocytophilum is an obligate intracellular, Gram-negative pathogen, causative agent of Human Granulocytic Anaplasmosis (HGA). HGA usually manifests as a non-specific febrile illness, accompanied by evidence of leucopenia, thrombocytopenia, and an alteration in liver enzymes. Neurologic manifestations of anaplasmosis are rare and rarely reported. We describe a 62-year-old man who developed encephalitis due to an Anaplasma phagocytophilum infection. The patient favorably responded to intravenous doxycycline and recovered without neurological sequela. In the tick endemic area, clinicians should have a high index of suspicion for tick-borne diseases in patients presenting with neurological deficits. A prompt diagnosis and treatment lead to improvements in morbidity and mortality.

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“…While meningitis and neurological symptoms have been reported with human monocytic ehrlichiosis (HME), this is a rarer occurrence in HGA 13–16. The presence of inclusion bodies in the monocytes of CSF has been documented in several patients with HME 17.…”

Section: Discussionmentioning

confidence: 99%

Anaplasmosis encephalitis and infection of non-myeloid bone marrow precursors

Sohani,

Zhao,

Weiss

et al. 2023

BMJ Case Rep

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Due to climate change, infections from tickborne pathogens are becoming more prevalent in the Northern Hemisphere. Human granulocytic anaplasmosis, caused by the obligate intracellular gram-negative bacteriaAnaplasma phagocytophilumand carried byIxodesticks, can lead to morbidity and mortality in select populations. Anaplasmosis is commonly accompanied by significant cytopaenia, the pathophysiology of which remains unknown. Our case report describes an uncommon meningoencephalitic presentation of anaplasmosis with substantial anaemia and thrombocytopaenia. Additionally, we propose a mechanism of bone marrow infection and suppression byA. phagocytophilumwhich may be responsible for the cytopaenia in anaplasmosis and provide pictographic evidence of anaplasma in peripheral blood, cerebrospinal fluid and bone marrow.

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Trigeminal Neuralgia As the Principal Manifestation of Anaplasmosis: A Case Report

Cited by 5 publications

References 18 publications

Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella: A Report of 3 Cases and a Literature Review

Combining Double-Dose and High-Dose Pulsed Dapsone Combination Therapy for Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome and Co-Infections, Including Bartonella: A Report of 3 Cases and a Literature Review

Anaplasma phagocytophilum Encephalitis: A Case Report and Literature Review of Neurologic Manifestations of Anaplasmosis

Anaplasmosis encephalitis and infection of non-myeloid bone marrow precursors

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