IDENTIFICATION AND TREATMENT OF CHRONIC INFECTIONS IN CFIDS, FIBROMYALGIA SYNDROME AND RHEUMATOID ARTHRITIS: SUPPORT FOR ANTIBIOTIC REGIMENS
Chronic Fatigue Immune Disfunction Syndrome (CFIDS) is characterized by a number of chronic (>6 months duration) signs and symptoms that do not resolve with rest. Among these are disabling fatigue, intermittent fevers, joint and muscle pain and loss of joint mobility, impairments in short-term memory, headaches, skin rashes, diarrhea, coughing, nausea and gastrointestinal and breathing problems, diminished vision and other signs and symptoms. Other chronic illnesses, such as Fibromyalgia Syndrome (FMS), Gulf War Illness (GWI), Rheumatoid Arthritis (RA), Inflammatory Bowel Disease, among others, also show many of these same signs and symptoms, suggesting that there may be some overlap in the underlying causes of these conditions or at least in the factors that may result in sickness (morbidity) or illness progression.[...]
As chronic illnesses such as CFIDS, FMS, GWI and RA progress, there are a number of accompanying clinical problems, particularly increases in autoimmune signs and symptoms seen in some patients. These include acquiring most but usually not all of the classical signs and symptoms of Multiple Sclerosis (MS), Amyotrophic Lateral Sclerosis (ALS or Lew Gehrig’s Disease), Lupus, Graves’ Disease, RA and other complex autoimmune diseases. Although it is not proven, such usually rare autoimmune responses are at least consistent with certain chronic infections, such as mycoplasmal infections, that penetrate into nerve cells, synovial cells in joints and other cell types. It is proposed that these autoimmune signs and symptoms are caused when intracellular pathogens, such as mycoplasmas and other bacteria, escape from cellular compartments. Some microorganisms like mycoplasmas can incorporate into their own structures pieces of host cell membranes that contain important host membrane antigens that can trigger autoimmune responses [1], and they can also mimick host cell antigen structures [3]. Thus patients with such infections may respond immunologically to microorganism antigens as well as their own membrane antigens, producing unusual autoimmune signs and symptoms.[...]
The recommended treatments for mycoplasmal blood infections require long-term antibiotic therapy, usually multiple 6-week cycles of doxycycline (200-300 mg/day), ciprofloxacin or Cipro (1,500 mg/day), azithromycin or Zithromax (500mg/day) or clarithromycin or Biaxin (750-1,000 mg/day). Multiple cycles are required, because few patients recover after only a few cycles [4-6], possibly because of the intracellular locations of the infections and the slow-growing nature of these microorganisms. We now recommend that patients who have been diagnosed with blood infections receive continuous antibiotics for at least 6 months before using the 6-week cycles of treatment. Although patients starting such therapy usually have Herxheimer reactions and feel initially worse due to die-off or release of toxic materials from damaged microorganisms, they eventually stabilize and then slowly begin to recover. Unfortunately, the treatment requires long term therapy and recovery is usually very slow. Patients that have been sick for many years are unlikely to recover within a year of therapy.