Metagenomics are particularly good in cases like this where tissue samples are small. These spirochete are too small for light microscopy - probably why the lab missed them.
If not for getting sick recently I'd probably still be dealing with whatever gut infection I had that the doctors essentially ignored.
5-6 years ago my buddy and I got violently ill on a trip to Japan. Both agreed it's the sickest either of us have ever been, and we both lost 15-20lbs each. Shortly after our illnesses went away we both developed digestion issues. Went through stool samples and colonoscopies. He got diagnosed with uc and I got diagnosed with post-infectious ibs-d. Was told all tests were fine, but life since was hell. That is up until 2 months ago when I went to the ER with an infection.
Was given 2 weeks of doxycycline and voila, I'm no longer scared to fart, not running to the bathroom after eating anything, not going 7 times a day, and having solid stools. Might be tmi but whatever this is something that I'm happy and feel incredibly relieved (no pun intended) about.
Only problem is I still have what I went to the ER for, no one knows what it is, and I have to get another colonoscopy :/
I've personally had quite some experiences navigating health issues, health anxiety, the medical system, etc. Nothing terribly interesting, but, still. I'm actually in middle of scheduling tests to see if I might, in fact, have an autoimmune condition. If they do find evidence of that, then it will have taken me around 6 years to figure it out from my very first symptoms. Thanks to modern medical science, I have little reason to sweat over it, though. (Of course, I'm still hoping for a negative, but at least in the case of a positive I can have the relief of knowing what the hell was wrong with me all this time.)
There are non-absorbable antibiotics designed to target intestinal bacterial overgrowth. It’s hit or miss, though.
Unfortunately for many people, taking antibiotics can have the opposite effect where it creates or worsens gut problems. It’s not an easy or reliable solution.
.dressed chicken .peanuts .soyabean oil .cumin
And we used to use these food "daily".
The allergy eruptions, digestive issues went from 100 to 5 starting next day.
This is such a small thing to check but it has saved us as a lot of trouble.
It cleaned up my infection, and I didn’t have any side effects —- but hard to shift illnesses can require significant amounts of antibiotics with significant side effects.
From my understanding it's much less common to get antibiotics in the UK vs US.
I've had 4 infections this year, including an ear infection, fingernail, chest (that caused pneumonia on my son) and one that caused my left eye to swell up.
I received no antibiotics for any of them, just a suggestion that if they didn't go away they might prescribe some. They all got better without them (except my son, who ended up in emergency and was given two different ones which cleared up his infection rapidly).
In the past though I'm pretty sure I would have been prescribed them immediately.
Maybe they tried something broad spectrum here, and what was necessary (and required the sequencing to know what it actually was) was something more targeted.
You know how everyone complains about antibiotic resistance? Yeah, they're not going to give some random antibiotic if they have no idea what something might be.
Modern medical ethics requires you always prioritise the individual over society, which means one should always give antibiotics if the benefits outweigh the downsides for this specific patient, even if that means you might cause antibiotic resistance for everyone else in the future.
For example, the Earlham Institute, the University of Oxford, and the UK Health Security Agency are all actively involved in metagenomics research and surveillance.
For example: https://www.phgfoundation.org/blog/metagenomic-sequencing-in...
https://www.earlham.ac.uk/events/nanopore-metagenomics-sampl...
After five years they'd never tried a broad-spectrum antibiotic treatment? That's the real story here.
Even if you don’t know what the bacteria is, if you have a culture, do a resistance study.
"All tests for infection came back negative and it was assumed she had an autoimmune condition."
They never confirmed the autoimmune hypothesis but tried to treat it. What about the hypothesis of "it's some other infection our tests don't catch"? Antibiotics are a fairly simple thing to try. She got cataracts due to that mistake. Now that eye doesn't have dynamic focus.
Not viral/bacterial but human mutations but this is an inspiring study --- https://pubmed.ncbi.nlm.nih.gov/31019026/ , https://radygenomics.org/2021/13-hours-rady-childrens-instit...
A child is born with potential rare genetic disease. They sequence their DNA within 13 hours and come back with a diagonsis in some proportion of cases (they give lots of stats, it's small sample size, maybe 1/4 improved outcomes, maybe 2/3 have immediate change to their care)
Leptospirosis is known to be both prevalent in tropical areas and to be difficult to positively culture and identify.
In Canada, when a complex issue like this arises, it's common to see several different specialists; the testing is typically very thorough, even including some forms of genetic testing. They do everything they can to get you off the steroids, knowing it will cause issues if taken long-term.
The timeline for delayed immune reaction to a leptospirosis infection makes diagnosis incredibly difficult. There was no mention of an acute febrile illness preceding this during the patient's trip to the tropics, which I assume a uveitis specialist would ask.
While empiric treatment with doxycycline wouldn't be a bad idea, you have to decide what to empirically treat with, and for how long, and what the ramifications of increasing resistance to antibiotics are for society. Do I commit a patient to the hospital for two weeks of IV penicillin because I "suspect" syphilis? of course not.
Better diagnostics for these occult diseases should be applauded. But we shouldn't be vilifying the clinicians that are by all accounts doing their best.
Don't doctors always ask about international travel when you present with an unknown illness? The exact timeline is difficult to infer from the article but that seems like pretty important detail to overlook.
But the problem is that it generates a ton of eye strain for some reason, so now I'm on eye drops probably every 30 to 45 minutes and if I don't take them my eyes become really sore and useless.
At least I'm working for myself so its less of a hassle, but taking constant breaks to rest the eyes isn't great for productivity.
I'll check out the ones you mention.
I always keep metagenomics in mind now for friends and family who have mystery ailments.
"Metagenomics technology uses cutting-edge genomic sequencing, which can identify all bacteria, fungi or parasites present in a sample by comparing them against a database of millions of pathogens.
[if you] do a separate test for each and every one and if you've got an infection with something that's unexpected, rare or not previously known, you won't find it."
I do agree though, you can’t do a resistance study before isolation. I assumed that they did isolate.
One example of the guidance: https://elearning.rcgp.org.uk/pluginfile.php/199275/mod_book...
And I'm curious, did all of your family find yourselves allergic or sensitive to all of those things, or is that list a combination that covers everyone while each individual was allergic to one or a few of them?
Dressed chicken, I meant to say broiler chicken. They are raised for the sole purpose of meat and the turnaround time is in 45 days or less now. They pump these birds full of lots of medication, vaccines and stuff. Everyone in the family gets sick eating them. OTOH, farm chicken that are naturally grown and have no medication is fine so its not chicken per se but maybe some medication or food given to these broiler chicken
It used to be that they were prescribed much more freely, because on the level of an individual case it's unlikely to do any harm and might help speed up getting better, and it was an easy way for doctors to make patients feel cared for to send them off with a prescription. But sensibly that's been course corrected now.
A related problem though is how hard it is to get an appointment with a doctor now. This is essentially why my son ended up in emergency.
Primary care physicians do not spend more than two minutes diagnosing you in my experience. The diagnosis is always shallow and sometimes wrong because of how rushed the process is.
You pay a third of your salary in taxes, then you pay VAT on everything you buy plus many more taxes for other things such as your property. It amounts to more than half the money you earn.
Well that's factually bullshit.
Unfortunately not necessarily. For many chronic conditions an individual may very well develop an antibiotic resistant bug. There's even plenty on YouTube about standard penicillins and strep bacteria that start growing right inside the antibiotics. Look it up, it's fascinating.
You're assuming (and indeed US medicine seems to assume this everywhere) that since there don't usually seem to be major negative side effects from antibiotics they're harmless. However we are now confident they're not - lots of interesting things live inside us and whether or not they can cope with antibiotics varies, we're an ecosystem and so this intervention is a massive change to that ecosystem, and while it will usually be justifiable if we know there's an infection if we don't know that's now a gamble.
You don't get to complain about antibiotic resistance if at the first sign of an issue you demand a bathing in random antibiotics, especially if you don't even know if you have a bacterial infection in the first place
Antibiotic resistance could just as easily first happen in the sewers and other places where there is a lowish concentration of antibiotics.
The prisoner would undoubtedly have a better life if not imprisoned. But society does better if they are imprisoned.
Now I have to go through the entire process again to rule out everything else before getting a fibromyalgia diagnosis.
Anyway antibiotics have unrelatedly literally saved my life on several occasions now and I am glad that in a few emergencies I was able to access them on the street without needing to navigate the healthcare system. Antibiotics are too tightly controlled for humans and not enough for animals.
That said, I have had to take them enough that I've definitely experienced negative gut effects a couple of times. Now I reach for probiotics after a regimen.
I'll have to take probiotics the rest of my life. Because I'm not doing a fecal transplant, thanks. Those three times of antibiotics completely wrecked my intestines.
"Antibiotics damage the colonic mucus barrier in a microbiota-independent manner"
Why?
This way they get the benefit of complaining about their suffering without criticism because it's a social faux pas to tell a person to undergo a medical procedure just as much as it's frowned upon to mock someone for suffering from a medical illness, even though the fix for their medical condition is getting an enema and sticking a couple of pills up their hee-hoo.
> A value-added tax (VAT or goods and services tax (GST), general consumption tax (GCT)) is a consumption tax that is levied on the value added at each stage of a product's production and distribution. […] VAT is an indirect tax, because the consumer who ultimately bears the burden of the tax is not the entity that pays it.
(Even then, Wikipedia is oversimplifying: "ultimately bears the burden" isn't how economies work.)
https://openbiome.org/feature/fecal-transplant-pills-large-s...
… And so on, and so forth. "The burden is on" is not how economies work. Personal property is owned, but money is merely controlled – and that control is subject to caveats, because money only has value as far as it can be exchanged for goods and services. Most forms of taxation (but especially VAT) are abstract accounting tricks to accomplish complex cybernetic effects, with no simple interpretation as a levy or tithe.