Usually Diagnosia is done by duodenal tissue biopsy mine did not reveal that way because it had already spread to other areas of my body which it had like my nervous system other organs like my heart and brain. The doctor told me it may not show on the duodenal tissue biopsy. Usually a tissue biopsy has to be done for it and the disease goes in stages of active and passive. I pieced it all together because I worked in the medical field for 10yrs before getting very ill from this. It took me a while to figure it all out. A health supplement from New Zealand gave me the infection. It's a common disease over there and the sores and lesions I have all over my skin match the same ones from the derm.netnewZealand websites where it shows them on an infected individual. I've been taking amoxicillin, Bactrim ds, hydroxychloroquine, black seed oil, drinking baking soda with acv and lemon. It's been pure hell but I'm still here and still fighting. It'll give you the worst gi symptoms and Arthritis you can ever imagine.