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Stuff I’ve been tested for and WHY 05/08/2012

Posted by thetickthatbitme in Diagnosis, TBI Facts, Whole Person.
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I apologize for the inconsistent posting lately; it’s been a busy couple weeks. No tick-lit today, so I’ll owe you some later in the week!

Tonight’s question: How did my doctor find 3 crazy infections that five other doctors missed? (One of which went undiagnosed for 7 years!)

medical records

This is the small binder I carry with me to doctor’s appointments. I have about half a file drawer dedicated to the rest.

Answer: He sent me to get tested for a whole lot of stuff.

How did he know what to order? He considered my risk factors and exposure to disease vectors (like ticks and pets). Is it important for your doctor to know if you’ve been out of the country? If you used to live in another state? If you have pets? If you hike or camp? If you’ve had food poisoning? Yes, yes, yes, yes, and yes!

Below, rather than listing the name of each disease/infection I was tested for, I’ve listed the names of the tests as they appear in my lab reports from Quest Diagnostics. (No, Quest did not pay me to mention their name. I just happen to like them, since they’re always nice to me and their tests helped find my infections.) They’re sorted according to why my doctor thought to order them.

Quest sends me pretty labs in color (as if that matters). Tip: always check the box on your lab slip that says “mail patient a copy” or something like that.

DISCLAIMER: Just because I’ve been tested for something doesn’t mean that you need to be. Only you and your doctor can decide what you should be tested for based on your history, risk factors, and symptoms.

Tick exposure

Borrelia hermsii AB IFA

Anaplasma phagocytophilum IFA

Ehrlichia chaffeensis IFA

Lyme Disease Antibody (IgG/IgM) Western Blot

WA1 (Babesia duncani) IgG Antibody, IFA

Babesia microti Antibody IgG/IgM

Cat exposure

Bartonella Species Antibody test w/reflex (FYI: One of my cats has tested positive for Bartonella, but I was negative. He’s never scratched or bitten me, but I have been bitten by a different cat.)

Toxoplasma IgG Antibody

Toxocara Antibody, ELISA (serum)

Having food poisoning in Mexico and China

Entamoeba histolytica IgG, ELISA

Giardia lamblia AB Panel, IFA

Helicobacter pylori IgG

Helicobacter pylori breath test

Salmonella and Shigella Culture (this was not fun, but I’m glad they were negative)

Camphylobacter Culture

Additional tests:

Immunoblobulins G, A, and M (to see if I was deficient, as this would affect the results of antibody tests and would mean I might need additional treatment, like IVIG—luckily I was not deficient)

CBC (to see if I was low on any particular kinds of blood cells, which might indicate an infection)

Questions? Feel free to comment/e-mail. For whatever reason, I seem to enjoy discussing labs.

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Ehrlichia: confusing cousins, the blood supply, and the new kid on the block 05/04/2012

Posted by thetickthatbitme in Diagnosis, TBI Facts.
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Ehrlichia…I just met a girl named Ehrlichia…and suddenly the sound…

Nope. Doesn’t quite work.

Paul Ehrlich

Paul Ehrlich (1854-1915). Image via Wikipedia.

Ehrlichia is actually named after German microbiologist Paul Ehrlich (1854-1915), who won the Nobel Prize in 1908. Here are some things you actually need to know about Ehrlichia:

1. Ehrlichia is transmitted through the bites of lonestar ticks and deer ticks. If you’ve had another infection carried by these ticks (like Lyme Disease), your doctor should have had you tested for Ehrlichia (or maybe you’ll be asking him/her to test you after reading this post?).

2. Symptoms of Ehrlichiosis include: fever, headache, chills, malaise, muscle pain, nausea / vomiting / diarrhea, confusion, conjunctival injection (red eyes), and rash (in up to 60% of children, less than 30% of adults). When it goes untreated (or improperly treated), complications can include breathing problems, bleeding disorders, and death (1.8% of cases).

3. Ehrlichia is effectively treated with doxycycline in both adults and children. The CDC recommends a 7-14 day course.

4. Your doctor shouldn’t wait for your test results to come back before prescribing you doxycycline. If your doctor thinks you might have Ehrlichiosis, he/she might order a PCR, a blood smear, or an IFA (antibody test). These tests can take a few weeks to come back, and in that time, you could get very, very sick. In addition, a negative result on any of these three tests does not rule out the possibility of infection. Often, in the first 7-10 days you are infected, you will test negative. For more information about these tests, take a look at the Ehrlichiosis fact sheet.

5. Ehrlichia can be easily misdiagnosed as one of two other infections. It’s a rickettisial disease, which means it’s in the same family with A. phagocytophilum and Rocky Mountain Spotted Fever (RMSF). Sometimes the rash patients get with Ehrlichia looks a lot like the rash patients get with RMSF.

6. It may be possible to contract an Ehrlichia infection through a blood transfusion. The CDC has not been very vocal about it, but it’s on their website. Fun fact: “Ehrlichia chaffeensis has been shown to survive for more than a week in refrigerated blood.” If you’ve had an Ehrlichia infection, it’s probably not a good idea for you to be a blood or organ donor.

7. There’s a newly identified species of Ehrlichia in Wisconsin and Minnesota. It doesn’t have a fancy species name yet, so scientists refer to it as Ehrlichia Wisconsin HM543746 or Ehrlichia muris-like (EML). This one is carried by deer ticks. If you live in one of these states and your doctor is not so hip to the new infectious disease research, he or she may have told you that you didn’t need to be tested for Ehrlichia because “we don’t have that here.” (I hate it when doctors say that!)Hopefully there will be a commercially-available, species-specific test for this soon. For now, my guess is that physicians in Wisconsin and Minnesota who suspect Ehrlichia infection are ordering tests for E. chaffeensis and E. ewingii.

Got an Ehrlichia story you’d like to share? Shoot me an e-mail.

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