Updated 4th March 2016
The prevalence and significance of Borrelia burgdorferi in the urine of feral reservoir hosts.
Bosler EM, Schulze TL.
Live Borrelia burgdorferi were isolated from the blood and/or urine of white-footed mice (Peromyscus leucopus) collected on Shelter Island, New York, in 1984 and 1985. Prevalence of spirochetes in urine was consistently higher than in blood or both fluids simultaneously. Spirochetes remained viable for 18-24 hours in urine and were maintained in culture for one week. Mice removed from the field were spirocheturic for at least 13 months. One spirocheturic mouse developed spirochetemia one month after field removal indicating the pathogen can return to the peripheral circulation.
Twenty-one kidneys from 22 mice had spirochetes in the interstitial areas and bridging the tubules. A positive correlation between Babesia microti infection and spirocheturia was seen. Although the mechanism of entry into the urine is unknown, B. microti infection may increase glomerular permeability. Babesia induced hematuria may provide possible nutrients to maintain spirochetes. Urine may provide a method for contact non-tick transmission of B. burgdorferi in natural rodent populations particularly during periods of nesting and/or breeding.
Localization of Borrelia Burgdorferi in the Nervous System and Other Organs in a Nonhuman Primate Model of Lyme Disease
Diego Cadavid, Tim O’Neill, Henry Schaefer, and Andrew R. Pachner
Department of Neuroscience (DC, ARP), University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey; and the Registry of Comparative Pathology (TO) and the Department of Neuropathology (DC), Armed Forces Institute of Pathology, and the Department of Neurology (DC, HS, ARP), Georgetown University Medical Center, Washington, DC
Quote from article ‘the bladder had the highest spirochetal load of all paraffin
Detection of Borrelia burgdorferi in urine of Peromyscus leucopus by inhibition enzyme-linked immunosorbent assay.
LOUIS A. MAGNARELLI,* JOHN F. ANDERSON, AND KIRBY C. STAFFORD III
JOURNAL OF CLINICAL MICROBIOLOGY, Mar. 1994, p. 777-782
In culture work with tissues from bladders, kidneys, spleens, or ears, 50 of 87 mice (57.5%) were infected with B. burgdorferi. Thirty-eight (76%) of 50 infected mice had antigens of this spirochete in urine, while 36 (72%) individuals had infected bladders. Of those with infected bladders, 24 (66.7%) mice excreted subunits or whole cells of B. burgdorferi into urine. Successful culturing of B. burgdorferi from mouse tissues, the presence of serum antibodies to this bacterium, and detection of antigens to this spirochete in urine provide further evidence that multiple assays can be performed to verify the presence of B. burgdorferi in P. leucopus [white footed mice].
Interstital Cystitis and Lyme- preliminary report
Experiences from a Lyme doctor:
Updated 12th November 2013
Urinary bladder detrusor dysfunction symptoms in lyme disease.
Int Neurourol J. 2013 Sep;17(3):127-9. doi: 10.5213/inj.2013.17.3.127. Epub 2013 Sep 30.
Puri BK, Shah M, Julu PO, Kingston MC, Monro JA.
Department of Medicine, Imperial College London, London, UK.
Symptoms of urinary bladder detrusor dysfunction have been rarely reported in Lyme disease. The aim was to carry out the first systematic study to compare the prevalence of such symptoms in a group of Lyme disease patients and a group of matched controls.
A questionnaire relating to detrusor function was administered to 17 serologically positive Lyme disease patients and to 18 control subjects.
The two groups were matched in respect of age, sex, body mass, and mean arterial blood pressure. None of the 35 subjects was taking medication which might affect urinary function and none had undergone a previous operative procedure on the lower urinary tract. Six of the Lyme patients (35%) and none of the controls (0%) had symptoms of detrusor dysfunction (P<0.01).
This first systematic controlled study confirms that Lyme disease is associated with urinary bladder detrusor dysfunction. Further evaluation of detrusor function is warranted in this disease.
PMID: 24143291 [PubMed] PMCID: PMC3797892 http://www.ncbi.nlm.nih.gov/pubmed/24143291
Updated 8th March 2013
Neurogenic bladder in lyme disease.
Authors: Kim MH, Kim WC, Park DS
Source: International neurourology journal 16:4 2012 Dec pg 201-4
Institution: Department of Neurology, CHA Bundang Medical Center, Seongnam, Korea.
Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day). The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.
PubMed ID: 23346488
Title: Lyme disease presenting as urinary retention.
Authors: Chancellor MB, Dato VM, Yang JY
Source: J Urol 1990 Jun;143(6):1223-4
Organization: Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York.
We report a case of Lyme disease that presented with urinary retention. The individual then experienced lower extremity paralysis. Paralysis and urinary retention resolved with intravenous ceftriaxone antibiotic. To our knowledge this is the first report of a urological manifestation as the initial clinical presentation of Lyme disease. Recognition of clinical symptoms and urological complications of Lyme disease also are discussed.
Unique ID: 90258152
Title: Lyme disease presenting as isolated acute urinary retention caused by transverse myelitis(as though the spinal cord has been severed): an electrophysiological and urodynamical study.
Authors: Olivares JP, Pallas F, Ceccaldi M, Viton JM, Raoult D, Planche D, Delarque A Source: Arch Phys Med Rehabil 1995 Dec;76(12):1171-2
Organization: Department of Rehabilitation, Timone Hospital, Marseille, France.
Several neurological manifestations of Lyme disease, both central and peripheral, have been described. Reported here is a case of acute transverse myelitis related to a Lyme neuroborreliosis that presented with isolated acute urinary retention and no lower-extremity impairment. This case, documented by urodynamic and electrophysiological investigations, partially resolved after 6 weeks of intravenous ceftriaxone, affording the removal of the indwelling catheter. Alpha blocker therapy was needed for 3 months, until the complete normalisation of urodynamic and electrophysiological records. This case study indicates that whenever urinary retention is encountered associated with acute transverse myelitis or alone, the patient should be investigated for Lyme disease.
Unique ID: 96130000
Title: Efficacy of the urinary bladder for isolation of Borrelia burgdorferi from naturally infected, wild Peromyscus leucopus.
Authors: Callister SM, Agger WA, Schell RF, Brand KM
Source: J Clin Microbiol 1989 Apr;27(4):773-4
Organization: Microbiology Research Laboratory, Gundersen Medical Foundation, La Crosse, Wisconsin.
The efficacy of culturing urinary bladder tissue for Borrelia burgdorferi from naturally infected, wild Peromyscus leucopus mice was determined. The urinary bladder cultures were as efficient as spleen, kidney, and blood tissue cultures. The rapid B. burgdorferi isolation (mean, 6 days) from mouse urinary bladders should aid in defining new Lyme disease foci.
Title: Cystitis induced by infection with the Lyme disease spirochete, Borrelia burgdorferi, in mice.
Authors: Czub S, Duray PH, Thomas RE, Schwan TG
Source: Am J Pathol 1992 Nov;141(5):1173-9
Organization: Department of Health and Human Services National Institutes of Health National Institute of Allergy and Infectious Diseases Hamilton MT 59840.
Spirochetes were cultured from the urinary bladder of all 35 mice inoculated with low- passaged spirochetes while we were unable to isolate spirochetes from any kidneys of the same mice. The pathologic changes observed most frequently in the urinary bladder of the infected mice were the presence of lymphoid aggregates, vascular changes, including an increase in the number of vessels and thickening of the vessel walls, and perivascular infiltrates. Our results demonstrate that nearly all individuals (93%) of the four types of mice examined had a cystitis associated with spirochetal infection.
Unique ID: 93072249
Title: The urinary bladder, a consistent source of Borrelia burgdorferi in experimentally infected white-footed mice (Peromyscus leucopus).
Authors: Schwan TG, Burgdorfer W, Schrumpf ME, Karstens RH
Source: JClin Microbiol 1988 May;26(5):893-5
Organization: Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, Hamilton, Montana 59840.
White-footed mice, Peromyscus leucopus, were experimentally infected in the laboratory with Borrelia burgdorferi, the causative agent of Lyme disease. After mice were infected by intraperitoneal or subcutaneous inoculation or by tick bite, attempts were made to culture spirochetes from the urinary bladder, spleen, kidney, blood, and urine. Spirochetes were most frequently isolated from the bladder (94%), followed by the kidney (75%), spleen (61%), and blood (13%). No spirochetes were isolated from the urine. Tissue sectioning and immunofluorescence staining of the urinary bladder demonstrated spirochetes within the bladder wall. The results demonstrate that cultivation of the urinary bladder is very effective at isolating B. burgdorferi from experimentally infected white-footed mice and that culturing this organ may be productive when surveying wild rodents for infection with this spirochete.
Unique ID: 88257349
Title: Persistent cardiac and urinary tract infections with Borrelia burgdorferi in experimentally infected Syrian hamsters.
Authors: Goodman JL, Jurkovich P, Kodner C, Johnson RC
Source: J Clin Microbiol 1991 May;29(5):894-6
Organization: Department of Medicine, University of Minnesota School of Medicine, Minneapolis 55455.
The heart can be severely affected in humans with Lyme disease, causing conduction defects and, rarely, heart failure. Although immunodeficient and young mice may develop cardiac lesions, cultivation of Borrelia burgdorferi from cardiac tissues of experimentally infected animals has not been reported previously. We infected Syrian hamsters with B. burgdorferi 297 and found a marked tropism of the spirochete for myocardial and urinary tract tissues.
Fifty-six of 57 hearts (98%) and 52 of 58 bladders (90%) were culture positive. The cardiac infection was persistent and could be documented in 21 of 22 hearts (96%) cultured from days 28 to 84 postinfection. The urinary tract was also a site of persistent infection in most animals, with 18 of 23 bladders (78%) being culture positive from days 28 to 84. The persistence of spirochetes was specific for the heart and bladder, as indicated by negative cultures of specimens from the liver and spleen, in which only 1 of 23 cultures was positive from days 28 to 84. Because of the high isolation rates, tropism, and persistence that we found for B. burgdorferi in the hamster heart and bladder, these sites will be useful and important for the cultivation of spirochetes in experimental studies that evaluate the efficacies both of candidate vaccines in preventing infection and of antibiotics in eradicating organisms from privileged sites. In addition, the clear demonstration of persistent cardiac infection with B. burgdorferi may provide a useful model for studying the pathogenesis of cardiac Lyme disease.
Unique ID: 91277193
source: When to Suspect Lyme Disease by Dr. John Bleiweiss
“…… In many of my patients, cysts are found not uncommonly in various locations: thyroid, breast, liver, bone, ovary, skin, pineal gland, and kidney. Some forms of Polycystic Kidney and Fibrocystic Breast Disease may be LD manifestations. LD can cause an interstitial cystis leading to bladder pain relieved by urination. A neurogenic bladder can develop with either hesitancy, frequency, loss of bladder awareness, urinary retention, incontinence or the symptoms of UTI (urinary tract infection). I suspect that some cases of chronic pyelonephritis are actually LD. Pediatricians may want to consider that nocturnal enuresis (bedwetting) is secondary to LD.
Constipation severe enough to cause fecal impaction can occur. Many LD patients will experience a spastic (irritable) colon and that diagnosis should spark a search for LD. I have treated LD attended by ulcerative colitis with substantial remission of the colitis when antibiotics were inaugerated. Fecal incontinence due to impaired rectal sphinctor tone can occur. Dr. Martin Fried has demonstrated Bb spirochete in the gastric and duodenal mucosa of children with LD who complained of abdominal pain and who were documented to have gastritis and/or duodenitis. It is appropriate to work up LD when confronted by these clinical entities……”
Title: Urinary dysfunction in Lyme disease.
Authors: Chancellor MB, McGinnis DE, Shenot PJ, Kiilholma P, Hirsch IH
Source: J Urol 1993 Jan;149(1):26-30
Organization: Department of Urology, Jefferson Medical College, Thomas
Jefferson University, Philadelphia, Pennsylvania.
Lyme disease, which is caused by the spirochete Borrelia burgdorferi, is associated with a variety of neurological sequelae. We describe 7 patients with neuro-borreliosis who also had lower urinary tract dysfunction. Urodynamic evaluation revealed detrusor hyperreflexia in 5 patients and detrusor areflexia in 2. Detrusor external sphincter dyssynergia was not noted on electromyography in any patient. We observed that the urinary tract may be involved in 2 respects in the course of Lyme disease: 1) voiding dysfunction may be part of neuro-borreliosis and 2) the spirochete may directly invade the urinary tract.
In 1 patient bladder infection by the Lyme spirochete was documented on biopsy. Neurological and urological symptoms in all patients were slow to resolve and convalescence was protracted. Relapses of active Lyme disease and residual neurological deficits were common. Urologists practicing in areas endemic for Lyme disease need to be aware of B. burgdorferi infection in the differential diagnosis of neurogenic bladder dysfunction. Conservative bladder management including clean intermittent catheterization guided by urodynamic evaluation is recommended.