Association of spirochetal infection with Morgellons disease

Abstract

Morgellons disease (MD) is an emerging multisystem illness characterized by skin lesions with unusual filaments embedded in or projecting from epithelial tissue. Filament formation results from abnormal keratin and collagen expression by epithelial-based keratinocytes and fibroblasts. Recent research comparing MD to bovine digital dermatitis, an animal infectious disease with similar skin features, provided clues that spirochetal infection could play an important role in the human disease as it does in the animal illness. Based on histological staining, immunofluorescent staining, electron microscopic imaging and polymerase chain reaction, we report the detection of Borrelia spirochetes in dermatological tissue of four randomly-selected MD patients. The association of MD with spirochetal infection provides evidence that this infection may be a significant factor in the illness and refutes claims that MD lesions are self-inflicted and that people suffering from this disorder are delusional. Molecular characterization of the Borrelia spirochetes found in MD patients is warranted.

Morgellons Disease

“…Middelveen et al34 reported that this disorder was associated with spirochetal infection ( B. burgdorferi ). Culture, histology, immunohistochemistry, electron microscopy, and molecular testing verified that Morgellons disease could be associated with a systemic spirochetal infection3.…”

“…It has been recognized as a delusional infestation2. However, recent studies are suggesting that it could be associated with an infectious organism: Borrelia burgdorferi 34. There have been a number of reports and investigations about Morgellons disease in the US or Europe, but there are none so far in Asia.…”

<p>Classification and Staging of Morgellons Disease: Lessons from Syphilis</p>

“…Both Bb and RFB have been consistently detected in MD specimens. 12,13,15,17,18 Although other pathogens have been detected in MD dermatological specimens, Borrelia spirochetes are the pathogens most consistently detected in MD lesions. Therefore, our proposed staging system focuses on the infectious patterns of Borrelia spp.…”

“…However, patients with MD have a visible manifestation of infection that is easily identifiable by the MD case definition, and spirochetal infection is detectable in dermatological tissue by direct detection methods, providing that the correct methodologies are used. 8,9,12,13,15,17,18 Methodologies that should be accepted as corroborative diagnostic evidence of spirochetal infection in MD patients should include those that can directly detect Borrelia spirochetes in skin specimens from tissue showing dermopathy. This can be accomplished by histological sectioning and staining with silver stains, IHC, FFM and or FISH; and by DNA detection using PCR technology.…”

“…Bbsl and RFB have been repeatedly and consistently detected in tissue and fluid specimens taken from MD subjects. 8,9,12,13,15 Furthermore, using sensitive molecular methodologies, Bb and RFB have been directly detected and cultured from skin lesions demonstrating MD pathology, 8,9,12,13,[15][16][17][18] thus satisfying many of the criteria outlined in Fredricks and Relman's molecular guidelines for establishing disease causation. 19 Borrelia spirochetes have been detected in MD tissue and body fluid specimens, both directly in dermatological specimens and in cultures from 25 North American MD patients using a combination of microscopic, histopathological and molecular methods.…”