Dissociating Delusional Disorders and Infections from Dermatologic and Neurologic Effects of Morgellons Disease

Morgellons disease (MD) is a multi-system disorder characterized by multicolor filaments extruding out of the skin along with an array of dermatologic and neuropsychiatric symptoms. It was previously termed Delusional parasitosis. However, published scientific data found the association of MD symptoms with the systemic manifestations of Lyme disease, caused by Borrelia spirochete. In a retrospective study of 122 MD patients, skin specimens were examined and 96% of them showed Borrelia spirochete in their histology sample. Hence, this association suggests that spirochete infection could be a possible cause of chronic illness in MD patients, and this rejected the physician’s perception that MD lesions might be self-inflicted. A cohort study reported tick-borne co-infections among MD patients, which could also be an etiological factor for dermopathy in MD patients. Some literature also discussed neuropsychiatric manifestations like cognitive impairment, dementia anxiety, depression, paranoia, and sensory hallucinations in Lyme disease and associated tick-borne infection. The objectives of this review are to identify the differences in the past and current perception regarding the pathogenesis of MD and determine the associations of spirochetal and tick-borne diseases with MD and psychiatric illnesses. More than 50 new research articles and case reports were reviewed and only 31 articles were shortlisted and used as references. This review has a detailed discussion on Morgellons disease and its association with Spirochete infection.

Association between Piscine Mycobacteriosis and Morgellons Disease: A Review of Literature

Piscine mycobacteriosis is a fatal fish illness that affects a variety of species globally. It affects over 200 species of freshwater and marine fish. Several species of Mycobacterium are responsible among them Mycobacterium marinum is the comment. It also affects humans when exposed to contaminated water. In fishes, the symptoms include eroded fins, body surface coated with heavy mucus, changing pigmentation, swelling of abdomen, ulcerative dermal necrosis, and scale loss. In humans, the infection is classified into three clinical groups. Type I is a self-limiting, verruca lesion. Type II is single or numerous subcutaneous granulomas in the presence or absence of ulceration. Type III is deep infections of the tenosynovium, bones, bursa, or joints, resulting in tenosynovitis, osteomyelitis, and septic arthritis. The diagnosis is made by Ziehl-Neelsen acid-fast staining, culture, biochemical reaction, and PCR being the most reliable approach. Piscine mycobacteriosis is treated by antibiotics and vaccination has been considered for its long-term prevention in order to reduce morbidity and mortality. Morgellons disease (MD) is a filamentous dermopathy in which lesions with strange filamentous inclusions appear out of nowhere. Furthermore, formication may accompany dermopathy. The identification of Borrelia spirochetes directly in Morgellons disease patient specimen is constant and repeatable when sensitive and precise detection techniques are utilized. It has been diagnosed by microscopy, histology and molecular diagnostic techniques which are highly sensitive and specific. Morgellons disease is still a myth therefore its treatment is evolving, up to date it has been treated symptomatically.

Association between Brainerd Diarrhea and Zebra Mussel Infestations

Brainerd Diarrhea is a syndrome of acute onset of watery, non-bloody diarrhea that lasts for a duration of 4 weeks or more. The index case of Brainerd Diarrhea was recorded in 1983, in the first such outbreak in Brainerd, Minnesota. In 1989, a prohibited invasive species named Zebra Mussels (Dreissena polymorpha) were found in the great lakes of the United States. The 7 recorded outbreaks of Brainerd diarrhea were correlated with the location and time of zebra mussel infestations. The first outbreak that occurred due to consumption of raw milk took place in Minnesota which is near the waters infested by zebra mussels. All other outbreaks were related to consumption of contaminated unchlorinated water occurred in regions not directly close to the infested rivers. However, since infestations are thought to occur due to human activity, undocumented infestations faraway are still possible. Evidence shows minor correlations between Brainerd Diarrhea outbreaks and Zebra Mussel infestations. However, none of the facts are strong enough to establish or deny a significant correlation or causation. Further cohort studies and research need to be done on the recent discoveries of Zebra Mussel infestations and new Brainerd diarrhea outbreaks. The primary search engine used to gather information for this review was ScienceDirect and PubMed. More than 35 articles and case reports were reviewed and only 20 were shortlisted and used as references. None of the studies included were restricted to study design, but studies with less than 10 participants/patients were excluded from the review.