Inside Lyme Podcast with Dr. Daniel Cameron (Dr. Daniel Cameron)

In this episode, Dr. Cameron will be discussing the case of a 26-year-old man who was diagnosed with mono-arthritis after his clinical evaluation overlooked the possibility of Lyme disease.

Welcome to another Inside Lyme Podcast with your host Dr. Daniel Cameron. In this episode, Dr. Cameron will be discussing the case of a 71-year-old woman who was initially diagnosed with Ehrlichia, a tick-borne illness but later developed Guillain-Barré Syndrome.

“An 80-year-old patient was admitted to the hospital after a fall, and subsequently developed an acute confused state requiring transfer to a neuropsychiatric unit,” writes Karrasch and colleagues in the journal Ticks and Tick-borne Diseases. [1]

Welcome to another Inside Lyme Podcast with your host Dr. Daniel Cameron. In this episode, Dr. Cameron will be discussing a case which examines the diagnostic value of a lumbar puncture in Lyme neuroborreliosis.

The case was first described by Portales-Castillo and colleagues in the journal Cureus in a paper entitled “To Lumbar Puncture or Not to Lumbar Puncture.” The authors presented a case of “early disseminated Lyme neuroborreliosis with manifestations of facial palsy and painful radiculoneuritis as determined by clinical and serological criteria.”¹

A 61-year-old woman was admitted to the hospital with an inability to close her left eye and an odd sensation on part of her face. She presented with erythematous raised circled rash and swelling on the base of the index finger of her right hand.

 In this episode, Dr. Cameron will be discussing the case of a 21-year-old soldier who was dismissed from active duty after failing treatment for multiple illnesses including Lyme disease.

The case was first described by Melanson and colleagues in a paper entitled “The Epistemic Fallacy: Unintended Consequences of Empirically Treating (Clinically Diagnosed) Chronic Lyme Disease in a Soldier.”1

“A 21-year-old, Division 1 student athlete patient presented with heart palpitations and frequent unprovoked adrenaline rushes,” wrote the authors. His symptoms were initially dismissed as stress.

In this episode, Dr. Cameron will be discussing the case of a 64-year-old woman with central nervous system involvement of the brain.

The case was first described by Mullholand and colleagues in the British Medical Journal in a paper entitled “Central nervous system involvement of anaplasmosis.” 1

A 64-year-old woman was hospitalized with a 24-hour history of confusion and lethargy. The following morning, her lethargy had worsened and she developed subjective fever, mild headache, nausea, vomiting and increased confusion, according to the authors.

These two cases highlight the findings from a COVID-19 & Lyme Survey

Question: What is the clinical presentation of someone with a history of Lyme disease who have contracted a COVID-19 infection?

Findings: This cross-sectional Survey reveals a high symptom burden in 1168 individuals with a history of Lyme Disease. The symptom burden was the highest for the 288 individuals with a history of Lyme disease and a COVID-19 infection. Nearly one in five individuals with a history of COVID-19 and Lyme disease developed long COVID. Twenty were hospitalized.

Meaning: Individuals with a history of Lyme disease and COVID-19 have a high symptom burden and are at increased risk of hospitalization and long COVID.

This case highlights the findings from a COVID-19 & Lyme Survey.

HIGHLIGHTS

Findings: This cross-sectional study reveals a high symptom burden in 1,168 individuals with a history of Lyme Disease. The GSQ-30 measure of symptom burden for 616 individuals with a history of Lyme disease who were vaccinated against COVID-19 was significantly lower than the symptom burden for the 552 who were not vaccinated.

Here are are a few of the case of individuals with Lyme disease who described side effects.

CASE 1:

“After about a week, I began to experience extreme fatigue, difficulties with my lungs (finding it harder to breathe), and heart palpitations. I also struggled to walk any distance as my body would become tired very quickly (these were symptoms I had not experienced for about four years since the start of my Lyme disease treatment).”

CASE 2:

“… got extremely ill, felt like the Lyme and babesia was activated and became as strong as it was before I began treatment (and I was very, very sick by then).”

CASE 3:

“… severe cognitive issues, arm/leg numbness, rage due to light and sound, purple legs sitting and laying down, no short-term memory, speech stuttering, severe word search, muscle weakness, balance, coordination, double blurred vision, dizziness, heavy head, like my head is balancing on a broomstick, and it is a medicine ball, headache around the base of my neck/skull, weight loss, severe fatigue. I would say my pain and fatigue symptoms were 3-4/10 and now they are 8-9/10. The cognitive/ speech/vision/memory problems and purple legs are post-vaccine.”

more see blog at https://danielcameronmd.com/side-effects-covid-19-vaccines-lyme-disease/

Dr. Cameron discusses Neuropsychiatric Lyme disease in his new ebook "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

Dr. Daniel Cameron released his e-book January 13, 2023. This book summarizes Dr. Cameron’s understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. There is also space at the end of this book to share readers comments and engage with Dr. Daniel Cameron. His ebook is available only his website at www.DanielCameronMD.com.

Dr. Cameron discusses Pediatric Lyme disease in his new ebook "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

Dr. Cameron discusses Babesia in his new ebook "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

This is a free audio addressing pain from Dr. Cameron's e-book. "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

Dr. Cameron recorded a meet the author discussion of his new ebook "A Expert's Guide on Navigating Lyme disease."   This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

This is a free audio addressing clinical presentations from Dr. Cameron's e-book. "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

Dr. Cameron discusses Babesia in his new ebook "An Expert's Guide on Navigating Lyme disease."  This book summarizes his understanding of Lyme disease based on his first 600 Lyme disease science blogs and 35+ years of treating Lyme disease patients. The book includes over 200 published Lyme disease cases. 
Support his work by buying a copy of his ebook. His  ebook is only available on his website at https://danielcameronmd.com/store-navigating-lyme-disease/

Or call Dr. Cameron's office at 914-666-4665.

This girl with Lyme disease contracted COVID-19.  She subsequently developed long COVID.  She was a participant in Survey of more than 900 individuals with a history of Lyme disease.  The first published paper can be found at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10044022/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

The 988 Suicide & Crisis Lifeline, available by simply dialing 988, is a 24-hour, toll-free, confidential suicide prevention helpline available to anyone in suicidal crisis or emotional distress. When someone calls the helpline, his or her call is routed to the nearest crisis center. The Lifeline’s national network, consisting of more than 250 local crisis centers, provides crisis counseling and mental health referrals day and night.

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

This ebook is available on Dr.  Daniel Cameron's website at https://danielcameronmd.com/lyme-books/ 

His print book, ebook and audio book are available on Amazon.  https://www.amazon.com/Experts-Guide-Navigating-Lyme-disease-ebook/dp/B0C6H3T542?ref_=ast_author_mpb

Call his office at 914-666-4665 if you would like to make an appointment.

You can also follow his Lyme disease science blogs on his website https://danielcameronmd.com/lyme-science-blog/

Lyme Disease and Your Dog

Welcome to our educational series on Lyme disease. Today, we'll discuss how to protect yourself and your loved ones, including your pets, from tick-borne diseases.

Let's start with a story. One of my patients took precautions by using DEET and wearing clothes treated with pyrethrum. He also had a dog that wore a tick collar and was checked for ticks regularly. Despite this, he woke up with a deer tick attached.

Ticks can carry several diseases, not just Lyme disease. These include Ehrlichia, Anaplasmosis, Babesia, and the Powassan virus. It's crucial to be aware of these risks."

Many patients use DEET, recommended by the CDC, for tick prevention. However, DEET is more effective against mosquitoes. I've had patients report tick bites despite using DEET."

Pyrethrum is another option. It can be applied to clothing, but not directly to the skin. It's effective, but can cause side effects like dizziness and headaches. Also, its effectiveness decreases with washing."

Risks with Dogs

Dogs can increase your risk of tick exposure. They can pick up ticks outside and bring them into your home. Even with tick prevention measures, ticks can still be a problem.

I recommend using a dust vac on furniture before sitting next to your dog. This can help reduce the risk of ticks in your home."

It's best to avoid letting your dog sleep in your bed. Ticks can leave your dog and bite you without you noticing."

Special Concerns for Pregnant Women

Pregnant women need to be especially careful. Tick bites can pose risks to both mother and baby. Avoiding tick bites is crucial, and if you do get bitten, consult your doctor immediately."

Practical Advice

Here are some practical tips:

1. Use a dust vac on furniture before sitting with your dog.

2. Avoid letting your dog into the bedroom.

3. Perform regular tick checks on yourself and your pets after spending time outdoors.

4. Pregnant women should consult their doctor if bitten by a tick." 

Conclusion

 While dogs are wonderful companions, they can increase your risk of tick exposure. By taking these precautions, you can protect yourself and your loved ones from tick-borne diseases. Thanks for watching, and stay tuned for more tips on staying safe from Lyme disease.

I had a patient who was quite reluctant to consider antibiotic treatment for Lyme disease after being unabIe to tolerate his initial treatment.  He was able to tolerate treatment by starting.   with a lower dose of antibiotics.

 I have patients with issues with gastroparesis, leaky gut, diarrhea, candida, yeast, constipation, and irritable bowel that has made it difficult to tolerate antibiotics.  I have patients who have had a Herxheimer reaction after an antibiotic for another conditions. A Herxheimer reaction also known as Jarisch-Herxheimer reaction (JHR) is a transient clinical phenomenon that occurs in patients infected by spirochetes who undergo antibiotic treatment.  I have patients who cannot swallow pills and others who cannot tolerate liquids.

 I refer my patients to specialists as needed to determine if there is another underlying cause for their difficulties with medications.  I refer to gastroenterologist if rule out other causes for stomach problems. I refer to other specialists to rule out an autonomic disorder as a cause for their stomach issues.

 I also have patients who are still sick after changes in their diet and alternative medicine.  I review the risk of antibiotics against the risk of remaining sick with Lyme disease.  Some of these patients are still unwilling to consider antibiotics.  I advise my patients to avoid alcohol and processed sugars.

Here are a few treatment options I have incorporated in my practice for those willing to be treated. I introduce treatment slowly. I start out with single therapy rather than combination therapy.  I have started patients with 50 mg of doxycycline instead of 100 mg. I have started with 25 mg of doxycycline at times with a liquid formulation.  I  have lowerd the dose of cefuroxime from 500 twice a day to 250 twice a day. I have prescribed Zithromax 250 every other day or every third day as Zithromax has a long half-life. I have lower the liquid atovaquone at 750 mg twice a day to atovaquone at 250 mg twice a day or a pediatric dose of atovaquone at 62.5 twice a day. The lower doses of atovaquone are available in an oral form combined with proguanil.

 I have start with once a day for some patient.  I typically raise the dose if tolerated. I find the lower doses helpful in some patient without having to increase the dose.

 I have not found intravenous ceftriaxone as helpful as I would like. IV ceftriaxone enters the stomach through the circulatory system leaving me with the same gastrointestional issues. Moreover, intravenous ceftriaxone is not the treatment of choice for tick-borne co-infections.

I follow by patients starting at one month to determine if they are tolerating the lower dose and to determine their response to treatment.  I advise my patient to contact me if they are having problem with tolerating the lower dose to work out a solution. 

Case Study 1: Missed Co-Infection

I had a patient who didn't get better after a month of doxycycline for Lyme disease. Six months later, she was still sick. It turned out that the deer tick bite also transmitted Babesia, a co-infection. After treating her with azithromycin and atovaquone, she recovered successfully.

Case Study 2: Unrecognized Transmission

Another patient unknowingly had Babesia and donated blood. The recipient of the blood transfusion developed Babesia as a result.

Rising Awareness of Babesia

As we enter another summer, it's important to recognize that Babesia is an increasing concern as a tick-borne pathogen. The first case of babesiosis caused by the B. microti parasite was identified in 1969 in a person who had vacationed in Massachusetts. Research by Krause and colleagues in 1998 found that 24 out of 46 untreated Babesia-infected subjects had Babesia DNA in their blood for an average of 82 days.

Serious Health Risks

Babesia can lead to serious health issues, including atrial fibrillation, noncardiogenic pulmonary edema, and anemia. In New York, between 1982 and 1991, seven people with Babesia died. On Nantucket Island, another patient developed pancarditis and died.

Chronic Illness

I've seen patients remain chronically ill until they were treated for Babesia. This highlights the importance of considering Babesia in patients who don't respond to standard Lyme disease treatments.

 Transmission Risks

Babesia can be transmitted through blood transfusions and, though rare, from a pregnant mother to her unborn child. Pregnant women should take extra precautions to avoid tick bites and exposure to infected animals. If infection occurs, immediate medical attention is crucial to protect both the mother and baby.

Treatment Options

Treating Babesia typically involves a combination of antimicrobial medications. The standard treatment includes atovaquone and azithromycin. Clindamycin and quinine are also used but have more side effects. Recently, a new drug called tafenoquine has been introduced for patients who relapse after standard treatment. According to a study by researchers at the Yale School of Public Health, adding tafenoquine can be a lifesaver for vulnerable patients.

Treatment Management

These treatments can effectively reduce the parasite load in the blood and alleviate symptoms. It's important for patients to complete the full course of treatment to prevent relapse and ensure the parasite is fully eradicated. For patients with weakened immune systems or the elderly, longer or repeated courses of treatment may be necessary.

Conclusion

Being vigilant about Babesia, especially in patients who don’t respond to Lyme disease treatments, can make a significant difference. Proper diagnosis and treatment are crucial for effective management and recovery.

Persistent Tick-Borne Infection

A patient came to me with Post Treatment Lyme Disease Syndrome (PTLDS) after completing a four-week course of treatment for Lyme disease. Despite the treatment, she continued to suffer from headaches, fatigue, sleep disturbances, memory problems, and joint or muscle pain. She was diagnosed with PTLDS, and her condition was largely dismissed as a chronic immune response. 

Initially, she believed that PTLDS was purely an immune response. However, she didn't know that PTLDS could also be caused by a persistent tick-borne infection. After a year of living with PTLDS, she was treated for Lyme disease and a co-infection with Babesia using a combination of Zithromax and Malarone. This treatment resolved her PTLDS symptoms. 

History and Debate:

The medical community has long debated the nature of chronic Lyme disease. In 2000, some doctors published guidelines that questioned the existence of chronic Lyme disease as a distinct condition, leading many to believe there was no evidence supporting chronic Lyme disease.

In contrast, in 2004, I collaborated with colleagues in the International Lyme and Associated Diseases Society (ILADS) to publish guidelines affirming the existence of chronic Lyme disease. Despite this, the debate continues, with doctors divided over the existence and causes of chronic Lyme disease. 

Current Perspectives: 

Some doctors now acknowledge that Lyme disease and other tick-borne illnesses can lead to chronic conditions, referring to it as Post Treatment Lyme Disease Syndrome (PTLDS). However, they often describe PTLDS as resulting from an immunologic process, without being informed of the possibility of a persistent infection.

Clinical Observations: 

In my practice, I've seen patients with PTLDS who improved after being treated for persistent infections. This suggests that in some cases, ongoing symptoms may be due to an unresolved tick-borne infection rather than solely an immune response.

Conclusion:

 The case of my patient, who found relief through additional treatment for persistent Lyme disease and a co-infection, highlights the importance of considering persistent infections in patients with PTLDS. While the medical community remains divided, it's crucial to explore all potential causes of chronic symptoms to provide the best care for patients.

Welcome! Today, we're discussing the treatment of Babesia and Lyme disease, focusing on real patient experiences and effective treatment strategies.

I had a patient who remained chronically ill six months after treating for Lyme disease. Despite exhaustive evaluations, she was still symptomatic. Her antibody tests came back positive for Babesia, although her thick smear and PCR were negative. She believed Babesia was asymptomatic since it wasn’t seen in her red blood cells, but she was very symptomatic.

 Babesia is a parasite transmitted by the same deer ticks that carry Lyme disease. Some patients have Babesia parasites visible in their red blood cells under a microscope, usually seen at the onset of the illness for one to two weeks. In some cases, especially in the elderly or immunocompromised, the parasite can persist longer, leading to severe illness requiring intensive care."

 Some Babesia patients don't experience acute, life-threatening illness and might not have visible parasites in blood smears. Instead, positive antibody tests for Babesia, such as IgM and IgG for Babesia microti or Babesia duncani, can indicate the presence of the infection. I've seen positive Babesia duncani tests even on the east coast, suggesting the need for further research.

 I've had patients who, despite negative tests, improved after Babesia treatment. These patients often failed treatments for Lyme disease, Anaplasmosis, Ehrlichia, and Bartonella for months or years, unaware that Babesia could be a co-infection.

 For Babesia treatment, I avoid quinine and clindamycin due to their higher rate of side effects. Instead, I recommend atovaquone combined with azithromycin, which is more tolerable. Atovaquone is marketed as Malarone and Mepron in the USA. Malarone is a pill, while Mepron is a thick yellow liquid. Malarone is generally less expensive and more convenient.

 Malarone also comes in a pediatric dose, making it easier to tolerate for patients with an upset stomach or those concerned about a Herxheimer reaction. I usually prescribe 30 days of atovaquone, longer than the 10 days suggested by some studies, as my patients often aren't treated at the onset of their Babesia infection."

 I combine atovaquone with azithromycin and discuss the risks of azithromycin versus untreated Babesia. If necessary, I consult a cardiologist to rule out prolonged QT interval and treat for the same duration as atovaquone."

 If a patient can't take azithromycin or if there's a possibility of co-infection with Anaplasmosis or Ehrlichia, I may substitute doxycycline. For patients failing atovaquone with azithromycin, tafenoquine (Arakoda) has been introduced as an alternative. Although it's currently difficult to obtain, it has shown some success in persistent Babesia cases."

 Atovaquone is often covered by prescription plans, and services like GoodRx can reduce the cost to less than $80 in some communities. This makes it a viable option for many patients.

 Conclusion

 Treating Babesia is often overlooked in patients with recurrent or prolonged illnesses. With ongoing research and new treatments, there's hope for better management and outcomes for patients with Babesia and Lyme disease. Thanks for watching, and stay tuned for more insights on managing tick-borne diseases."

Welcome! Today, we’re exploring the key milestones in Lyme disease research and treatment.

I had a 57-year-old patient who remained chronically ill after being diagnosed and treated for Lyme disease. He didn't realize that a persistent tick-borne infection could explain his chronic illness. He was treated with a combination of azithromycin and atovaquone for the persistent infection, and today, he is doing well.

He was surprised that, despite the milestones in Lyme disease research, he wasn't aware that a persistent infection could lead to his chronic illness. So, let's take a closer look at these milestones.

1. 1977: Discovery of Lyme Disease

Our story begins in 1977 in Lyme, Connecticut. A cluster of children and adults were diagnosed with what was initially thought to be juvenile rheumatoid arthritis. This event marked the identification of Lyme disease as a distinct illness and the start of modern Lyme disease awareness."

2. 1982: Discovery of the Bacterium Responsible for Lyme Disease

In 1982, Dr. Willy Burgdorfer identified Borrelia burgdorferi, the bacterium responsible for Lyme disease. This discovery was a major milestone, enabling more precise identification and treatment of the disease. 

3. 1990: Recognition of Chronic Lyme Disease

By 1990, chronic Lyme disease, with its long-term and persistent symptoms, was officially recognized. This led to more comprehensive treatment protocols and increased awareness of the disease's chronic nature.

4. 1995: Discovery of Babesia microti

In 1995, Babesia microti was identified as a co-infection transmitted by the same ticks that carry Lyme disease. This highlighted the complexity of tick-borne illnesses and the need for integrated treatment approaches.

 5. 2000: Publication of IDSA and ILADS Guidelines

The year 2000 saw the publication of treatment guidelines by both the Infectious Disease Society of America (IDSA) and the International Lyme and Associated Diseases Society (ILADS). These guidelines showcased different approaches to treating Lyme disease, marking another significant milestone. 

6. Ongoing Research and Future Milestones 

Research is ongoing, and we look forward to future milestones that could lead to breakthroughs in diagnosis and treatment. Studies on biofilms, persisters, and tick-borne co-infections may enable doctors to develop treatment plans that significantly improve patient outcomes.

Conclusion

Understanding these milestones helps us appreciate the progress made in the fight against Lyme disease. With continued research and dedication, we move closer to effective management and potential cures. Thank you for watching, and stay tuned for more insights on Lyme disease."

Welcome! Today, we're discussing my concerns with a single dose of doxycycline for a tick bite. 

Case Study: Ineffective Prophylactic Treatment 

I had a patient who took a single 200 mg dose of doxycycline within 24 hours of removing an engorged tick, thinking it would prevent Lyme disease. Unfortunately, seven months later, he was chronically ill with Lyme disease. He never developed a rash, and his lab tests for Lyme disease were negative. He eventually resolved his chronic illness with doxycycline followed by a combination of atovaquone and azithromycin.

 Co-Infections and Their Impact

 Ticks can harbor multiple infections, not just Lyme disease. In the Northeast, common co-infections include Ehrlichia, Anaplasmosis, Babesia, and Bartonella. These can lead to acute and chronic illnesses such as Lyme arthritis, Lyme carditis, chronic neurologic Lyme, Postural Orthostatic Tachycardia Syndrome (POTS), and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).

 The Need for Effective Prevention

Effective prevention following a tick bite remains a challenge. One study found that a ten-day antibiotic course failed to prevent Lyme disease. Another study suggested that a single 200 mg dose of doxycycline could be effective if taken within 72 hours of a deer tick bite in endemic areas.

However, a single dose of doxycycline hasn't been shown to prevent common Lyme disease manifestations like Lyme arthritis, Lyme carditis, Lyme meningitis, POTS, or PANS. It also doesn't prevent co-infections such as Babesia.

 Concerns with Single Dose Prophylaxis

A single dose of doxycycline raises several concerns. It may prevent the erythema migrans rash, which is crucial for early diagnosis and treatment. It might also prevent a positive test result needed to confirm Lyme disease early.

Discussing Treatment Options 

I discuss with my patients the risks of prophylactically treating with a single dose of doxycycline versus not treating at all. I've seen patients return with acute and chronic neurological symptoms after a single dose of doxycycline.

I generally follow two approaches. Some patients are monitored closely without treatment and followed up after a month to check for any signs of Lyme disease or co-infections. Blood tests can be helpful in these cases. Other patients are treated for 3 to 4 weeks with a follow-up to assess the outcome. 

 Patients and their families unfamiliar with Lyme disease are more likely to opt for monitoring. Those with prior experience with Lyme disease often agree to antibiotic treatment with follow-up. 

Conclusion 

We need a preventive measure that effectively prevents both acute and chronic manifestations of Lyme disease and its co-infections. Although we're not there yet, understanding these challenges helps us move closer to effective solutions. Thank you for watching, and stay tuned for more insights on Lyme disease.

Welcome! Today, we’re discussing the unexpected and unusual presentations of Lyme disease that I've encountered in my practice.

Case Study: Unexplained Foot Pain

One of my patients experienced severe foot pain, even while walking to the bathroom. A podiatrist diagnosed him with plantar fasciitis, and he tried various treatments including icing, NSAIDs, stretching, iontophoresis, shoe inserts, and cortisone injections. Despite these efforts, his foot pain persisted.

In addition to foot pain, he suffered from exhaustion, poor sleep, impaired concentration, neck and back pain, mood disturbances, palpitations, lightheadedness, migratory pains, and sensitivity to light and sound. Remarkably, his foot pain and other symptoms resolved following treatment for Lyme disease.

Expected Lyme Disease Presentations

In my practice, the expected presentations of Lyme disease include:

- Erythema migrans

- Bell’s palsy

- Chronic Neurologic Lyme disease

- Neuropsychiatric Lyme

- Postural Orthostatic Tachycardia Syndrome (POTS)

- Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)

- Lyme carditis

- Lyme arthritis

Unusual Lyme Disease Presentations

However, I've also encountered several unusual presentations of Lyme disease that resolved with treatment. These include:

- Thumb pain

- Intermittent blue color of the hands and feet

- Distorted vision and floaters

- Uveitis

- Atypical seizures

- Temporomandibular joint (TMJ) disorder

- Tinnitus

- Movement disorders

- ALS-like and MS-like presentations

- Parkinsonian symptoms

- Dementia

- Gastroparesis

- Mold sensitivity

- Small intestinal bacterial overgrowth (SIBO)

- Mast cell activation syndrome (MCAS)

- Ehlers-Danlos syndrome (EDS)

- Median arcuate ligament syndrome (MALS)

- Fibromyalgia

- Chronic fatigue syndrome

- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

- Functional and somatic disorders

- Anxiety, depression, OCD, and ADHD

The Challenge of Diagnosis

It can be challenging to determine whether Lyme disease is the cause of these unusual presentations, as patients may have multiple conditions. Proper diagnosis and treatment are crucial for resolving these complex symptoms.

Conclusion

Understanding the wide range of Lyme disease presentations helps us better identify and treat this complex illness. If you or someone you know has unexplained symptoms, consider consulting a Lyme-literate doctor. Thank you for watching, and stay tuned for more insights on Lyme disease.

Welcome! Today, we'll explore the top ten symptoms of Lyme disease that I've encountered in my practice, highlighting the case of a patient who experienced them.

Case Study: A 34-Year-Old Man's Journey

He was a 34-year-old man who had been chronically ill for 14 months. He had seen his primary care physician and various specialists, but multiple conditions were ruled out. Despite some improvement with symptomatic treatments, he couldn't work and struggled to care for his family. He didn’t realize his symptoms were consistent with Lyme disease and a tick-borne co-infection.

Top Ten Lyme Disease Symptoms

Here are the top ten Lyme disease symptoms I've seen in my practice:

1. Exhaustion: Severe fatigue that doesn't improve with rest.

2. Poor Sleep: Trouble falling asleep, staying asleep, or feeling rested.

3. Impaired Concentration: Difficulty focusing and memory problems.

4. Headaches: Persistent and severe headaches.

5. Mood Disturbance: Irritability, anxiety, depression, and mood swings.

6. Neck Pain: Stiffness and pain in the neck.

7. Postural Orthostatic Tachycardia Syndrome (POTS): Lightheadedness, rapid heartbeat upon standing.

8. Nausea and Constipation: Gastrointestinal issues.

9. Sensitivity to Light, Sound, Heat, and Cold: Heightened sensitivity to environmental stimuli.

10. Joint Pain and Numbness: Migratory joint pain and tingling or numbness in the hands and feet.

Additional Symptoms

He also experienced:

- Distorted vision and pain behind his eyes

- Chest and back pain

- Ringing in his ears (tinnitus)

- Night sweats and air hunger

- Testicle pain

He thought his head pressure was related to sinusitis, but ENT evaluations and a CT scan were negative. He attributed his exhaustion to chronic fatigue syndrome and poor concentration to fatigue and poor sleep. He didn’t connect his sensitivity to light, sound, heat, and cold to his illness.

He couldn't understand the cause of his irritability, sadness, anxiety, and despair. He didn’t know that his lightheadedness, nausea, and constipation could be linked to an autonomic immune response to Lyme disease. He also didn't realize that the burning in his hands and feet and migratory joint pain were related to his illness.

Treatment and Recovery

His chronic illness resolved with a combination of Malarone and Zithromax after failing a course of doxycycline. This case highlights the importance of recognizing the diverse and often unexpected symptoms of Lyme disease.

Conclusion

Understanding these symptoms can help in the early diagnosis and effective treatment of Lyme disease. If you or someone you know has unexplained symptoms, consider consulting a Lyme-literate doctor. Thank you for watching, and stay tuned for more insights on Lyme disease.

Welcome! Today, we're discussing the top causes of treatment delays for Lyme disease that I've encountered in my practice."

Case Study: An 18-Month Struggle

One of my patients was ill for 18 months. She had a tick bite and an atypical rash. Her ELISA titer was positive for Lyme disease, but she had only two IgG western blot bands. Despite multiple evaluations, Lyme disease was considered but dismissed after a negative test. She presented with Chronic Neurologic Lyme and Postural Orthostatic Tachycardia Syndrome (POTS) and required extensive treatment due to these delays. Fortunately, she improved after treatment, but the delay made her recovery more challenging.

Top Causes of Treatment Delays

Here are the top causes of treatment delays I see in my practice:

1.  Absence of a Tick Bite: Many patients don't recall being bitten by a tick, leading to delays in considering Lyme disease.

2.  Absence of a Rash: Not all Lyme disease patients develop a rash, which can cause misdiagnosis.

3.  Atypical Rash: Only one in four Lyme disease cases present with the classic bull’s eye pattern.

4.  Equivocal or Negative Tests for Lyme: Inconsistent or negative test results can lead to delays in diagnosis.

5.  Equivocal or Negative Tests for Co-Infections: Co-infections like Babesia may not be detected, complicating diagnosis.

6.  Dismissal as Another Illness: Symptoms may be mistaken for chronic fatigue, fibromyalgia, gastroparesis, or other conditions.

7.  Inadequate Public Health Information: Lack of awareness and information can lead to delays in seeking appropriate care.

8.  Poor Understanding of the Signs and Symptoms of Lyme Disease: Misinterpretation of symptoms by both patients and healthcare providers.

9.  Stigma Associated with the Diagnosis of Lyme Disease: Fear of stigma can prevent patients from seeking a diagnosis.

10.  Difficulties Finding a Doctor Who Will Treat Lyme Disease: Limited access to Lyme-literate doctors can delay treatment.

11.  Reliance on Symptomatic Treatment or Alternative Treatments: Focusing on symptomatic relief without considering Lyme disease.

12.  Reluctance of Professionals to Consider Lyme Disease: Some healthcare providers are hesitant to diagnose Lyme disease.

Addressing the Challenges

Addressing these challenges requires raising awareness, improving diagnostic methods, and ensuring better access to doctors experienced in treating Lyme disease. Patients and healthcare providers need to be informed about the varied presentations and complexities of Lyme disease.

Conclusion

Understanding the causes of treatment delays helps us improve the timely diagnosis and treatment of Lyme disease. If you or someone you know is experiencing unexplained symptoms, consider consulting a doctor experienced in treating Lyme disease. Thank you for watching, and stay tuned for more insights on Lyme disease.

What is a common-sense approach to testing for Tick-borne infection. I focus on the most common infections that I see a Lyme disease infection. I order a Lyme disease test as well as test for infections like Ehrlichia, Anaplasmosis, and Babesia. I don’t typically order Mycoplasma or Chlamydia unless there is evidence that there’s active infection. 

I order an ELISA test, which is also called Lyme titer.  I also order a western blot and IgG and IgM test. These are test where you need two out of three bands IgM bands. You need five out of 10 IgG bands to be called positive by the CDC criteria. These are bands that were identified and in 1994 at a consensus meeting in Dearborn Michigan.  These markers are protein that have been identified in Lyme disease infections.  For example, the 41 kDa band represents a protein contained in the tail of a spirochete.

I have not been ordering a C6 peptide or VlsE protein tests for Lyme disease as they are not as reliable as I would like.  None of these tests for Lyme disease are all that sensitive in my experience.  I have often had to use clinical judgement to diagnose and treat Lyme disease.

I also order IgG and IgM tests for co-infections with Babesia, Bartonella, Anaplasmosis, and Ehrlichia. I have not found PCR tests for these co-infections as helpful as I would like.

I have found a blood smear for Babesia not helpful if a patient has been sick more than 2 weeks.  

Some doctors have assumed Bartonella tests have been positive due to exposure to fecal matter from mites living on cats. I can’t be sure the cause of positive tests for Bartonella in patients with Lyme disease. 

I don’t typically ordered labs for infections such as tularemia or Brucellosis despite concerns by some of my colleagues. I have found treatment for Lyme disease would take care of these infections if they were present.

I typically do not sent bloods to a specialty lab if someone’s on a budget. I also do not send bloods to these labs if I am going to treat clinically.  

I also order extensive testing to rule other illnesses like a CBC, comprehensive metabolic profile, ANA, RA, thyroid, sed rate, vitamin B12 and D.    I may order a free T4 and free T3 if I am considering a thyroid condition.  I have found ANA frustrating as most of the ANA tests are false positive. A positive dsDNA supports the diagnosis of lupus. My patients don’t typically have three other conditions that would support the diagnosis of Lupus. I refer my patients to see a rheumatologist if there is a need to rule out lupus.

I typical order blood test for a tick-borne illness four weeks or 4 to 6 weeks after onset of their illness to increase the chances that I might get a positive test.  I have had to use clinical judgement to treat a tick-borne infection if my patient is sick for less than 4 weeks or if I suspect a false negative test,

My Lyme disease patient was afraid of seeking treatment for Lyme disease. She was not alone. She is not alone. I will explore the stigma surrounding Lyme disease, the impact on patients, and treatments. One of the main hurdles is the fear of the diagnosis itself.

Lyme disease manifests in various stages with symptoms ranging from mild to severe and can become a chronic condition if not diagnosed and treated promptly. If not diagnosed and treated promptly. 

Patients are aware that being diagnosed with Lyme disease can lead to skepticism from both the public and healthcare providers. This skepticism can result in delayed treatment and inadequate care, exacerbating the patient's suffering. Some articles and reports have been dismissive of compelling evidence that demonstrates Lyme disease as a complex chronic condition. This bias contributes to the harmful stereotype of chronic Lyme sufferers as hypochondriacs, individuals who are excessively preoccupied with their health without a legitimate medical reason. Such portrayals undermine the seriousness of this disease and invalidate the experience of those suffering from it. The portrayal of Lyme disease sufferers as hypochondriacs leads to significant

stigma within healthcare settings. Healthcare providers may be influenced by this bias, leading them to dismiss patient’s symptoms or attribute them to psychological causes rather than exploring a potential Lyme disease diagnosis. Patients may feel isolated, misunderstood, and reluctant to seek further medical help due to previous negative experiences.

The development and implementation of new treatments for Lyme disease often face harsher criticism compared to treatments for other chronic diseases. This criticism stems from a combination of skepticism about the chronic nature of Lyme disease and concerns over the long term use of antibiotics. Despite evidence supporting the efficacy of extended antibiotic therapy, in some chronic Lyme cases, these treatments are frequently scrutinized and dismissed. This hesitancy to embrace new treatments limits options for patients and hinders progress in managing the disease effectively. A significant aspect of the controversy surrounding Lyme disease treatment is the debate over antibiotic therapy. Recent reporting

Critics highlight potential side effects and the risk of antibiotic resistance, suggesting that patients should endure their symptoms rather than pursue long term antibiotic treatment. This perspective fails to acknowledge the debilitating nature of chronic Lyme disease and the potential benefits that some patients experience from prolonged antibiotic therapy.

The dismissal of chronic Lyme disease and a reluctance to support extended antibiotic treatment has profound consequences for patients suffering from chronic symptoms such as fatigue, joint pain, neurologic issues, and cognitive impairment. Patients are left with limited options.

The suggestion that patients should endure their symptoms without adequate treatment disregards the impact of this disease on their quality of life. Addressing the stigma and challenges in Lyme disease treatment requires a multifaceted approach. It is crucial to acknowledge Lyme disease as a complex chronic condition and to validate the experience of those suffering from it. 

By fostering a more compassionate and evidence-based perspective, we can improve the diagnosis, treatment, and overall care for Lyme disease patients. Healthcare providers, media, and policy makers must work together to reduce stigma, support research into new treatments, and ensure the patients receive the comprehensive care they need.

Unfortunately, there simply isn’t a one-size-fits-all treatment protocol for patients infected with Lyme disease and/or co-infections. This is why it's critical for physicians treating Lyme disease to invest time with patients, thoroughly understand their medical history, and closely monitor symptoms and treatment response.

With that in mind, there are currently two different treatment approaches for Lyme disease. The Infectious Disease Society of America (IDSA) and the International Lyme and Associated Diseases Society (ILADS) have each published their own set of evidence-based treatment guidelines. IDSA guidelines recommend a short course of antibiotics, typically 14 to 30 days.

IDSA argues that the Borrelia burgdorferi bacteria do not persist in a patient beyond this timeframe and that lingering symptoms are the result of an ongoing immune response and not an active infection. It also cites scientific evidence claiming treatments beyond 30 days are ineffective, unnecessary, and even dangerous. IDSA physicians will stop treatment after 30 days, even if symptoms remain. They advise an additional 30 days of treatment recommended for patients with Lyme arthritis. 

On the contrary, ILADS offers its own scientific data to show that a additional treatment with antibiotics is required to eradicate the bacteria. ILADS recognizes that a month of treatment may be sufficient for patients in the acute stage of Lyme disease, but in cases where the spirochete has disseminated and the disease has advanced, a 30-day treatment regimen is inadequate.

ILADS guidelines recommend additional antibiotics until a patient's symptoms have been resolved. Treating Lyme disease in its advanced stage can be complicated based on the complexity of the organism itself, differences in each patient's immune system, the length of time infected, and the possible presence of other co-infections transmitted by the same tick.

There are several choices in treating Lyme disease, which include oral, intravenous, and intramuscular antibiotic options. Other options may include sequential antibiotic therapy, higher doses of antibiotics, taking antibiotics for a longer period of time, a combination of antibiotics, retreatment, as well as diagnosing and treating co-infections. Some specific antibiotics used in treating Lyme disease are doxycycline, minocycline, amoxicillin, cefuroxime, azithromycin, and clarithromycin.

Other tests include measures of blood counts, chemistries, liver function tests, ANA, dsDNA, RF, TSH, free T3, free T4, ESR may be helpful at ruling out other conditions.  Referral to specialist might help to rule out other conditions. 

I find shared decision with my patient helpful. I also find follow-up helpful to assess my patient's response to treatment to rule out other conditions.

There are additional protocols that may also aid in treating Lyme disease, such as avoiding alcohol, simple and processed sugars, exercising as tolerated, counseling for a Jarisch-Herxheimer reaction, managing symptoms, monitoring and reducing the risk of an adverse event, and reducing stress. However, there is a chance of side effects such as Clostridium difficile-associated diarrhea (CDAD). Probiotic have been prescribed with the hope of reducing the risk of developing CDAD.

My patient took a "bury-your-head-in-the-sand" viewpoint toward Lyme disease, which did not help him. He had been ill for over two years, suffering from severe fatigue, brain fog, poor sleep, headaches, poor concentration, irritability, neck pain, chest pain, palpitations, stomach pains, and joint pain. He remained ill despite having been evaluated by a number of specialists to rule out other illnesses. He was reluctant to consider Lyme disease or tick-borne infection without a positive test.

His condition significantly affected his quality of life, and he experienced increasing frustration as each specialist he consulted was unable to identify the cause of his symptoms. Despite his worsening condition, he was hesitant to pursue a diagnosis of Lyme disease due to a lack of definitive test results and a belief that it was unlikely without a positive test or known tick bite.

His family, concerned about his deteriorating health, encouraged him to reconsider his reluctance and seek treatment for Lyme disease. After much persuasion, he agreed to undergo treatment. He was successfully treated with doxycycline followed by a combination of Zithromax and Malarone for Lyme disease with Babesia coinfection. The improvement in his symptoms was remarkable; his fatigue, brain fog, and other symptoms began to resolve.

He is now kicking himself for taking that "bury-your-head-in-the-sand" viewpoint and not considering Lyme disease earlier. His experience underscores the importance of considering Lyme disease as a potential diagnosis in patients with persistent, unexplained symptoms, even in the absence of a positive test or known tick bite. Early intervention and treatment can prevent prolonged suffering and lead to significant improvements in health.

Preventing Chronic Lyme Disease: Insights from 37 Years of Experience

As a Lyme disease expert, preventing chronic illness associated with Lyme disease has been a primary focus of my practice for the past 37 years. Despite early intervention and comprehensive care, some patients still find themselves battling long-term, debilitating symptoms. This post outlines the strategies and lessons I’ve learned over the years in my mission to prevent chronic Lyme disease.

Understanding the Challenges of Lyme Disease

Lyme disease is a complex and often misunderstood condition. It can manifest in a variety of symptoms, which differ widely from patient to patient. These symptoms can range from mild to severe and can affect multiple body systems, making diagnosis and treatment particularly challenging. Even when Lyme disease is caught early and treated with antibiotics, some patients continue to suffer from persistent symptoms, leading to what is often referred to as chronic Lyme disease.

Early and Accurate Diagnosis: The First Line of Defense

One of the most critical steps in preventing chronic Lyme disease is ensuring an early and accurate diagnosis. Lyme disease is primarily a clinical diagnosis, meaning that it should be based on a patient’s symptoms and history rather than relying solely on test results. This is because the standard two-tiered testing approach can miss early or late-stage infections.

In my experience, comprehensive evaluations are essential, especially for patients with persistent symptoms. This includes not only testing for Lyme disease but also for co-infections like Babesia, Bartonella, and Ehrlichia, which are often transmitted by the same ticks that carry Lyme disease. These co-infections can complicate the clinical picture and require different treatment approaches.

Tailored Treatment Plans: No One-Size-Fits-All Approach

Not all patients respond to standard treatment protocols. While a typical course of antibiotics might be effective for some, others may require extended treatment or a combination of therapies to address the varying stages of the infection. Monitoring each patient’s progress is crucial, and being willing to adjust treatment plans based on their response is key to preventing chronic symptoms from developing.

Patient Education and Support: Empowering Patients for Better Outcomes

Educating patients about the potential for chronic symptoms, even after early treatment, is vital. Patients need to be aware that symptoms can recur and that it’s important to seek medical attention promptly if they do. This awareness can prevent the disease from progressing to a chronic state and can help patients manage their health more effectively.

Continuous support from healthcare providers is also essential. Chronic illness can be isolating, and having a supportive medical team can make a significant difference in a patient’s journey. This support can take many forms, including regular follow-up appointments, providing resources for symptom management, and offering encouragement and reassurance.

Holistic Care and Immune Support: Addressing the Whole Patient

Incorporating supportive therapies and focusing on overall immune system health can significantly improve outcomes for patients with Lyme disease. A holistic approach to care, which addresses both physical and mental health, can help mitigate the progression of chronic Lyme disease. This might include therapies such as physical therapy, nutritional support, and mental health counseling to address the wide-ranging impacts of the disease.

My patient’s understanding of Lyme disease and its complexities was incomplete. Although he was familiar with nymphal ticks, he lacked awareness about adult ticks, which also play a crucial role in transmitting Lyme disease. He knew about the Bull’s-eye erythema migrans rash, a clear sign of early Lyme disease, but was unaware of the other types of rashes associated with chronic Lyme disease or different tick-borne infections.

He had heard of early Lyme disease but didn’t realize that chronic Lyme disease could develop if the infection isn’t treated adequately. While he knew about Post-Treatment Lyme Disease Syndrome (PTLDS), he didn’t understand that PTLDS might be related to a persistent infection rather than just residual symptoms after treatment.

He was aware of the recommendation to take a single dose of doxycycline to prevent an erythema migrans rash, but didn’t know that this approach isn’t proven to prevent other serious manifestations of Lyme disease, such as Lyme arthritis, Lyme carditis, or neurological Lyme disease. Although he understood the basics of the two-tier laboratory test for Lyme disease, he was not informed that Lyme disease often remains a clinical diagnosis due to the limitations of current testing.

Furthermore, he didn’t grasp the importance of identifying and managing co-infections. For example, he didn’t realize that Babesia, a common co-infection, can’t be treated with doxycycline alone and requires specific antiparasitic medications. He was also unaware of the potential for treatment failures and relapses, which complicate the management of Lyme disease and its co-infections.

Closing these gaps in public health information is essential for improving patient outcomes. Providing thorough education on these topics can empower patients to recognize symptoms, understand treatment options, and make informed decisions about their healthcare."

Since opening my Lyme disease practice in 1987, I’ve witnessed significant changes in how we diagnose and treat this complex illness. Early on, I prescribed doxycycline for Lyme disease and Ehrlichia. However, my first three patients in 1987 did not respond to doxycycline, so I referred one to Boston for further consultation. They returned with a recommendation for amoxicillin, marking the first major shift in my treatment approach.

By 1990, I had started prescribing intravenous ceftriaxone (Rocephin), based on emerging reports of its effectiveness in chronic neurologic Lyme disease. This adjustment was influenced by reports from doctors Dr. Logigian, Kaplan and Steere, who documented treatment of chronic neurologic Lyme disease cases.

I added azithromycin (marked as Zithromax in the USA) and clarithromycin (marketed as Biaxin I the USA) into my practice, based on emerging reports of its effectiveness.

My practice changed again when Dr. Krause and colleagues reported the presence of Babesia, a parasite found in the same ticks that carry Lyme disease. At the time, treating Babesia was challenging, as the available regimen of clindamycin and quinine was difficult for patients to tolerate. The introduction of alternative treatments like atovaquone (Mepron) combined with azithromycin provided a more tolerable option, and I began prescribing these, particularly for patients who were not improving with other antibiotics.

Over the years, I’ve adapted my practice to include longer treatment durations and combination antibiotic therapies, especially in cases of chronic or persistent Lyme disease. I’ve also incorporated treatments for co-infections like Bartonella, which was initially thought to be associated with cat scratches but is now recognized as a potential tick-borne illness.

In addition to antibiotics, I’ve kept a close eye on new developments, such as the use of disulfiram (Antabuse) and double-dose dapsone, which has been explored by Dr. Horowitz for its potential benefits in treating chronic Lyme disease. While I have not yet adopted these treatments extensively, I remain open to new evidence-based approaches.

The concept of biofilms and persisters—bacteria that survive despite standard treatment—has also influenced my practice. The persister hypothesis borrowed from research on other persistent infections like tuberculosis, suggest that longer or more aggressive treatment may be necessary for some patients.

While antibiotics remain the cornerstone of my treatment approach, I also recognize the role of alternative therapies for some patients. I collaborate with alternative medicine practitioners when needed, ensuring that every patient receives a comprehensive and closely monitored treatment plan.

I continue to share my experiences and insights through writing and social media, fostering dialogue and contributing to the ongoing conversation about Lyme disease treatment.

The treatment landscape for Lyme disease has undergone significant evolution over the years, offering a wider array of options to manage this multifaceted illness. When I first began treating Lyme disease in 1987, the primary antibiotic prescribed was doxycycline. This choice was driven by doxycycline’s effectiveness not only against Lyme disease itself but also against co-infections such as Ehrlichia and Anaplasmosis. These co-infections, often transmitted by the same ticks that carry Lyme, present additional challenges in patient management. However, when patients couldn’t tolerate doxycycline due to side effects or failed to respond to the treatment, rifampin emerged as a viable alternative.

For pediatric patients, the treatment approach required special consideration. amoxicillin was commonly used to avoid the risk of dental staining associated with doxycycline, which can be a concern for growing children. However, the limitation of amoxicillin lies in its inability to combat co-infections like Ehrlichia or Anaplasmosis. Over time, other antibiotics related to amoxicillin, such as Pen VK, IM Bicillin, Omnicef, and Ceftin, became available. Of these, Ceftin (cefuroxime axetil) is notably the only one FDA-approved specifically for Lyme disease, reinforcing its role in the treatment regimen.

When dealing with neurologic Lyme disease, which can involve the central nervous system and present with symptoms such as memory loss, cognitive difficulties, and neuropathy, the approach often necessitates more aggressive treatment. Intravenous (IV) antibiotics like ceftriaxone (Rocephin) and Claforan were preferred due to their ability to cross the blood-brain barrier, a crucial factor in effectively treating neurological manifestations. These IV antibiotics are essential for some patients, particularly those with severe or persistent symptoms, but they are not without risks. The use of PICC lines for IV administration carries potential complications, including infections and blood clots. Interestingly, in my experience, many patients with chronic neurologic Lyme have shown significant improvement with oral antibiotics, allowing them to avoid the complexities and risks associated with IV treatments.

For patients who are allergic to or unable to tolerate doxycycline, or for those who are sun-sensitive—a common side effect of doxycycline—Zithromax (azithromycin) and Biaxin (clarithromycin) have emerged as effective alternatives. These antibiotics belong to the macrolide class and have shown efficacy comparable to doxycycline in the majority of clinical studies, offering additional options for patient care.

In the treatment of co-infections like Bartonella, the approach becomes more nuanced. Bartonella, initially identified as the causative agent of cat scratch fever, has been a subject of ongoing debate in the context of Lyme disease. This bacterium is traditionally associated with transmission through cat scratches, where the bacteria are introduced under the skin from cat saliva or flea feces. However, there is growing evidence suggesting that Bartonella may also be transmitted via tick bites, complicating the clinical picture for Lyme disease patients. In treating suspected Bartonella co-infections, I have employed antibiotics from the doxycycline, Zithromax, and rifampin families, drawing on research related to cat scratch fever. Additionally, I have used Bactrim (trimethoprim-sulfamethoxazole) in some cases. However, I generally avoid fluoroquinolones like ciprofloxacin due to their association with severe side effects, including joint pain, tendonitis, and tendon ruptures.

Babesia, another common co-infection found in Lyme disease patients, requires a different treatment approach altogether. Babesia is a parasite that infects red blood cells, causing symptoms similar to malaria. For treating Babesia, I often prescribe atovaquone, availa

When I first began treating Lyme disease, I adopted an “escalation” approach. This method involved starting with a standard course of doxycycline, typically lasting a month, and then observing how the patient responded. If the symptoms persisted or if I suspected that a co-infection might be present, I would escalate the treatment—adding or changing medications as needed. This approach was cautious and reactive, focusing on adjusting the treatment plan based on the patient’s progress over time.

However, through years of experience and patient outcomes, I’ve shifted my strategy to what I now call an “early aggressive” treatment approach. Rather than waiting to see if symptoms persist or worsen, I take proactive steps right from the start. 

• I start treatment as soon as possible after initial symptom onset to give patients the best chance of minimizing a chronic illness
• I maintain a low threshold for switching therapies when there is breakthrough disease activity (clinical relapses and/or continued illness) -- this may help prevent chronic illness
• If a patient has an inadequate (subtherapeutic) treatment response to a antibiotic, choose another antibiotic with a different mechanism of action. 

If I suspect a co-infection with Babesia, I start treatment with atovaquone right away. This is crucial because Babesia requires different treatment than Lyme disease and can significantly impact recovery if not addressed early. Similarly, if Bartonella is a possibility, I begin treatment early, even if I’m not sure of the exact source.

Similarly, if I suspect Bartonella, another common co-infection, I begin treatment early, even if I haven’t confirmed whether the infection was transmitted by a tick or a cat. Bartonella can cause a range of symptoms that complicate Lyme disease, and early intervention can prevent the condition from becoming more severe or chronic.

This “early aggressive” approach represents a significant shift from the more traditional, wait-and-see methods. The reasoning behind this shift is rooted in the understanding that Lyme disease and its co-infections can be relentless and complex, with symptoms that vary widely among patients. By addressing potential complications head-on and without delay, I’ve seen much better patient outcomes. Recovery times are often shorter, and the risk of developing chronic symptoms is reduced.

Moreover, this approach is not just about quicker recovery—it’s also about improving the overall patient experience. Lyme disease can be a devastating condition, both physically and emotionally. The uncertainty and frustration that come with prolonged illness can take a significant toll on a patient’s mental health and quality of life. By being proactive and addressing all possible aspects of the disease early, I can provide my patients with a clearer path to recovery and reduce the likelihood of prolonged suffering.

In summary, my move to an “early aggressive” treatment strategy has been shaped by my commitment to providing the best possible care for my patients. This approach allows me to tackle Lyme disease and its co-infections more effectively, offering patients a better chance at a swift and complete recovery. It’s about being proactive, thorough, and responsive to the complex nature of tick-borne illnesses, ensuring that no stone is left unturned in the quest to restore my patients’ health.

My patient recovered from her chronic illness after receiving early aggressive treatment, a result that underscores the importance of this approach in managing Lyme disease.

Chronic illness resulting from Lyme disease is one of the most compelling reasons I advocate for early aggressive treatment. Lyme disease is not just a simple infection; if left inadequately treated, it can lead to a range of severe and persistent conditions. Chronic neurologic Lyme disease can cause debilitating symptoms such as cognitive impairments, severe headaches, and neuropathy. POTS (Postural Orthostatic Tachycardia Syndrome) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) are other serious complications that can significantly disrupt a patient’s life, leading to symptoms like dizziness, rapid heart rate, and sudden behavioral changes.

Lyme arthritis, another potential outcome, can cause long-term joint pain and swelling, making daily activities difficult. Lyme carditis, which affects the heart, can lead to dangerous complications, including heart block and arrhythmias. Neuropsychiatric Lyme, involving mood disorders, anxiety, and cognitive dysfunction, adds an additional layer of complexity to the patient’s condition, affecting mental health and overall quality of life.

Given the high stakes, early aggressive treatment becomes not just an option but a necessity. By intervening quickly and with a comprehensive treatment plan, we can reduce the risk of these chronic manifestations taking hold. In my experience, starting treatment early—often before the full spectrum of symptoms has developed—can make a significant difference in the patient’s prognosis.

This approach also involves treating potential co-infections like Babesia and Bartonella from the outset, even if they haven’t been fully confirmed. These co-infections can complicate the clinical picture and contribute to the persistence of symptoms if not addressed early. By being proactive and thorough, we can give patients the best chance of a full recovery and prevent the long-term complications that make Lyme disease so challenging.

Ultimately, early aggressive treatment is about more than just addressing an infection; it’s about preventing the transition from an acute illness to a chronic, life-altering condition. It’s about giving patients the opportunity to regain their health and quality of life as quickly as possible, without the lingering fear of ongoing or worsening symptoms. The success of this approach with my patients reinforces its importance and validates the need for a proactive, comprehensive strategy in treating Lyme disease. 

The likely reason for relapse is failure to eradicate the spirochete completely with a two-week course of intravenous ceftriaxone therapy,” wrote Drs. Logigian, Kaplan, and Steere in their seminal 1990 paper on chronic neurologic Lyme disease. This observation remains as relevant today as it was over three decades ago, highlighting a persistent challenge in the treatment of Lyme disease: the difficulty in fully eliminating the Borrelia burgdorferi bacterium, which can lead to relapse or persistent symptoms even after what is considered adequate treatment.

In chronic Lyme disease, or what is often referred to as Post-Treatment Lyme Disease Syndrome (PTLDS), patients continue to suffer from symptoms such as fatigue, pain, and cognitive difficulties long after completing the standard antibiotic courses. This condition has sparked considerable debate within the medical community. Some experts believe that ongoing symptoms are due to lingering effects of the initial infection, while others propose that they may be due to an active, persistent infection that was not fully eradicated by the initial treatment.

The 1990 study by Logigian, Kaplan, and Steere explored these possibilities by examining patients who had been treated with a two-week course of intravenous ceftriaxone. Despite this treatment, some patients either relapsed or failed to recover fully, leading the authors to speculate that the spirochete might not have been completely eradicated. This concept has been supported by subsequent studies suggesting that Borrelia burgdorferi can persist in the body in a dormant state, possibly shielded within tissues where antibiotics have limited penetration.

More recent research has further explored the idea of persistent infection. Studies have shown that Borrelia burgdorferi can form biofilms—complex communities of bacteria that are more resistant to antibiotics. These biofilms could potentially harbor bacteria that re-emerge after the initial course of antibiotics is completed, leading to the recurrence of symptoms.

Moreover, the nature of Lyme disease itself complicates treatment. The bacterium Borrelia burgdorferi can exist in multiple forms—spirochete, round-body, and biofilm—which might require different antibiotics or treatment approaches to fully eradicate. This complexity may explain why some patients do not respond to the standard treatment regimen.

For patients like mine, who experience a relapse after standard treatment, the journey can be frustrating and disheartening. The initial hope of recovery is replaced by confusion and concern when symptoms return or persist. This situation emphasizes the need for ongoing research into more effective treatment strategies for chronic Lyme disease, including longer antibiotic courses, combination therapies, and alternative treatments that address the different forms the bacterium can take.

The challenge of treating chronic Lyme disease also raises important questions about the broader healthcare system’s approach to this condition. There is a pressing need for more awareness among healthcare providers, more research funding to explore the underlying mechanisms of persistent infection, and better support systems for patients navigating the complexities of this illness.

In conclusion, the issue of relapse in Lyme disease treatment is not just a clinical problem but also a deeply personal one for patients who struggle to regain their health. It highlights the importance of individualized treatment approaches, ongoing patient support, and the continuous pursuit of knowledge to develop more effective treatments for this complex and often misunderstood disease.

Chronic Lyme disease, characterized by persistent symptoms that can linger for months or even years, is a growing concern for both patients and healthcare providers. Traditionally, Lyme disease has been seen as a straightforward infection—diagnosed early, treated with antibiotics, and resolved. However, for a significant number of people, Lyme disease can evolve into a chronic condition, marked by ongoing fatigue, pain, and cognitive issues. But what if much of this chronic suffering could be prevented?

Recent insights suggest that the progression to chronic Lyme disease might be mitigated, or even prevented, by focusing on several key factors. This approach is similar to how we prevent other chronic diseases like type 2 diabetes or heart disease: through early detection and appropriate treatment.

**The Importance of Early Diagnosis and Treatment**

One of the most critical steps in preventing chronic Lyme disease is the early diagnosis and treatment of the infection. When a patient presents with a tick bite or early symptoms of Lyme disease, such as the characteristic erythema migrans rash, it’s vital to begin treatment promptly. Early intervention with antibiotics like doxycycline can significantly reduce the risk of the infection progressing to a chronic stage.

Moreover, it’s essential to maintain a vigilant follow-up process. Even after initial treatment, patients should be asked to return for evaluation if symptoms persist or recur. Lyme disease can sometimes be insidious, with symptoms reappearing after what seems like successful treatment. Regular follow-ups allow healthcare providers to monitor the patient’s progress and catch any signs of relapse early.

**Look for Co-Infections**

Co-infections are another critical factor in the progression of Lyme disease to a chronic condition. Ticks often carry more than just Borrelia burgdorferi, the bacteria responsible for Lyme disease—they can also transmit other pathogens like Babesia, Bartonella, and Anaplasma. These co-infections can complicate the clinical picture and may require different treatments. It’s important to test for and consider co-infections, especially if a patient’s symptoms do not resolve with standard Lyme treatment. Addressing all possible infections early on can prevent the persistence and worsening of symptoms.

**Consider Retreatment**

In cases where initial treatment does not fully resolve the symptoms, it may be necessary to consider retreatment. Clinical judgment plays a crucial role here. While some cases of Lyme disease respond well to the standard course of antibiotics, others may require a more prolonged or alternative treatment approach. Retreatment should be considered for patients who continue to experience significant symptoms, particularly if they show signs of ongoing infection or co-infections.

**Follow-Up Care is Crucial**

Consistent follow-up care is essential in managing Lyme disease and preventing its progression to a chronic state. Even after symptoms appear to have resolved, patients should be monitored for any signs of recurrence or new symptoms. Chronic Lyme disease can sometimes develop months or even years after the initial infection, making long-term follow-up a key component of care.

**Environmental Awareness and Preventive Measures**

**Raising Awareness and Improving Access to Care**

Lyme and PANS: A Critical Connection in Teenagers

At just 16, my patient found herself facing a complex and overwhelming set of symptoms. What began as ordinary teenage stress evolved into something far more debilitating—raging outbursts, severe compulsions, motor and vocal tics, and memory problems. Her academic performance plummeted, and her social life disintegrated. Diagnosed with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), she and her family embarked on a challenging journey for answers.

PANS, a condition characterized by the sudden onset of severe neuropsychiatric symptoms, is often triggered by infections or autoimmune responses. These symptoms include obsessive-compulsive behaviors, severe anxiety, and a wide array of neurological issues. In my patient's case, the impact was profound, disrupting nearly every aspect of her life.

A Frustrating Treatment Journey

Her school quickly implemented a 504 plan to accommodate her needs, but even with these supports, she struggled to attend classes regularly. The academic gaps widened, and the isolation grew. Initially, her treatment focused on intravenous immunoglobulin (IVIG) therapy, a standard approach for PANS aimed at modulating the immune system. Unfortunately, despite several courses of IVIG, her symptoms persisted, leading to a sense of despair for both her and her family.

The Lyme Disease Connection

It wasn’t until the family explored further that they discovered a potential link between Lyme disease and PANS. Lyme disease, transmitted by ticks and caused by the Borrelia burgdorferi bacterium, is notorious for its wide range of symptoms, many of which can overlap with neuropsychiatric disorders. When Lyme disease enters the picture, it can trigger or exacerbate PANS, leading to an even more complicated clinical scenario.

Upon testing, my patient was diagnosed with Lyme disease and a co-infection, which had gone undetected. The realization that these infections were contributing to her PANS symptoms was a breakthrough. She began antibiotic therapy, which is often essential in treating Lyme disease, especially when co-infections are involved. Over time, this approach started to pay off—her symptoms gradually improved, the rage outbursts and compulsions became less frequent, and her cognitive function began to recover.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing three premature babies who contract Babesia from blood transfusions.

These cases were originally described in the Journal of the Pediatric Infectious Disease Society, written by Saetre and colleagues in 2017.

Three premature babies contracted Babesia from a single blood donor. The diagnosis and treatment are discussed.   

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at: 

 https://danielcameronmd.com/lyme-disease-podcast-babies-contract-babesia-blood-transfusions/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing two children who contracted Babesia from their mothers.

These cases were originally described in the Journal of the Pediatric Infectious Disease Society, written by Saetre and colleagues in 2017.

Both mothers were treated for Lyme disease during their pregnancy. Both babies were apparently born healthy and sent home. One of the babies had a positive PCR test for Babesia before going home but was not treated.  Both babies returned to the hospital with Babesia. Both required prolonged hospitalization and treatment.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at:

https://danielcameronmd.com/lyme-disease-podcast-children-contract-babesia-from-mothers/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 17-year-old young man who dies of Lyme Carditis. 

This case was first discussed in the journal Cardiovascular Pathologist written by Yoon and colleagues in 2015.

The autopsy showed evidence of Lyme disease. The spirochetes that cause Lyme disease were found in the young man’s fresh liver and myocardial tissue. There was also evidence of these spirochetes in the heart, lung, and brain tissues using immunohistochemistry staining and polymerase chain reaction (PCR) tests.

The cause of death was fatal Lyme carditis.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-podcast-17-year-old-young-man-dies-from-lyme-carditis/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 5-week-old girl with Lyme disease.

This case was first described in the journal Pediatrics, written by Handel and colleagues in 2019.

The doctors were concerned that the girl might suffer from Lyme meningitis.  This is an uncommon but important concern for the doctor treating Lyme disease.  The spinal tap was not successful.  The doctors treat for Lyme meningitis with intravenous antibiotics since they were still concerned the baby might have Lyme meningitis.  The girl was discharged from the hospital after two weeks of intravenous ceftriaxone.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-podcast-5-week-old-girl-lyme-disease/5-week-old-baby-girl-lyme-disease-3/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 6-week old boy with Lyme disease.

This case was first described in the journal Pediatrics, written by Handel and colleagues in 2019.

The doctors were initially not able to identify the reason the boy was ill or why there was anemia or a low platelet count.    The doctors prescribed three antibiotics - ampicillin, ceftriaxone, and vancomycin until they could determine a cause of the illness.

The laboratory tests revealed the parasite Babesia in the red blood cells under the microscope 

The baby was prescribed oral atovaquone and intravenous azithromycin.  

The anemia worsened. The hemoglobin dropped to 6.9 gram/dl, which is quite low. The doctors transfused a unit of blood.

The doctors were concerned that the baby might also have suffered from Lyme disease. The doctors added 14 days of amoxicillin to the treatment.

The baby remained well on follow-up, according to the doctors.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-podcast-6-week-old-boy-babesia/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 74-year-old woman with a triple tick attack.

This case was initially described in the journal Cureus, written by Kumar and colleagues in 2019.

A 74-year-old woman had underlying medical problems.  She was a smoker with chronic obstructive pulmonary disease (COPD). She also had hypertension. She was in shock and on a ventilator.

She was also diagnosed with three tick-borne illnesses - Babesia, Anaplasmosis, and Lyme disease.

She recovered.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with our cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-podcast-74-year-old-woman-triple-tick-attack/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 24-year-old army officer who was forced out of the military due to Lyme disease.

Weiss and colleagues first described this case in the Journal of the Pediatric Infectious Disease Society in 2017.

The 24-year-old young man initially suffered from recurrent knee swelling. Doctors diagnosed Lyme disease through after draining fluid from his knees.  He later developed severe fatigue, memory issues, headaches, sleep disturbances, and complaints of angina.  

He failed to resolve his illness. "he was deemed unfit for duty,” wrote Weiss and colleagues."

The authors concluded their paper with a discussion of post-treatment Lyme disease syndrome (PTLDS).

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-forces-24-year-old-army-officer-out-of-military/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing four Lyme disease patients who developed Post Treatment Lyme disease syndrome (PTLDS).

Wormser and colleagues first described these four cases in the journal Diagnostic Microbiology and Infectious Disease in 2019.

Wormser and colleagues set out to prove that 14 days of amoxicillin would be safe and effective.  

At least four of their 24 patients remain ill on follow-up. They were diagnosed with Post Treatment Lyme Disease Syndrome (PTLDS). 

Wormser and colleagues did not report symptoms important to Lyme disease patients. The list includes fatigue, poor sleep, impaired concentration, headaches, lightheadedness, neck and joint pain, muscle pain, and paresthesias. Paresthesias refer to numbness and tingling or a“pins-and-needles” sensation.

Nor did Wormser and colleagues describe other complications of Lyme disease important to patients. This list includes Lyme encephalopathy, Lyme neuropathy, Postural tachycardia syndrome (POTS), Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), and Neuropsychiatric Lyme disease.  

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-podcast-lyme-disease-patients-develop-ptlds/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing two mothers who transmitted Babesia to their babies.

Saetre and colleagues first described these cases in the Journal of the Pediatric Infectious Disease Society in 2017.

Two mothers contracted Lyme disease during their 3rd trimester. Both transmitted Babesia to their children while they were in utero.

I discussed this paper from the baby’s perspective in an earlier Inside Lyme podcast titled - Two children who contracted Babesia from their mothers.

In this podcast, I will be focusing on the mothers.   

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/mothers-transmit-babesia-to-babies/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing how to remove a deer tick from an 8-year-old girl’s eye. 

Jaroudi and colleagues first discussed this case in the journal Case Reports in Ophthalmology in 2020.

A large tick was deeply anchored to the right upper eyelid of an 8-year-old girl. The tick was surgically removed.  

The author discusses how to remove a deer tick from the 8-year-old girl’s eye.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/remove-engorged-tick-in-eyelid/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 78-year-old confused woman with Babesia and Anaplasmosis.

Paparone and her colleague first discussed this case in the journal Nurse Practitioner in 2018.

A 78-year-old woman was evaluated in an emergency room with fever, chills, lethargy, fatigue, and confusion. The doctor initially considered sepsis. 

The doctors were able to identify the parasite that causes Babesia in the woman’s red blood cells The doctors were also concerned that the woman might suffer from another tick-borne illness called Anaplasmosis because of her low white blood count and low platelet count. 

The woman’s cognitive function improved dramatically following two weeks of treatment, according to the authors. What can we learn from this case?

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/anaplasmosis-and-babesia-infection-cause-cognitive-impairment/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing Two travelers who contracted Babesia while traveling to the United States.

Kwon and her colleague first discussed this case in the journal Korean Journal of Parasitology in 2018.

Both women returned to South Korea from the USA. The doctors initially suspected Malaria. Instead, both women suffered from Babesia. One woman died 31 days after admittance to the hospital.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/tourists-visiting-the-united-states-contract-babesia-leaving-one-dead/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing an 83-year-old-man with a stroke associated with Lyme disease.

Legast and her colleague first discussed this case in the journal Case Reports in Neurological Medicine in 2018.

An 83-year-old man was hospitalized for right-sided weakness and speech difficulties. He was diagnosed and treated for a stroke associated with Lyme disease.

He was able to walk with a cane but still had a severe right arm weakness. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-and-stroke/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 46-year-old woman with Lyme disease with bilateral vision loss.

Jha and her colleague first discussed this case in the Wisconsin Medical Journal in 2018.

An ophthalmologic exam confirmed the optometrist finding of optic neuritis. Optic neuritis is an inflammation of the optic nerve. She also had am impaired color vision in both eyes,

Her vision loss was significant. Legal blindness is defined as having a visual acuity of 20/200 or worse in the better eye after correction. Her visual acuity was 20/400 in both eyes. 

“Upon questioning, she endorsed some improvement in vision after initiation of antibiotic,” write the authors.

But the final outcome was uncertain since the woman left the hospital against medical advice and did not adhere to her follow-up appointments. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-disease-vision-problems/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 15-year-old boy with severe cardiac problems associated with Lyme disease.

Nawrocki and his colleague first discussed this case in the Air Medical Journal in 2018.

His friends immediately called 911. They were not sure how long he was unconscious. The boy was pale with a heart rate of 300 beats per minute, according to the medics. 

He required synchronized cardioversion. He was flown to a cardiac intensive care unit (ICU) at a children's tertiary care hospital via rotary-wing aircraft staffed with two flight nurses.

Doctors suspected Lyme disease and prescribed intravenous ceftriaxone. He had three additional episodes of ventricular tachycardia. He was cardioverted twice.

But after several days of intravenous antibiotics, the boy’s heart block gradually resolved, and the pacemaker was removed.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/boy-with-severe-cardiac-lyme-disease/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 43-year-old woman with Sjögren’s syndrome secondary to Lyme disease

Smiyan and her colleague first discussed this case in the journal Reumatologia in 2019.

This woman’s diagnosis was changed from possible Lymphoma to primary Sjögren’s syndrome, to secondary Sjögren’s syndrome. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-podcast-sjogrens-syndrome-secondary-to-lyme-disease/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 67-year-old woman with a delayed onset of Babesia.

Hoversten and her colleague first discussed this case in the British Medical Journal Case Reports in 2018.

The authors discussed the nearly three-week gap in time between the woman’s erythema migrans rash and her diagnosis of Babesia. This is not the first case where the onset of Babesia was delayed.

The authors cited two papers describing a 3 to 4-week delay in the onset of Babesia. I described a paper in an earlier podcast where two babies contracted Babesia from their mothers.  https://danielcameronmd.com/lyme-disease-podcast-children-contract-babesia-from-mothers/

This delay may explain why some Lyme disease patients relapse after initially improving with doxycycline or amoxicillin. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at: 

https://danielcameronmd.com/lyme-podcast-a-babesia-infection-3-weeks-after-treatment-for-lyme-disease/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing 75-year-old Chinese man with a negative Lyme disease test.

Lamichhane and colleagues first discussed this case in the journal Case Reports in Infectious Diseases in 2018.

The man presented with a high fever, unsteady gait, encephalopathy, diffuse myalgia, and tachycardia. The doctors apparently did not request a western blot test after the initial negative Lyme disease test. 

His doctors then ordered more than the screening Lyme disease test. His blood tests were now positive for Lyme disease and Babesia.  

He was treated for Lyme disease but not for Babesia.  He did well according to the authors.  

I was concerned about the untreated Babesia.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 69-year-old man with Lyme disease and double vision.

Dixit and colleagues first discussed this case in the journal Case Reports in Neurological Medicine in 2018.  

He had been hiking in a rural area of New York but did not notice a tick bite or rash. He developed a headache followed by diplopia. 

He was diagnosed with Lyme disease and double vision from 3rd nerve palsy rather than the more common 7th nerve palsy.

I discussed a wide range of eye problems related to Lyme disease in two previous blogs.

https://danielcameronmd.com/growing-list-eye-problems-lyme-disease/

https://danielcameronmd.com/eye-problems-tick-borne-diseases-lyme/

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing a 25-year-old man with transverse myelitis and Lyme disease.

Dumic and colleague first discussed this case in the journal IDCases in 2019.

“A previously healthy 25-year-old man presented with inability to urinate and frequent falls associated with bilateral lower extremity weakness and numbness.” wrote the authors.

His condition worsened. He began to fall due to the weakness of both legs and problems with his gait. His MRI revealed myelitis.  His spinal tap revealed pleocytosis consistent with Lyme disease.

The man’s motor, sensory, and autonomic dysfunction were typical of acute transverse myelitis. He was diagnosed with acute transverse myelitis and Lyme disease.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know COVID-19 is through reviewing actual cases. In this Podcast episode, he will discuss the risk for children with Coronavirus COVID-19.   

Dong and colleague first discussed this case in the journal Pediatrics in 2020. The authors described 2143 pediatric Patients COVID-19 in China

You may be wondering why I am discussing COVID-19 during an Inside Lyme podcast. First, I am concerned for my children and grandchildren. Second, I am concerned about my Lyme disease patients.  Lastly, I need to understand the disease.

13 children with COVID-19 infections had what the authors defined as critical disease. These children would “quickly progress to acute respiratory distress syndrome (ARDS) or respiratory failure, and may also have shock, encephalopathy, myocardial injury or heart failure, coagulation dysfunction, and acute kidney injury. Organ dysfunction can be life threatening.” wrote the authors.

The youngest pediatric patients with a COVID-19 infection were the most likely to develop severe or critical disease.   Nearly 7 out of 10  their pediatric patients with COVID-19 infections under five years of age had moderate, severe, or critical disease. A 14-year-old boy died.

You will hear more about these children in this COVID-19 podcast.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

You can read the full text of this podcast at:

https://danielcameronmd.com/covid-19-podcast-risk-children-with-covid-19/

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

You may be wondering why I am discussing COVID-19 during an Inside Lyme podcast. I am concerned for my children, grandchildren, and my patients. I would like to share my understanding of COVID-19 through my eyes as a clinical epidemiologist. 

I was surprised to run across the question of fecal transmission of COVID-19 to children in the same article by Cruz and colleagues. “There is also evidence of fecal shedding in the stool for several weeks after diagnosis, leading to concern about fecal-oral transmission of the virus, particularly for infants and children who are not toilet-trained, and for viral replication in the gastrointestinal tract.”  

How important is fecal transmission of COVID-19 in children?

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know COVID-19 is through reviewing actual cases. In this Podcast episode, he will discuss the risk for patient to health care worker and patient-to-patient transmission of CVID-19

Wang and colleagues first discussed this case in the journal JAMA in 2020. The authors 138 Hospitalized Patients WithCOVID-19 infected Pneumonia in Wuhan, China

You may be wondering why I am discussing COVID-19 during an Inside Lyme podcast. First, I am concerned for my children and grandchildren. Second, I am concerned about my Lyme disease patients.  Lastly, I need to understand the disease.

Forty hospitalized health care workers were presumed to have been infected in the hospital. Ten of the health care workers contracted COVID-19 from a single patient. 

The authors also described patient-to-patient transmission.  The authors traced the transmission from one patient to three others.  

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know COVID-19 is through reviewing actual cases. In this Podcast episode, he will discuss the evidence supporting hydroxychloroquine and azithromycin for COVID-19.

Researchers have turned to existing drugs that might be effective without causing significant side effects. Hydroxychloroquine and chloroquine have shown some antiviral benefits in vitro 

A recently published second French trial by Gautret and colleagues added further support for the hydroxychloroquine with azithromycin. 

Hydroxychloroquine and azithromycin lowered the COVID-19 viral load patient. Moreover, most of the patients with a COVID-19 infection were improved or discharged in the second Gautret trial.

Neither Gautret trials assessed whether hydroxychloroquine with azithromycin would be effective for prophylaxis before an infection. The study only enrolled hospitalized patients already infected with the COVID-19 virus.

What now?

For now, researchers and politicians are divided on whether to recommend hydroxychloroquine and azithromycin for the prevention and treatment of COVID-19.  There is growing pressure on doctors to wait for science. 

Doctors have patients who are sick now.  Doctors have patients who want to prevent getting COVID-19. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know COVID-19 is through reviewing actual cases. In this Podcast episode, he will be discussing a 73-year-old resident of a skilled nursing facility who died from COVID-19.

McMichael and colleagues discussed this case in the New England Journal of Medicine in 2020.

As of March 18, 2020, there were 101 residents of the skilled nursing facility with a confirmed case of COVID-19. 

As of March 18, the preliminary case fatality rate for the skilled care residents was 33.7% for residents and 6.2% for visitors wrote the authors.

The authors described a list of factors identified by the authors that could have contributed to the cluster of COVID-19 cases.  

The authors also described a list of steps to prevent another cluster of  COVID-19 in a skilled nursing facility.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing autonomic dysfunction in a 64-year old woman with a history of Lyme disease and COVID-19.  She was initially diagnosed and treated for Lyme disease at the age of 60.  She was diagnosed with two autonomic disorders. Her distal burning sensation without weakness were diagnosed as small fiber neuropathy (SNF).  Her dizziness, brain fog, and fatigue were diagnosed as orthostatic hypoperfusion syndrome (OCHOS).

She was diagnosed with COVID-19 pneumonia at the age of 64. She was treated with IVIG but was left with headaches and fatigue. 

The authors concluded that COVID-19 triggered autoimmunity. I would have questioned whether the autonomic dysfunction was related to her history of Lyme disease. 

Fortunately, the 64-year-old woman with a history of headaches, hypothyroidism, and autonomic dysfunction from PTLDS was able to recover from COVID-19. 

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing 16-year-old male with Lyme disease presenting with palpitations and chest pain,  His EKG progressed from first degree heart block to episodes of complete heart blog.

Myers and colleagues wrote about this case in the journal BMC Infectious Diseases or his blog. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Dr. Cameron feels that the best way to get to know Lyme disease is through reviewing actual cases. In this Inside Lyme Podcast episode, he will be discussing three deaths associated with Lyme disease.

I first read about these cases in the Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC).

All three individuals tested positive on autopsy.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

A 36-year-old man suffered with severe neuropathic pain in both feet. The pain was severe at a level 10 out of 10 despite methadone 5 mg every four hours as needed. The doctors elected not to treat with antibiotic under the assumption that the tick-borne infection had resolved.

I first read about this case in the journal Neuromodulation  by Karri  and colleagues.

The pain remained severe despite trials of gabapentin, duloxetine, bupropion and narcotics. The pain improved with two surgical procedures 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

a 61-year old woman who was diagnosed with stage 2 breast cancer and later Lyme disease.   The woman underwent a  lumpectomy, chemotherapy and radiation.

I first read about this case in the journal Diagnostics  by Ørbæk  and colleagues.

One  year later, she developed leg and back pain so severe that narcotics would not even alleviate her pain. There was no evidence of a recurrence of her cancer.  She was diagnosed  and treated for Lyme disease.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I have Lyme disease patients in my practice who are concerned with COVID-19. I also have Lyme disease patients who are reluctant to take the COVID-19 vaccine.   The reluctance to take a vaccine has been called vaccine hesitancy.

A vaccine was introduced in the late 1990 to prevent Lyme disease.  The Lyme disease vaccine was quite effective at preventing a Lyme disease rash. The Lyme disease was only 50% effective at preventing neurologic and neuropsychiatric manifestations of Lyme disease according to the package insert.

There is a low trust for the COVID-19 vaccine among Black Americans, writes P.R. Lockhart in an NBC News article.

“A recent national survey found that if a successful COVID-19 vaccine is produced and widely available, only 49% of Americans intend to get it; for Black adults, only 40% indicated they would take the vaccine while 32% indicated they were unsure.” wrote Quinn and colleagues  from the Am J Health Promo .

I have seen vaccine hesitancy in my Lyme disease patients. They are concerned that the vaccine will be harmful and feel their concerns have been dismissed.

I discuss the risks and  benefits of a COVID-19 for Lyme disease patients.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive motor neuron disease.

“In July 2018, that is, within six months, he developed paraparesis of both arms and also suffered from cramps in the shoulder girdle and hand muscles,” wrote the authors. “By August 2018, the patient was severely impaired in everyday life activities.”

I first read about this case by Wirsching and colleagues in the journal Clinical Case Reports. 

His spinal test was positive for Lyme disease a high white count and positive labs tests for Lyme disease.  He was treated with a 3 week course of intravenous antibiotics without gains. The author concluded he suffered from ALS instead of Lyme disease.

“It is vital to exclude potentially treatable diseases in the differential diagnostic work-up of all patients not to miss seldom, but treatable differential diagnoses such as neuroborreliosis,” the authors concluded.

1. Wirsching I, Ort N, Uceyler N. ALS or ALS mimic by neuroborreliosis-A case report. Clin Case Rep. Jan 2020;8(1):86-91. doi:10.1002/ccr3.2569

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

At age 8, the boy had been hospitalized for severe abdominal pain and underwent extensive testing. But results were negative. His abdominal pain remitted over the next two months.

One year later, the boy became ill again with new symptoms. “He experienced learning difficulties with attention deficit and irritability, in addition, he developed difficulty in walking,” wrote the authors. 

He was diagnosed with Lyme disease by blood and spinal tap.  He was successfully treated with 6 weeks of antibiotics.

I first read about this case by Savasta and colleagues in the Italian Journal of Pediatrics.1

This case report highlights the importance in considering “Lyme disease in the differential diagnosis of abdominal pain of unknown origin in children, especially in countries where the infection is endemic,” the authors wrote. 

1.             Savasta S, Fiorito I, Foiadelli T, et al. Abdominal pain as first manifestation of lyme neuroborreliosis in children, case report and review of literature. Ital J Pediatr. Nov 23 2020;46(1):172. doi:10.1186/s13052-020-00936-y

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

The man had been diagnosed with the tick-borne illness Babesia in Florida 10 weeks after travelling to New York. Initially, he presented with a 4-day history of fever, generalized weakness, and flu-like symptoms. 

I first read about this case by Patel and colleagues in the journal Cureus .

His fever was 104.8 F.  His hemoglobin dropped from 9.3g/dL to 6.7g/dL within 5 hours. He was diagnosed with hemolysis and transfused with 2 units of packed red blood cells. A peripheral blood smear revealed a Maltese cross typically seen in Babesia.  

He was treated successfully. But what can learn about this delayed onset case of Babesia?

1.             Savasta S, Fiorito I, Foiadelli T, et al. Abdominal pain as first manifestation of lyme neuroborreliosis in children, case report and review of literature. Ital J Pediatr. Nov 23 2020;46(1):172. doi:10.1186/s13052-020-00936-y

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

This case involves a 7-year-old girl who developed multiple physical and neuropsychiatric symptoms six months after vacationing in a tick endemic region of the US. 

I first read about this case by Cross and colleagues in the journal Frontiers in Psychiatry.

The patient’s symptoms were extensive, Jones explains, and included “dramatic declines in cognitive functioning, concentration, and ability to focus, a loss of math skills, the onset of dysgraphia and difficulty with social cues, decreased processing speed, word selection problems, anxiety, fatigue, nighttime awakening, chills, joint and muscle pain, moodiness, both general and separation anxiety, and panic attacks.”

She was diagnosed and treated for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and Lyme disease. The Cunningham panel was positive for three out of four antineuronal antibodies consistent with PANDAS.  

She was treated successfully with a combination of antibiotics and IVIG.   

1.             Cross A, Shimasaki C, Bouboulis D, and Jones CR. Case Report of PANDAS and Persistent Lyme Disease with Neuropsychiatric Symptoms: Treatment, Resolution and Recovery.  Frontiers in Psychiatry. Vol. 12, 2021

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

In this episode, I discussed a unique case involving a 43-year-old man with neurological manifestations of Lyme disease including both meningitis and radiculitis.

This case was described by Dabira in the journal Neurology International.

He first presented with an atypical rash.   Within two weeks he presented with a broad range of symptoms “including cough, fever, anorexia, malaise, fatigue, myalgias, cervicalgia/neck stiffness with flexion and extension, mild photophobia, headache,”  the authors wrote. He was diagnosed with viral meningitis.

One month later, the patient developed progressive weakness, severe radicular lancinating pain, emotional lability along with depression and anxiety, an occasional action tremor in hands interfering with fine motor tasks, and tremor in his legs causing imbalance and instability.

He was diagnosed with meningitis and radiculitis due to Lyme disease.

1. Dabiri I, Calvo N, Nauman F, Pahlavanzadeh M, Burakgazi AZ. Atypical presentation of Lyme neuroborreliosis related meningitis and radiculitis. Neurol Int. 2019 Dec 2;11(4):8318.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing the case of a 66-year-old woman who ignored a Bull's eye rash, indicative of Lyme disease, and later developed acute renal failure.

This case was described by Mishra and colleagues  in the American Journal of Medicine .

She presented with a tick bite followed by a rash.  She ignored the tick bite and rash.

A month later she developed acute renal failure.  Her renal functions improved following hydration, antibiotics, and discontinuation of her losartan and nonsteroidal anti-inflammatory drugs,” the authors explain. 

Renal failure has been described in dogs but not in people.  The renal failure could have been related to other factors. Ignoring a tick and rash for a month could not have helped.

1. Mishra AK, Hashmath Z, Oneyssi I, Bose A. Disseminated Erythema Migrans. Am J Med. 2020 Feb 13. pii: S0002-9343(20)30114-5.  For free access to case report.  https://pubmed.ncbi.nlm.nih.gov/32061730/

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing the case of a man in his 70’s with Lyme disease with radicular pain and involuntary movements

This case was described by Li and colleagues  in the journal BMJ Case Reports .

He developed a large EM rash and a tick while visiting Czech.  He was not diagnosed or treated for Lyme disease.

Threes later he developed radicular pain and involuntary movements. He was was initially diagnosed as a functional disorder also referred to as a psychogenic disease.  In other words his disease was considered a psychiatric  problem.

He was finally diagnosed with Lyme disease on his third emergency room visit.

1. Li X, Kirschner A, Metrie M, Loeb M. Lyme neuroborreliosis presenting as spinal myoclonus. BMJ Case Rep. Dec 29 2019;12(12)  For free access to case report.  

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a unique case involving a 67-year-old man whose diagnosis of Lyme disease was delayed because clinicians suspected his symptoms were due to COVID-19.

This case was described by Novak  and colleagues  in the journal Case Rep Infect Dis.

In July 2020, the man presented with symptoms consistent with COVID-19 with chills, body aches, fever, headache, and neck ache.   He was encouraged to be quarantined.

Six weeks later he developed an erythema migrans (EM) rash. He was treated with with doxycycline for either an insect bite or rash.  

A week later he developed double vision due to a 6th nerve palsy, headaches, neck stiffness, and new onset fatigue. 

His was diagnosed and treated with Lyme disease at a Lyme disease telemedicine referral clinic.

1. Novak CB, Scheeler VM, Aucott JN. Lyme Disease in the Era of COVID-19: A Delayed Diagnosis and Risk for Complications. Case Rep Infect Dis. 2021 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a unique case involving a 67-year-old man involving a patient who slowly began having difficulties with his balance. 

This case was described by Gimsing   and colleagues  in the journal Gimsing 

A 67-year-old man developed multiple symptoms over a 3- to 4-month period. He complained of balance problems, diffuse dizziness, urinary urge-incontinence, problems concentrating and with finding words, increased irritability, sore muscles of the arms muscles and around the neck, a moderate morning headache, and an increasing feeling of exhaustion. 

He had  enlarged ventricles in his brain that was presumed due to Normal Pressure Hydrocephalus (NPH) typically requiring a shunt from the brain to the stomach.

His diagnosed was changed to secondary normal pressure Hydrocephalus  (sNPH) based on an abnormal spinal tap.

His symptoms cleared and the enlarged ventricle in his brain resolved with doxycycline.

1. Gimsing LN, Hejl AM. Normal pressure hydrocephalus secondary to Lyme disease, a case report and review of seven reported cases. BMC Neurol. Sep 16 2020;20(1):347 ,

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a unique case involving a 46-year-old Lyme disease patient who was left with tinnitus and hearing loss.

This case was described by Jozefowicz-Korczynska   and colleagues  in the journal Frontiers in Neurology . 

A 46-year-old male farmer was hospitalized with a “sudden onset of tinnitus and hearing loss in the left ear, dizziness, severe balance instability, and gait ataxia,”  wrote the authors.  (Gait ataxia consists of lack of voluntary coordination of muscle movements.)

The doctors initially suspected and Acoustic Neuroma.  The tests were negative.

Instead, the doctors diagnosed Lyme disease by a spinal tap.  He was prescribed 3 weeks of doxycycline followed by vestibular therapy.

His balance improved but not his hearing loss or tinnitus. 

I would have treated the farmer longer or considered intravenous antibiotics.

1. Jozefowicz-Korczynska M, Zamyslowska-Szmytke E, Piekarska A, Rosiak O. Vertigo and Severe Balance Instability as Symptoms of Lyme Disease-Literature Review and Case Report. Front Neurol. 2019 Nov 12;10:1172. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a unique case involving a 9-year-old boy with a pseudotumor cerebri due to Lyme disease 

This case was described by Ezequiel  and colleagues  in the journal BMJ Case Rep.  . 

Pseudotumor cerebri means “false brain tumor” because its symptoms are similar to those caused by brain tumors. It's also known as idiopathic intracranial hypertension.

The boy was admitted to the hospital with “daily pulsatile frontotemporal headache, pallor, photophobia and phonophobia, without night awakening, vomiting or visual changes,”  wrote the authors

The doctors initially suspected a pseudotumor cerebri .  The tests were negative.

Instead, the doctors diagnosed Lyme disease by a spinal tap and blood tests.  He was prescribed 3 weeks of intravenous ceftriaxone.  His pseudotumor cerebri resolve.

1. Jozefowicz-Korczynska M, Zamyslowska-Szmytke E, Piekarska A, Rosiak O. Vertigo and Severe Balance Instability as Symptoms of Lyme Disease-Literature Review and Case Report. Front Neurol. 2019 Nov 12;10:1172. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.
How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing two children ill with both Lyme disease and Mono. 

This case was described by Koester  and colleagues  in the journal Clinical Medicine & Research.

Mono and Lyme disease are common diseases.

 What happens when child living in an area endemic for Lyme disease has both conditions?

These are not the first time patients with both mono and Lyme disease. Koester and colleagues described a study where 52 patients tested positive for Lyme disease and Mono.

Koester and colleagues urged caution before dismissing a positive IgM western blot test and run the risk of treatment delays.

1.   Koester TM, Meece JK, Fritsche TR, Frost HM. Infectious Mononucleosis and Lyme Disease as Confounding Diagnoses: A Report of 2 Cases. Clin Med Res. 2018.. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing two children ill with both Lyme disease and Mono.

In this episode, I will be reviewing a topic that was recently featured in Vox Magazine by author Julia Belluz.1 The article, “Long COVID isn’t as unique as we thought” reviews some commonalities between patients with post-COVID-19 symptoms and those with other chronic illnesses.

 In her article, she describes the case of Dr. Craig Spencer, who experienced long-term symptoms after contracting Ebola in late 2014 while working with Doctors without Borders.

Dr. Spencer explains, “Though the physical effects eventually faded, cognitive complications persist to this day.” These symptoms are “a subtle but noticeable difference in concentration and ability to form new memories.” He also has muscle and joint pain, along with fatigue.

Ebola, COVID-19 and Lyme disease share the same chronic symptoms including fatigue, pain and cognitive issues.

Dr. Spencer’s experience has “led him to join the growing chorus of health professionals, patient advocates, and researchers who argue we need to reframe how we think about coronavirus long-haulers.”   wrote the author.

Trust me. It is a good read.

1.         Long Covid isn’t as unique as we thought by Julia Belluz in Vox.    https://www.vox.com/22298751/long-term-side-effects-covid-19-hauler-symptoms     Last accessed 4/10/21. .
2.         Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv. Jan 30 2021;doi:10.1101/2021.01.27.21250617

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a 20-year-old girl with a 3 year history of multiple sclerosis treated with B cell suppressive therapy . She was prescribed two biological disease-modifying antirheumatic drug (DMARD).

This article was written by Sjowall and colleagues in the journal Frontiers in Neurology.

She was initially prescribed tocilizumab, marketed in the US as Actemra.   Tocilizumab is a monoclonal antibody blocks signals from IL-6 receptors them, is a monoclonal antibody against the interleukin-6 receptor. Tocilizumab can lower the ability of your immune system to fight infections.

She was subsequently prescribed rituximab, sold under the brand name Rituxan, another B- cell treatment.

She suffered for 6 months with knee arthritis and a persistent rash. Lyme disease was considered by dismissed at the Lyme disease tests were negative.

She was finally treated 6 months after the fact with doxyc ycline.

1.         Sjowall J, Xirotagaros G, Anderson CD, Sjowall C, Dahle C. Case Report: Borrelia-DNA Revealed the Cause of Arthritis and Dermatitis During Treatment With Rituximab. Front Neurol. 2021;12:645298 .

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing findings from a study which examined 271 Lyme disease patients with erythema migrans (EM) rashes.

This article was written by Rebman and colleagues in the journal Infection.

The authors concluded “Given that EM remains a clinical diagnosis, it is essential that both physicians and the general public are aware of its varied manifestations.”"

1.         Rebman AW, Yang T, Mihm EA, et al. The presenting characteristics of erythema migrans vary by age, sex, duration, and body location. Infection. Mar 7 2021 .

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing findings from a 54-year-old male with a 12-year history of multiple sclerosis who was diagnosed with Babesia microti.

This article was written by Haberli  and colleagues in the journal Multiple Sclerosis and Related Disorders.

He failed treatment with 4 different disease modifying drugs ─ glatiramer acetate, natalizumab, dimethyl fumarate, and fingolimod.  He was lost to followup for 6 years.

He was seen again 12 years after the onset of his multiple sclerosis. The doctor suspected a recurrence of his multiple sclerosis and treated him  with  another disease modifying drug  called Ocrevus™.

He was hospitalized 4 months later for possible sepsis. He was diagnosed with Babesia.   He required 8 weeks of treatment. 

There are two unanswered question.  Was the flareup of multiple sclerosis after 12 years due to Babesia.  Or was the severity of his Babesia due to taking an immunosuppressive agent Ocrevus™.

1.         Haberli N, Coban H, Padam C, Montezuma-Rusca JM, Creed MA, Imitola J. Babesia microti infection in a patient with multiple sclerosis treated with ocrelizumab. Mult Scler Relat Disord.

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing a 4-year-old toddler with Lyme disease who was reported to the local County Social Services for Children and Youth.

This article was written by Pan and colleagues in the journal Case Rep Orthop.

He  presented to his pediatrician with a swollen knee, potential forearm fracture and a bruise on his buttocks.  He was placed in foster care.

The doctors determined he had Lyme disease . He was returned to his home.

1.         Pan T, Nasreddine A, Trivellas M, Hennrikus WL. Lyme Disease Misinterpreted as Child Abuse. Case Rep Orthop. 2021;2021:6665935. doi:10.1155/2021/6665935

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I will be discussing the case of a 65-year-old woman with abdominal pain, ileus/pseudo-obstruction and constipation due to Lyme disease.

This article was written by Zulfiqar and colleagues in the journal  Community Hosp Intern Med Perspect.

The doctors  initially hospitalized her for a suspected stroke based on her 7th nerve palsy, sometimes called Bell's Palsy. The brain CT and MRI were negative. They next suspected herpes zoster infection.

She was eventually diagnosed with Lyme disease based on her exposure, rash, Bell's palsy, positive tests, and abnormal spinal tap.

She gastrointestinal issues related to her Lyme disease.  I also see gastrointestinal issues in Lyme disease patients that appear to be related to autonomic dysfunction.  Autonomic dysfunction is better know as POTS.

1.         Zulfiqar S, Qureshi A, Dande R, Puri C, Persaud K, Awasthi S. The many manifestations of a single disease: neuroborreliosis. J Community Hosp Intern Med Perspect. Jan 26 2021;11(1):56-59. 

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
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• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

I discuss Lyme disease and COVID-19 in children.  I would appreciate your help in having you child share their experience with Lyme disease  during this pandemic even if they have not had COVID-19 or taken the COVID-19 vaccine.    Here is the link to the Lyme disease and COVID-19 vaccine https://danielcameronmd.com/lyme-disease-covid-survey/

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.

Drs. Horowitz and Cameron review the risks and benefits of the COVID-19 vaccine for individuals with Lyme disease.  We would appreciate your help in sharing your experience with Lyme disease  during this pandemic even if you have not had COVID-19 or taken the COVID-19 vaccine.   Here is the link to the Lyme disease and COVID-19 vaccine https://danielcameronmd.com/lyme-disease-covid-survey/

You can hear more about these cases through his blogs, social media, and YouTube. Sign up for our newsletter to keep up with these cases.

How to Connect with Dr. Daniel Cameron:

• Check out his website: https://www.DanielCameronMD.com/
• Call his office: 914-666-4665
• Email him: DCameron@DanielCameronMD.com 
• Send him a request:  https://danielcameronmd.com/contact-daniel-cameron-md/
• Like him on Instagram: https://www.instagram.com/drdanielcameron/
• Join his Facebook group: https://www.facebook.com/danielcameronmd/
• Follow him on Twitter: https://twitter.com/DrDanielCameron
• Sign up for his newsletter: https://www.DanielCameronMD.com/
• Subscribe and ring the bell: https://www.youtube.com/user/danielcameronmd/ 
• Leave a review on iTunes or wherever else you get your podcasts.

We, of course, hope you’ll join the conversation, connect with us and other readers, ask questions, and share your insights.

 Dr. Cameron is a Lyme disease expert and the author "Inside Lyme: An expert's guide to the science of Lyme disease." He has been treating adolescents and adults for more than 30 years.

Please remember that the advice given is general and not intended as specific advice as to any particular patient. If you require specific advice, then please seek that advice from an experienced professional.