Clongen has a species PCR runnning for Babesia. It includes 15 species. This is the first test of its kind available. It still won't cover untyped strains. PCR methods are not fool proof.
Here is some evidence for Bartonella proponents. I got back a positive Bartonella species PCR with a negative Bartonella henselae PCR. This suggests that atypical strains of Bartonella in TBD patients do in fact exist. Side bar: On the meds that are supposed to work for atypical Bartonella- Levaquin and Rifampin, she is getting worse. Now that I know what this patient has, I will have to figure out what actually works for this non-typed Bartonella species.
Lyme disease patients have small highly motile gram negative bacteria in their blood. These bacteria are coccobacilli and appear uniform in morphology. They do not adhere to red blood cells. The are present in patients treated with Rocephin, Zithromax and Doxycycline. The DNA sequencing should be done next week. I think they may be GI anerobes from the tick gut. But that is just a wild guess.
Finding out what this bug is may represent a new turn our understanding of this complex poly-microbial disease, and hopefully will offer a new direction regarding possible therapy.
Dr. Kilani mentioned that many physicians are spending a tremendous amount of money ordering tests which are rarely helpful. Here is a suggestion of cost effective screening for patients: Lyme WB. Babesia species PCR. Bartonella species PCR. Ribosomal DNA 16S sequencing for other bacteria. The Bartonella test is optional since it may show up with the RDNA 16S screen. He does not do serology. I would add antibody studies for Ehrlichia and Anaplasma if available. PCR testing for Lyme is rarely positive and should not be done routinely. Other basic information including CBC,Chems,Sed rate, CRP, vit D 25 and 1,25, and B12/folate are essential in my experience. CD57, C3a, C4a: I like to get them out of habit. I have not found that they alter my clinical judgement regarding diagnosis or therapy.