Exploring the Association Between Morgellons Disease and Lyme Disease

Identification of Borrelia Burgdorferi in Morgellons Disease Patients

Marianne J Middelveen; Cheryl Bandoski; Jennie Burke; Eva Sapi; Katherine R Filush; Yean Wang; Agustin Franco; Peter J Mayne; Raphael B Stricker

Disclosures

BMC Dermatol. 2015;15(1) 

In This Article

Background

Morgellons disease (MD) is a complex dermopathy characterized by the spontaneous appearance of slowly-healing skin lesions that contain multicolored filaments either lying under, embedded in, or projecting from skin (Figure 1A-C).[1–9] Patients may also exhibit constitutional, musculoskeletal and neurocognitive symptoms that are associated with Lyme disease (LD) and tickborne coinfections. The presence of these symptoms suggests an infectious etiology of the dermopathy and possible vectoring by ticks.[4,7,8]

Figure 1.

Clinical features of Morgellons disease. A, MD patient back showing lesions covering entire surface, including areas out of patient's reach. B, Back of patient with scratching-induced lesions showing distribution limited to patient's reach. C, Multicolored fibers embedded in skin callus from MD Patient 2 (100x). B reproduced from Reference 19, used with permission of the publisher.

Previous studies found that MD patients demonstrate seroreactivity to Borrelia burgdorferi (Bb) antigens and multisystemic symptoms consistent with LD, suggesting a spirochetal etiology.[4,7,8] In addition, histological, electron microscopic and PCR studies of dermatological tissue containing filamentous inclusions from four MD patients confirmed the presence of Bb sensu stricto spirochetes.[6,7] Successful bacterial culture of motile spirochetes in BSK-H medium inoculated with MD dermatological tissue demonstrated the viability of spirochetes in two of these patients, and one culture was confirmed as Bb sensu stricto by PCR analysis.[7] A case study of an MD patient in Australia reported that endpoint PCR and Basic Local Alignment Search Tool (BLAST) analysis resulted in the detection and identification of Borrelia garinii.[8] These preliminary studies suggest that MD may be a particular manifestation of LD and that strains of Bb sensu stricto and Bb sensu lato are implicated as etiologic agents.[7,8]

In light of the preliminary studies indicating an association of Lyme spirochetes with MD, we undertook a histological, electron microscopic and DNA study of North American MD patients to investigate the presence of borrelial spirochetes systemically and in dermatological specimens. Culture was also undertaken to establish if spirochetes detected in MD tissue were viable organisms and to determine whether Borrelia infection in these patients is systemic.

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