The analysis of a blood wet mount has become part of the routine evaluation of patients presenting with an evaluation for TBD. Positive results are seen in 70 to 80% of patients. So far we do not know what the organisms are. Many patients have large numbers of small motile bacteria which stain gram negative. Other distinct and separate morphologies are also frequently seen. Some of these organisms are tear drop and crescent shaped and resemble Toxoplasmosis. Others appear as rods. It is important that researches be found who will take these anomalies seriously and help solve these mysteries. According to conventional medical knowledge,It is not normal for us to have bacteria and parasites freely swimming in our blood. Transient bacteremia occurs when we brush our teeth, but the normal immune system quickly eliminates the organisms. The blood should appear as a sterile fluid under normal circumstances. Well known blood borne pathogens such as HIV and Hepatitis C are viruses and cannot be seen with the light microscope.
Perhaps some of these organisms are normal residents of the human body. It is unknown. Perhaps these microbes appear in the blood in large numbers when immune suppression is present as may occur with Lyme disease.
It is not scientific- but my clinical experience indicates that the sickest TBD patients usually have the highest loads of these organisms- AND they usually have mixed morphologies, some resembling bacteria and other resembling parasites. Patients with the protozoa type morphologies are usually the sickest.
Ultimately the identity of these organisms will be disclosed. It is yet to be known how these results will play into the management of patients with tick borne illness- or other illness for that matter. Do these organisms represent a new set of previously unknown tick borne co-infections? Will it be shown that they are normal human flora? Will they be used as a marker of disease activity or will they require specific, targeted therapies? For now I can only offers clinical impressions which may or may not have validity as the science is unraveled.
The amazing thing about this part of the puzzle is that these findings are as clear as the tip of your nose. You don't need sophisticated Western Blot or PCR technology.
There can be no debate whether an adequate course of a particular antibiotic has eradicated a particular blood wet mount organism. These organisms appear right under your eyes.
All you need is a drop of blood and a standard light microscope set at 1000 power.
There are many patients will a complex multi-system disorder associated with Lyme disease and other tick borne infections. Many, if not most of these patients have blood organisms which remain unidentified. These patients as a whole respond to antimicrobial therapy of various sorts. As clinicians we do our best, but we need help.
We need scientists: parasitologists, microbiologists, molecular biologists, experts in DNA sequencing at high powered universities and research centers who have the expertise to solve the riddle. What are these mystery bugs and what role do they play in the course of human disease?