In the first initial phase after infection, diagnosis and recognition of these filamentous organism called "Morgellons" is very difficult (See also "process of an infection"), since generally there are only a few typical skin symptoms recognizable and the overall clinical picture usually presents at first similar to "Scabies", or some fungal infections as Pityrosporum folliculitis or Phaeoacremonium parasiticum or Coccidioides immitis or some dermatophytes and protozoa infection as Pythium insidiosum with similar symptoms.
More exact microscopic investigations result in clarity and are always compellingly necessary therefore. It is also always advisable if symptoms are lacking, if difficulty making the correct diagnosis, or recognition of the severity of the infestation, then one must receive a skin scrabing, biopsy, or adhesive tape sampling, whatever results in better success in the recognition.
This should be especially helpful particullary if this specimen sample was taken directly at the infestation areas. Almost always there will be some external unusual fibrous matter easly seen under light microscop at 100-200X magnification.
However, one should know in addition what one actually should do with for which findings and what one must look for. If an scrabing or a withdrawal sample by needle brings a kind of coloured fuzz, then that maybe the only "parasite" you will be able to recover and you should accept this. Further samples could be attempted to try for more statistical significance, in order to exclude coincidences with cloth fabrics.
To diagnose Morgellons as disease by antibodies might be difficult, but at least one should start first with usual blood tests for Lyme disease and its typical co-infections (note: most tests are negative initially or later). M-R-O survey (check here) and interviews with thousands of Morgellons sufferers showed that many are suffering from Lyme disease (approx. 45%).
Using the DNS standard test by means of the Polymerase-chain-reaction (PCR), until recently, PCR's have been used as a good means for detection of many un-identified parasitical infections, as well as their identification by means of certain customary blood tests (Sero-diagnostic). However, now some of these tests for the antigens of parasites have, unfortunately, become outdated because there are so many new strains and species of parasites and many parasites antigens were still not isolated yet.
One could also perform blood tests of these parasites with the use of recombinant antigens specifically directed against Protozoan, Fungi, Bacteria, as well as other parasites of the internal organs. However, this could become also quite difficult, because presently there have been no antigens isolated from this new life form. In addition, usual testing (Lyme) should occur at least 6 weeks after exposure, in order to insure adequate time for an immune response to be demonstrated on clinical test findings.
Morgellons filaments/fibers and its internal protoplasm/biofilm are contagious. In a later infestation stage these fibers present in the skin pore, are generating long filaments and fuzz balls (typical fungal or bacterial growth), and by sweating they get swapped out on the skin surface causing re-infections later, too. The contact with the skin and the sweat or with contaminated objects is contagious! It is still not sure if the wildlife form (black filaments) can transmit spirochetes, agrobacteria and other pathogens, or that patients had primarly an active or latent spirochetal infection.
The differential diagnosis should consider and exclude the usual pseudo-scabies, as well as any form of usual bacterial or other fungal skin infections. Infections with Staphilococcus aureus bacteria can show initially similar symptoms and they may be, sometimes, involved too.The immune competence of the patient also plays a role, of course, in the sort of physical expression of this infection. A weak immune system and a certain chemical body condition e.g. hormonal and granulozytes lack are playing a major role in immunity against parasites and invasive fungal infections. A decrease of total granulocyte counts in peripheral blood (below 1000 /mm3 ) has been recognized to be a crucial risk factor for the acquisition of similar infections.
A former tick or mosquito bite and infections with some typical involved bacterias (babesia, ehrlichea, rickettsia, anaplasma etc.), may be also a reason for a lower level of granulozytes, which is reducing in common the immunity against external parasitical infections, as well the morgellons infection.
But a direct substitution of granulocytes in immunocompromised patients has in most cases failed to prove efficacious. As well predisposing factors like diabetes mellitus, a former corticosteroid therapy, neutropenia, constant stress (cortisol), metabolism disorders, surgery trauma, and a malnutrition is mostly decisive for an occurrence of the pathogen`s symptomatology. But it can occur also in healthy patients in the presence of insignificant trauma.Also the immune response to the antigens of this parasite occurs, basically, like that with other parasitic infection: induction phase, delayed hyper sensitivity, direct hyper sensitivity and sometimes later also with a desensitization.
The initial inoculation often takes place on hairy areas, or on bare skin patches. In both areas large abscess-like lesions, blister lesions, or pimple development, as well as skin rash can appear either within 10-14 days after exposure, or even during the first day of infestation. This is usually related to the relative size, the number and the different kinds of carried pathogens of the initial infesting parasites and if the contact happend over the skin or internally by swallowing.
It is possible, as well, that they can live undiscovered in the host body (nostrils, eyes, ears) for a certain time. Some situation or a certain food can provoke them, like a trigger reaction such as with herpes, and then the manifestation of them is recognizable in typical skin symptoms. The difference between considerated "HEALTHY PEOPLE" and evidently infected persons might be, that in common some are reacting more allergical then others to such infections. Surely also healthy people may have Morgellons but it takes longer to manifest skin or internal symptoms, and some may have only infestation of the eyes, nose and ears.
Previously one limited investigation on the predictability for infected areas between the fingers and the backs of the hand, may have led investigators to be circumspect in their physical exams for these types of infection.
This exam is surely not adequate for these new parasites. Therefore, if there is suspicion for infection with this parasite, the whole body should always be examined. This includes, but is not limited to: external upper arms, shoulder areas, lumbar region, inside thigh, as well as the nasal cavities, ear canals, etc. (see also process of infection)
Indeed many reports on this illness demonstrate initially a scabies-like behavior and skin distribution, with all typical preliminary signs, such as, even the skin scars that can be seen after an infestation.
If the pustules or nodular lesions frequently form around the eyebrows, upper and lower eyelids and on the forehead area, or in general in the facial area as well as on the scalp, especially in the nares and on the nose, and on occasion also throughout the whole body; then one can presume this to be an infestation of the new parasite, and therefore exclude any typical scabies infestation.
These first typical signs cannot count only as an indicator, but also as the propagation trend in the direction of scalp, face, ears and nose. Because in general also around the nipples, the backs of the hand, between fingers and all the other areas which generate sweat, will be the favorite areas where it can be found later.
The external symptoms particullary with an infestation on the hairs are noticeable that they will turning whitish and the hair will looks rather glassy and transparent as it turns grey in the usual form. It looks rather like an exhausted and transparent straw. It seems generally that this organisms prefers also the contents of the hairs (melanin).
Additionally a loss of sight (blur) and degradation of the eyes with inflammations/infections and increased luminous sensivity. A general poorer visibility is common due to the bacterial (keratitis) biofilm on the cornea. These eye symptoms infestation in the front and rear ocular segments, retina (temporary flashs/lightings) and on the cornea are caused from organisms which flow out of the blood/lymph system.
However, there are connections to symptoms caused from fungi Endomorphthoraceae and Aspergillus spp. In general, such fungal symptoms can be compared to a non-typical mold infection.
Starting in general with lesions, pustules and nodules on the skin, as well with swelling of the lymph nodes, formation of wrinkles of the skin and pigment disturbances, cough, as well as numbness/tingling of the extremities and also an increasing visual disturbances of the eyes (cornea/callosity, double vision).
An acute illness runs first with chills or heat flushes. These symptoms are released also by the immune response of the human body. The outbreak of the chronic illness after an infection amounts on an average of 4-8 months or longer.
In the further process there occurs an encapsulation of the micro organisms which leads to connective tissue nodes with inflammatory granuloms, with edema, itch, papulosa exanthema and lymphadenitis. (see symptoms)
Followed later with a chronic dermatitis, depigmentation of the skin (bright spots), lichenification and atrophy. Cellulitis and hanging skin and hanging lymph nodes can occur too, and a sclerosiatic lymphadenitisas.
In a later stage a general physical weakness is common, also a reduced efficiency, chronic fatigue syndrome accompanied by concentration problems and neurological signs as fibromyalgy, MS and meninigitis/encephalitis. As well a state of heightened anxiety, mood swings, angryness, resignation, depression, apathy and often suicide minds.
Most have also gastrointestinal difficulties (failure), unexplainable back pain, coughs, rigid neck and other parts and progressive parodontal disease (tooth decay) and gum detoriations.
Many cases include edemas, swollen legs, face etc. (lymph), later also swollen glands and lymph nodes and difficulty in breathing, heart and liver problems (insufficiency) and a constant weariness, as well opportunistic fungal infections (candida etc.) and urological problems.
Similar symptoms and particullary Meninigitis/Encephalitis might be caused not only from Lyme but also from viruses as Varizella, Coxsackie, Enterovirus, EBV (Ebstein-Barr Virus), Herpes simplex Typ 2, LCM-virus, HIV. As well from other bacteria such as Enderobacteria (E.coli), Mycoplasma, Clamydia pneu., Streptococcus group B, and Listeria monocytogenes. Also fungi (Aspergillus spp.) and parasites (Naegleria fowleri) can cause similar symptoms.
In a later stage of an infestation also an invasion (spiderweb-like slimy tubuli) of internal body areas can occur. (lung, nerves, organs, gut, skin). Different further complications can follow (thrombosis, heartache etc.).