Filament formation associated with spirochetal infection: a comparative approach to Morgellons disease

Abstract

Bovine digital dermatitis is an emerging infectious disease that causes lameness, decreased milk production, and weight loss in livestock. Proliferative stages of bovine digital dermatitis demonstrate keratin filament formation in skin above the hooves in affected animals. The multifactorial etiology of digital dermatitis is not well understood, but spirochetes and other coinfecting microorganisms have been implicated in the pathogenesis of this veterinary illness. Morgellons disease is an emerging human dermopathy characterized by the presence of filamentous fibers of undetermined composition, both in lesions and subdermally. While the etiology of Morgellons disease is unknown, there is serological and clinical evidence linking this phenomenon to Lyme borreliosis and coinfecting tick-borne agents. Although the microscopy of Morgellons filaments has been described in the medical literature, the structure and pathogenesis of these fibers is poorly understood. In contrast, most microscopy of digital dermatitis has focused on associated pathogens and histology rather than the morphology of late-stage filamentous fibers. Clinical, laboratory, and microscopic characteristics of these two diseases are compared.

Keywords:

• Digital dermatitis
• Morgellons disease
• Lyme disease
• Borrelia burgdorferi
• spirochetes

Acknowledgments

The authors thank Gordon Atkins, Robert Bransfield, Dorte Dopfer, Doug Kahn, Alan MacDonald, Peter Mayne, Deryck Read, Janet Sperling, Michael Sweeney, and Randy Wymore for their helpful discussions. We are grateful to Harriet Bishop and Cindy Casey for providing first-hand information about Morgellons disease, and Lorraine Johnson for manuscript review.

Disclosures

RBS serves without monetary compensation on the medical advisory panel for QMedRx Inc. He has no financial ties to the company. MJM has no conflicts of interest to report.