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Friday, July 11, 2008

Fry labs and hemobartonella

There is a sudden intreest in something I wrote 12 years ago.

The information is based on opinions and science.

I do not with to pick on a particular  laboratory. Mainstream science and medicine have abandoned our quest to learn more about chronic tickborne illness.

Some laboratories offer experimental tests for a charge.

Please look at the small print:  The test is experimental and not to used for the diagnosis of any disease.

Let me correct the record.  The test in question is the blood smear exam and photomicrographs which report hemobartonella.  At this point I have 12 years more experience looking a blood smears.

There are a number of stains in use.  The Wright-Giemsa is used in general hematology, the Giemsa stain, which I use is generally used for "blood smears" for red blood cell parasites (Babesia, Malaria sp). A very simple methylene blue stain is used by veterinarians looking for feline blood pathogens. (I see tons of bacteria with this stain). Labs may have other procedures.

Hemobartonella are found in cats, not people.

Human blood and Cat's blood are quite different. The feline immune system is different. People, dogs and horses suffer with Lyme and Cat's are generally immune.

At one time it was believed that most compartments in the body are sterile, free of bacteria. We now know this to be untrue.

Cats may be infected with various bartonella species, including B. Henselae, a cause of cat scratch fever and it is a tickborne pathogen.

Bartonella are intracellular bacteria. They live only within  cells. Their home is the cells that line the internal surface of blood vessels (endothelial cells).  Transiently, with fresh infection, the bacteria are transported by red blood cells and may be found on a blood smear. With chronic disease, as in the case with the typical Lyme patient with coinfection, Bartonellae are entrenched inside their home endothelial cells and will not show up on a blood smear.

The exception to this rule is B. bacilliformis which causes a rare, fulminant and frequently fatal form of bartonellosis called Carrion's disease incurred by the bite of sandflies in Peru and a number of other South American countries. This is an acute  deadly (90% mortality rate) not a chronic disease. 

We do see bacteria adherent to the outside of red blood cells at times. They could be part of the blood's normal microbiome, a contaminant or something else. With certain stains more of these bacteria are seen. The identity of these "mystery bugs" could not be uncovered with 16S RNA sequencing methods.

Deep gene sequencing is now available. It uses state of the art, advanced RNA/ DNA sequencing of all the organisms present in a blood sample.  I have seen reports with various obscure species.  I have not seen a report of a Bartonella species. Not many of my patients have had the test and currently I do not recommend it.

Sometimes it looks like a red blood cell is  teaming with bacteria.  This red blood cell is a reticulocyte, an immature red blood cell. The finding can be misinterpreted.

Bartonella is difficult to diagnose with any currently available test.  Antibody levels against B. henselae are frequently elevated, especially IgG.  This tells you the person has been exposed to Bartonella. The chronic Bartonella syndrome associated with chronic Lyme disease is characterized by persistence of bartonella species living within endothelial cells.  Positive antibodies (not usually seen) may suport a clinical diagnosis.

PCR, which finds the organism's DNA has been the gold standard.  Unfortunately, since the pathogen is rarelypresent in blood the test has a very low positive yield or sensitivity.

One lab, Glaxay labs, has tried to increase the yield by culturing a larger sample of blood in an enrichment media before doing PCR.  This increases the yield some but the sensitivity is still low.

A PCR done on a Bartonella associated rash may yield a positive result -- requires biopsy and proper transport of the specimen to a speciality lab.

Lyme, Babesia and Bartonella. Laboratory confirmation is difficult for each and Bartonella is the hardest. 

I understand the desire to have a positive confirmatory test.  Clinical diagnosis is the most sensitive, specific and reliable method available today.



25 comments:

darlabrown1 said...

That answers my question! I got a Fry test that says "suggestive of" Mycoplasma and Hemobartonella. All I found on hemobartonella was in cats! I didn't know if Bartonella was the same thing. Interesting...I can't wait to show your post to my doc. Thanks for sharing.

Unknown said...

What is your opinion on Vitamin D?

I am an educated person, but no MD or PHD. I went 1.5 years in the prime of my life with no diagnosis, until Dr Fry of Fry Labs diagnosed me with Hemobartonella or Bartonella spp. He is a Microbiologist and has several degrees. I tested positive on band #41, positive on Bartonella Quintana/Hensalae and positive blood smear I did not have any positive Lyme tests. I grew up in TN and probably have every known pathogen that a tick can carry, but this new Bartonella like species, BLO , is new and very REAL. I had lymph node swelling, rashes, SEVERE anxiety, depression, weight loss...etc. I felt like I was choking for 1.5 years. I am a Christian...so I will not say want I want to, but you should rethink your statement about Dr Fry. He is dedicated to the ONLY species that cannot be completely eradicated as a Co-infection of Lyme's. Co-infections are not overrated, they are the primary cause of why everyone with Lyme's cannot get well. I know of thousands of people who...if they had this "Hemobartonella" cured, they wouldnt be sick...and I am one of them. I just assumed that you would know this new organism works like a Parasite. It is the most difficult to eradicate. Everyone I know that has had Babesia, Lyme's, Erlichia...have been cured or put into remission. But, Bartonella is different and the Doctor you speak of in this way, is the one of the most qualified LLMD's in the country and could be the best Co-infection doctor in the country and just recently devoted his lab to finding a "cure" for this terrible infection. He is going to try to grow the infection, from Bartonella infected people and begin testing to find an effective way to eradicate such a destructive disease.

I greatly appreciate your desire to help those who have Lyme's and Co-infections. I hope that you can heal many people and I hope God blesses you with many years helping others.

Lyme report: Montgomery County, MD said...

I have another blog about vitamin D. I appreciate you comments. The information about hemobartonella is based on independent research I did. I could not find other information to confirm you claims about Dr. Fry. The role of co-infections certainly varies quite a bit. I have seen many patients who were treated extensively for Fry diagnosed Hemobartonella who had not improved at all. The traditional Bartonella is tick borne and may causes serious infection when immunosupression is present. It is certainly reported to increase psychiatric pathology. The hemobartonella, BLO, is a feline infection. It resembles Mycoplasma. Mycoplasma fermentans has certainly been reported as a tick associated co-infection. I also have an undergraduate degree in Microbiology. I am unaware of any stain which allows the visualization of cell wall deficient bacteria. It is also unclear to me how such bacteria can attach to the surface of RBCs and not be intracellular. If Dr. Fry has developed some special technology then he should share his methods openly. Many Lyme patients have Mycoplasma infections and Chlamydia pneumonia infections which may be very difficult to eradicate. While it is true that the current technology for diagnosing Lyme is quite lacking, it doesn't mean that a new technology which always gives positive results is the long awaited answer. If I am wrong please educate me. Thanks.

lyme4achange said...

Hi Doc...

I have never used Fry Labs but I do know a girlw who actually sees him as her doctor.

One, I would be very careful quoting what a patient said he said about the co-infections, some killed off allowing other stuff to grow? Sounds like another Lymenet poster's hallucination to me, quite frankly.

We have been frankly discussing Dr. Fry's lab on another forum. It is clear to me that he does believe he has found a new hemobartonella that can exist in humans. It is also clear to me that he does not know if it is a TBI or not.

I have not had this test. I know I test IgG positive for mycoplasm pnemoniae. I was IgM postive for Lyme and my Elisa was huge...but I don't see myself doing more tests at this point.

I will reserve judgement on Dr. Fry until I know more. All good researchers are scoffed at before they are believed...so I'll sit back and wait to see if it is true.

Nancy
tinysmalllittle@yahoo.com
www.myspace.com/tinysmalllittle

Lyme report: Montgomery County, MD said...

Our bodies are loaded with different bacteria. Mycoplasma fermentan is known to be transmited by Ixodes ticks. This bacteria has been shown to persist in the joints of people with chronic inflammatory arthritis. Science shows that germs is clearly a problem. Patients and their treating physicians who get results from Fry are not made aware of the controversy which you discus,in my experience. The real issue is deciphering which bacteria are associated with illnes versus those that are benign. Of course with Lyme, immunosuppresion may allow otherwise harmless germs to cause additional problems. My approach is first to hit Lyme hard. If patients get better then related infections may be resolved by a restored immune system. If patients respond poorly co-infections must be considered more actively. Clearly, Babsesia is the most troublesome tick borne co-infection associated with Lyme. Some patients with primary symptoms of arthritis and fibromyalgia may be suffering from the consequences of Chlamydia pneumonia or Mycoplasma species. Chronic Lyme patients generally have more neurological and cognitive difficulties. Stratton's research on Chlamydia pneumonia is pretty clear. If some new form of Bartonella is causing illness then there needs to be some science to back this up. The term BLO used by Burrascano and that used by Fry describe an entirely different entity. Fry should make this very clear when he reports the presence of BLOs. His web site is lacking. He should detail his procedures and methods and correlate them with clinical information, at least of an anecdotal nature. There are many questional practices employed by doctors who treat Lyme. Lyme docs need to be meticulous and follow evidence based practices as endorsed by ILADS.

Competitive Rider said...

I was born in 1964, my mother raised exotic animals in Phoenix, Arizona. Back then we had every unique exotic imaginable, wooley monkeys to ocelots. My parents divorced in 1971, the exotics were gone, but I found myself plagued with many health issues, mainly joint/muscle issues. My teenage years were plagued with strange joint swelling which has continued into my 40's.
I have suffered with disk degeneration and have been told that I have arthritis since I was 16 and hypothyroidism at 18. I have been active and busy all of my life, otherwise if I sit down, I feel like I would just die. Keeping my mind off my pain is my sanity. I can't even begin to give you the laundry list of crazy things from Bell's Palsy, chronic sinitus to crippling knee swelling and strange growths for absolutely no reason.
At 40 I realized I felt 60 and honestly didn't care if I lived or died. My memory loss and word loss is embarrassing and I walk around in a fog. (In hind sight I've been in a fog since grade school.)
Thank God, my orthopedic surgeon took me seriously about my "feelings" and sent me to Dr. Fry. For once in my life I'm feeling better, my husband says he noticed that I'm using the correct words and completing sentences now. I have extreme vitamin D deficiency, +ANA, +P41, +P43, a test showing a Hemobartonella bacteria, which I actually have a picture of my blood cells with the attachment.

My mother has passed away so I called my father, I asked him if we had problems with ticks/fleas. He told me we had a terrible time with these critters and he felt that I had been bitten several times...heck I even remember giving chicken pocks to one of our wooley monkeys!!! Can anyone else out there say they've kissed monkeys and shared chicken pocks and ticks?

I've been on my antibiotics for 3 months now and have herxed 3 times, I'm a very active person and I continue to ride my horses and hope to continue getting my "clear head" back. At this point I can't tell you how happy I am to feel better. (No knee swelling).
Until you've suffered all your life with strange problems, you'll never understand.

Jon and Lisa said...

I hate to Mr. Negative but the fact is that neither yourself, Fry labs nor any other medical professional know much about anything.

Competitive Rider said...

Read this if you want to read about a miracle....
All I can say is that I believe in Dr. Fry's work. I can't speak for anyone else, but I have had severe memory loss, showed signs and symptoms of MS, fatigue, swelling in my knees for no apparent reason. I turned 40 and basically felt like a 65 year old...or older. I have been frightened and frustrated with the way I feel as a very active equestrian athlete.

I was raised from age 1 to 6 years old with exotic animals including monkeys. We had tick/flea infestations that we fought constantly. I was too young to tell you if I ever got bit by any creature other than an ocelot, a howler monkey and my many hamsters and gerbals. I started having symptoms of bad health at about age 8 but each symptom was written off as an individual symptom including back pain at age 16 and arthritis at age 18.

I stayed strong and active and ate healthy but when I turned 40 I just couldn't take it anymore...My Osteopath said I showed symptoms of Lymes disease and refered me to Dr. Fry.
I sat down and wrote out my life history and all my problems...what an eye opener...then I went to Dr. Fry.
I have Hemobartonella, I have been on antibiotics for 5 months now and my memory is coming back, my blood is actually really red and runny now and I'm feeling like I think I should be feeling...44 again! A happy healthy active 44! I could SEE the difference in my blood when I cut my hand! It was the best accident I have ever had! My husband can tell you that he has seen the difference in my speech and memory power too! So if you don't like the Hemobartonella diagnosis....so what! I'm living proof that Dr. Fry is helpful and placebo's don't work for me! By the way, I've been waiting for my knee to swell any time after riding my horse on a 30 mile riding day, NOT! It hasn't happened in 4 months!!! A miracle if you ask me!

Anthony Murawski said...

Edward B. Breitschwerdt at the North Carolina State University College of Veterinary Medicine has been doing some interesting work on human Bartonella infection and Bartonella detection methods.

He has co-authored a few small studies recently suggesting Bartonella may cause serious infection in immunocompeent patients.

Here are a some excerpts:

We detected infection with a Bartonella species (B. henselae or B. vinsonii subsp. berkhoffii) in blood samples from six immunocompetent patients who presented with a chronic neurological or neurocognitive syndrome including seizures, ataxia, memory loss, and/or tremors.

All six patients in this study were infected with B. henselae, and as has been reported previously for people and for dogs, patient 3 was coinfected with B. henselae and B. vinsonii subsp. berkhoffii. Patient 6 was either coinfected or was chronically infected with B. henselae, the organism that was
isolated, and subsequently infected with B. vinsonii subsp. berkhoffii, as reflected by the documentation of seroconversion.

Fatigue, insomnia, memory loss and/or disorientation, blurred vision and loss of coordination, headaches, and depression were the most commonly reported symptoms (Table 1). Seizures, severe paresis, and debilitating migraines were the predominant neurological abnormalities in patients 1, 5, and 6,
respectively. Patients 2 to 4 each reported fatigue with accompanying neurological abnormalities that persisted for 3 to 5
years (Table 1).

It is important to emphasize that the isolation of B. henselae and B. vinsonii subsp. berkhoffii from, or the molecular detection of these pathogens in, samples from the patients in the study does not confirm causation. Three of six individuals appeared to respond to antibiotic treatments, whereas the responses in three patients were minimal or transient.

Source: “Bartonella sp. Bacteremia in patients with Neurological and Neurocognitive Dysfunction.” Journal of Clinical Microbiology. Sept. 2008, p. 2856–2861 Vol. 46, No. 9.

See also Breitschwerdt et al., "Bartonella Species in Blood of
Immunocompetent Persons with Animal and Arthropod Contact." Emerging Infectious Diseases, Vol. 13, No. 6, June 2007.

Re. detection methods, see Duncan, Breitschwerdt, et al., “A combined approach for the enhanced detection and isolation of Bartonella species in dog blood samples: Pre-enrichment liquid culture followed by PCR and subculture onto agar plates.” J Microbiol Methods. 2007 May;69(2):273-81. Epub 2007 Feb 2.

Anthony Murawski said...

By the way, an LLND mentioned to me just the other day that Dr. Fry is very responsive if you contact him directly with questions.

Anthony

huffgarr said...

I have recently gone to visit Dr Fry and came out with a diagnosis of a hemobartonella infection. I have not been diagnosed with Lyme disease though. There appears to be no published material online that I can discover and by reading some of the forums it is still acute in it's research. I'm a 26 year old male looking for answers and solutions to my issues. I was hoping that some of the subscribers to this blog wouldn't mind offering up their email addresses so I may discuss some of the issues I've experienced in this arduous battle and to communicate about what you guy's have been experiencing on your end. My email address is revitatouch@hotmail.com or huffgarr09@yahoo.com. Please email me if you find the time.

Thank You,

Garrett

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Janette Warren said...

I just heard Dr. Fry speak at Dr. Klinghardt's lyme conference and, if you were there, you would have seen slides and heard him be specific about his work. This seminar will be available on DVD soon from www.klinghardtacademy.com He is real. He cares very much about humanity. He is brilliant.

keith said...

It's quite silly and downright false to claim that "organisms such as these do not stain" when you have no basis for saying such a thing. These organisms do stain, and in the case of hemobartonella with so little known about it and nothing published about it NO ONE can say that it does or does not stain except those that have actually tried! And I'm figuring the blogger here has not tried. So take it easy. Back up accusations with some real science or back off Dr. Fry who is at least trying.

(Lazy, Hazy, Crazy) LymeDaze said...

I'm grateful for your post LymeMD. I just posed a query on a Facebook Lyme board and this lab was suggested. I'm struck by the wealth of vital and valuable information that you offer though your blog. Though I rarely comment, I end up here time and again, seeking information helpful to my decisions concerning treating my Lyme. Your blog also saves me stress, money and steers me towards and away from treatment decisions. It me narrow down and focus on important questions for my visits with my LLMD.

Jason said...

I can't bash Dr. Fry. He is trying to give people answers. Nobody is ever happy. I would give him a shot. Why not? I've been a lab mouse for long enough now, it doesn't bother me. His services provide more detailed information on your illness. When people bash a guy who is trying to find answers, I don't understand.

Unknown said...

once upon a time, there were the "cutting edge" researchers who were attempting to prove that tiny little invisible organisms were responsible for a great many ailments- and folk thought they were crazy.
now we take for granted the reality of "germs"... and lots of other pathogens besides.

so why would we continue to mock the "cutting edge" researchers who are still finding new discoveries in the microbial world? Just becoz it is not easily proven does not indicate something is false... only that more hard work is needed to illuminate the truth of the matter.

give the good doctor a break. to me it sounds like he is a thinking investigator and at least he is not simply fobbing all the latest drug samples made available by Big Pharma.
He may be onto something big, only as yet virtually unknown.

The Orange Grape said...

Hope someone will answer - I am looking for a Dr. to help me figure out if I have Lyme or not - All the Dr's. I have talked to look at me and laugh think I am crazy - I live in AZ and am thinking about Dr. Fry - It sounds like he wont laugh at me. If anyone has any info I am willing to go any where if it helps me feel better - Thank you email theredaprons@yahoo.com

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Unknown said...

Mycoplasma haemofelis (haemobartonella) can certainly be stained. At one point "haemobartonella" was being investigated as a possible cause of SLE back in the 1970's and 1980's.

This organism is being found in cats, dogs, horses, and even falcons.

The only antibiotic that has shown to be curative is arsenicals such as potassium arsenite (in a short 10 days or less). This is used sometimes in veterinary medicine. Refractory staph and fungal infections disappear after eradication of these hemotropic mycoplasmas.

I don't know Dr. Fry, but this organism is certainly alive and well in humans with immune disorders (such as those with CFS or SLE).

It very well could be that this is some other coccobacilli-like or micrococci-like organism, so maybe referring to it as hemoplasma is premature.

Nevertheless, both hemoplasmas and coccobacilli-like organism stain with ease. In fact, I just did it today. You can clearly see them adhering to the outer surface of the red cell membrane and aren't an artifact.

Buy a microscope, find a pathologist friend to teach you, do some smears, and then speak.

But please don't make stuff up when you know nothing about staining hemoplasma.

Unknown said...

Mycoplasma haemofelis (haemobartonella) can certainly be stained. At one point "haemobartonella" was being investigated as a possible cause of SLE back in the 1970's and 1980's.

This organism is being found in cats, dogs, horses, and even falcons.

The only antibiotic that has shown to be curative is arsenicals such as potassium arsenite (in a short 10 days or less). This is used sometimes in veterinary medicine. Refractory staph and fungal infections disappear after eradication of these hemotropic mycoplasmas.

I don't know Dr. Fry, but this organism is certainly alive and well in humans with immune disorders (such as those with CFS or SLE).

It very well could be that this is some other coccobacilli-like or micrococci-like organism, so maybe referring to it as hemoplasma is premature.

Nevertheless, both hemoplasmas and coccobacilli-like organism stain with ease. In fact, I just did it today. You can clearly see them adhering to the outer surface of the red cell membrane and aren't an artifact.

Buy a microscope, find a pathologist friend to teach you, do some smears, and then speak.

But please don't make stuff up when you know nothing about staining hemoplasma.

Unknown said...

Furthermore, Bartonella bacilliformis can certainly stain and be seen by microscopy as well.

http://cid.oxfordjournals.org/content/33/6/772/F2.expansion.html

Elizabeth said...

TRUTH!! People love to judge others who are onto whatever the truth is! Thank you for pointing this out...LONG history of this!! And a lonely position to be in.

Elizabeth said...

Look into Facebook groups Bottoms Up (focuses on colon cleansing, ALL forms, but all kinds of pathogens, toxins discussed) also several great Lyme groups. Lots firsthand experience from people just figuring out health issues to those that successfully overcame illness.

Elizabeth said...

At one time everyone laughed at the doctor who figured out that when delivering a baby or prior to surgery, it was a good idea to wash your hands!! DOCTORS who were "educated"!! "Educated" doctors also use to recommend cocaine and smoking for good health!!!
One of my best friends at age 24 had a full physical exam that claimed he was in great health...he died of Luekemia within 2 months!! Wish I had paid more attention to the fact that an "educated" doctor completely missed a severe infection that within weeks put my friend in the hospital (I even noticed this 24 year old had unusual fatigue...of course doctors love to blame signs & symptoms on "old age", "just tired, stressed mom", the list goes on...
My point is from firsthand experience, being very let down by Western medicine (regret trusting thier Annual exams instead of my body trying to warn me fairly gently before I finally HAD to open my eyes and do my own research and then save my own quality of life)...just because people have a degree or certification in a field does not mean they REALLY have a clue as to what they are talking about. I will always trust a person who has experienced something firsthand or who shows the kind of drive Dr. Fry has shown over a so called "Expert", CDC, FDA, AMA, ADA, etc.