| One-Minute Clinician

Spirochetal Infections

Spirochetal infection symptoms include

  • Muscle pain
  • Nausea
  • Vomiting
  • Abdominal pain

Common types of infections

  • The two most common: Lyme disease and syphilis
  • Both are great masqueraders in terms of symptoms
  • They can cause and they can mimic other conditions and throw people off

Lyme disease history

  • The first discoveries in Lyme disease were in a rheumatologic setting
  • All of a sudden people were having meningitis and radiculitis and even cardiac heart block and other conditions; Bell’s palsy was a common presentation. These were associated with the Lyme spirochete
  • It became clear that Lyme actually invaded the nervous system early and was more of a neurological disorder or it was more prominently a neurological disorder than a rheumatological disorder
  • If you don’t check, you don’t know
  • If a person doesn’t present in a characteristic way, they may not be screened, or the assay that was used may not have been appropriate
  • We commonly see people who have gone untreated still

Post Lyme disease

  • An interesting and tragic phenomenon: people who are seemingly appropriately treated with antibiotics continue to have symptoms that seem to be referable to their original Lyme infection but they’re not associated with active Lyme
  • There’s a controversy over what’s fueling it; patients are not necessarily responsive to additional antibiotics and there’s some interesting ideas about immune system activation and how that may play a role