Lyme disease forces 24-year-old army officer out of military
We often think of Lyme disease as a threat to the public engaging in enjoyable outdoor activities, like hiking, camping and gardening. But Lyme disease and other tick-borne illnesses are a constant threat to individuals serving in the military, who spend most of their time working in heavily forested or mountainous terrain.
In the case report “Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer,” Weiss et al. describe a 24-year-old Second Lieutenant, trained at the U.S. Military Academy, whose career was terminated due to Lyme disease. [1]
The young man had unexplained knee swelling after successfully completing hip surgery. Doctors removed 75 cubic centimeters of fluid and treated the patient for a possible Gonorrhea infection. But tests were negative and the swelling persisted.
Lyme disease tests were performed, which came back positive. The man was diagnosed with Lyme disease based on the presence of antibodies and PCR testing against B. burgdorferi in the synovial fluid.
“The patient was treated with a combination of periodic knee joint aspirations to remove swelling and a 30-day course of doxycycline,” writes Weiss. However, during treatment, the man developed swelling in his other knee.
Over the next several weeks, swelling in both knees continued, but Lyme disease tests were negative. The man was given anti-inflammatory medications and had periodic fluid removal but showed little improvement.
After a repeat test detected B. burgdorferi in the synovial fluid, the man was treated with one month of IV ceftriaxone.
However, he remained ill, developing severe fatigue, memory issues, headaches, sleep disturbances and complaints of angina. He had chronic knee and hip pain and minor effusions in both knees. A tear likely contributed to a Baker’s cyst.
[bctt tweet=”Military personnel are at risk of developing Lyme disease. ” username=”DrDanielCameron”]
It was unclear whether the man’s symptoms were due to a Lyme disease infection 15 years earlier or whether he was re-infected. Nevertheless, he was assumed to suffer from post-treatment Lyme disease syndrome (PTLDS). No additional antibiotics were prescribed.
“Eventually, a medical retention decision point was reached, and he was deemed unfit for duty,” writes Weiss.
The economic burden to the military of losing a trained army officer was estimated to be high. “It is important to note that the average 4-year cost for educating a single U.S. Military Academy cadet is currently over $300,000,” explains Weiss.
“Moreover, medically retiring an officer results in life-long disability payments and medical coverage.”
This case “highlights the need for increased surveillance for Borrelia burgdorferi (B. burgdorferi) in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease,” the authors conclude.
Editor’s note: I have opposed the diagnosis of “PTLDS” until we have a reliable test to rule out a persistent infection.
Related Articles:
Lyme disease mimics prosthetic joint infection following knee replacement
References:
- Weiss T, Zhu P, White H, et al. Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer. Mil Med. 2019.
Alexander Stewart
12/14/2020 (12:06 am)
I acquired Lyme Disease in 1998, while in the National Guard after serving 9 years on active duty. I was on active duty status at Fort Knox, Kentucky when I got the Lyme Disease. The Lyme Disease almost took my life 2 times and cost me my Military career, my professional boxing career, and my State job in youth corrections. When I was forced to leave my National Guard unit in 2001, I was given an active duty US Army retired card and had that card since 2001. I recently went to get an ID card for my wife because she has MS and had to leave her civilian job due to her MS. I was told that I had two retired statuses ,U.S. Army Retired and Reserve Retired and that I could only have one status. Do I still keep my U.S. Army retired ID or do I have to take the reserve retired ID card ? I am 100% disabled and unemployable !
Dr. Daniel Cameron
12/14/2020 (7:34 am)
I have patients who have lost their service job due to Lyme disease. I do not have enough information to help with your retired status.
Samantha Thomas
02/12/2020 (8:48 pm)
So terrible. I am having the same issues. My career of 6 years Army and now 6 years Air Force is over because I had Thyroid Cancer but once treatment was done and I was Cancer free I kept getting more and more sick. A PCM I never even met called my Commander and told him that the Med Group had done him a disservice by keeping my on profile as long as I was. She then called me and told me to stop taking my heart medication to help with being so tired and to get therapy to get over having a Cancer diagnosis. A medboard began and I ended up in the hospital. That is when I was tested positive for Lyme. The worst part is that I cant even add the Lyme Disease to my MEB paperwork now because treatment hadn’t started and I didnt have enough evidence. For TWO years I was made to look like I was crazy or dramatic. Lyme Disease is absolutely terrible and military members are always in danger of getting it. We are required to get certain shots and to get tested for HIV. I believe Lyme needs to be a mandatory test ran if symptoms are happening. Lyme disease has been harder than Cancer in my opinion. Hope anyone else that loses their career at least finds a treatment to ease the symptoms that come with Lyme.
Maribel
08/31/2020 (1:31 pm)
Samantha,
The current way to test for Lyme by the CDC that the military follows, is a two part test. The first test is the ELISA test. If that comes positive. Then, you are given the Western Blot test. If that comes positive. Then, you are given a positive diagnosis of Lyme Disease. The military will treat you with doxy for 2-4 weeks. After that, your immune system is more than likely down. When they test you again. There is no antibodies present in your system. Therefore, you magically no longer have Lyme Disease (which is non-curable). The military fails to test for co-infections. Which is what gets us. The way to get tested for Lyme disease to include co-infections is with a DNA test. That will show that not only do you have Lyme but, more than likely eight other co-infections. Epstein Barr tends to be one of the co-infections. The VA rates Lyme at 100% while is active. My advice to you is, since you are probably either just separated or about to separate given the time stamp on your message (365 days after separation is still service connected). Attempt to find a Lyme-Literate MD (L-LMD) and ask for a DNA test. If you are still in, request a DNA test for Lyme and it’s coinfections. I know that Igenex labs accepts Humana. I still have not been able to get a DNA test. Even though you came positive for Lyme, the VA will test you again for your claim. That baby will come back negative and your claim will be not service connected. I somehow, manage to do 18 1/2 years active duty with Lyme (20 yrs overall). Everything that I know about my condition, has been by my own research. I mentioned that I have Lyme to an off post medical provider and their eyes almost popped out of their head. They found someone that knew how they felt. For instance, that pain that you feel sometimes in your chest that radiates to your back and hurts when you breathe at times, is not your lungs. Is your ribs that have inflammation. I can’t tell you the many times the chiropractor had to stop because I could not take the pain, I eventually powered through the appointment. I had one that pulled out the medical book to try to figure out why my ribs hurt so much when he put a slight pressure on it. Last month, I looked through my medical records and saw a doctor tested me for all drugs known to man back in 2013. He did not tell me he was testing me for drugs. After, he did tell me that, don’t take this the wrong way but, you come here and complain about stuff and everything comes back normal. I said, yet, I am still in pain. I had my gallbladder removed last year. The doctor said, it was chronically inflamed. I told him, my entire body is inflamed! Look up Dr. Bill Rawls and the Lyme disease org.
Good luck!
V/r,
Belle
Jason
08/29/2019 (1:09 pm)
Also, in the original case study, not mentioned above, is the fact Soldier was treated with steroids in addition to antibiotics. The steroids are immuno-suppressive, and should never have been prescribed with a positive lyme indication. Sounds like military medical malpractice.
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04/15/2019 (12:58 pm)
Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. Although gonococcal arthritis was initially suspected from preliminary laboratory results, a comprehensive evaluation contradicted this diagnosis. Despite antibiotic therapy, aspiration of the effusions, and steroid treatment to control inflammation, the condition of the patient deteriorated to the point where he was found to be unfit for duty and subsequently discharged from active military service. This case illustrates the profound effect that latent Lyme disease can have on the quality of life and the career of an active duty military member. It highlights the need for increased surveillance for Borrelia burgdorferi (B. burgdorferi) in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease.
GMD
04/12/2019 (12:16 am)
This young man’s story is so similar to so many others. Stupid and ridiculous “PTLDS” diagnosis severely hurt this young man, hurt our military, hurt taxpayers, and was totally unnecessary. Ibe month, 30 days of IV ABX is totally ridiculous. It took me almost a year to respond to 4 grams of IVABX a day. I kept taking that same treatment for well over five years. I got my life back of at least 90%. What a shame for this young man. And by the way, I finally realized I had really been suffering with Lyme disease for over 60 years before I knew I had it. AND I RESPONDED TO TREATMENT very positively. The medical community, including the military, is still not thinking out of the box. Actually, current conventional medicine already knows about Lyme disease but for ridiculous reasons just is hiding their heads in the sand. Those of us with Lyme do not have the time t wait for tons of research when current proper treatment really already helps us tremendously. My heart goes out to this young man. I do hope he is open to and gets proper sustained treatment. Not only IV ABX, but herbs, digestive enzymes, proper nutrition, hyperbaric oxygen, hyperthermia treatment, and other known treatments.