Lyme neuroborreliosis

Purpose of review To review the recent evidence clarifying the symptomatology and diagnosis of nervous system Lyme disease. Recent findings Two-tier testing combining pairs of ELISAs, using C6 or VlsE assays to replace second tier Western blots, may eliminate confusion about test interpretation. Cerebrospinal fluid (CSF) can be informative in diagnosing central nervous system (CNS) Lyme disease, not peripheral nervous system (PNS) disorders. CSF CXCL13 may provide useful adjunctive information in CNS infection; its specificity remains to be defined. Lyme encephalopathy is not indicative of CNS infection. Post treatment Lyme disease symptoms do not occur in patients who have had definite CNS Lyme infection. Whether post treatment Lyme disease symptom (PTLDS) is an actual entity, or reflects anchoring bias when commonly occurring symptoms arise in patients previously treated for Lyme disease, remains to be determined. Regardless, these symptoms do not reflect CNS infection and do not respond to additional antimicrobial therapy. Summary Serologic testing is robust in individuals with a priori likelihood of infection of greater than 2–6 weeks duration. Western blots provide useful confirmation of screening ELISAs, but may be replaced by second ELISAs. CSF testing, including CXCL13, may be informative in CNS Lyme, not PNS, and is generally normal in Lyme encephalopathy. PTLDS does not occur following CNS infection, and may not be a distinct entity.
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Adarsh Bhimraj Source Type: research

Related Links:

Lyme disease (LD) is an infectious multi-system illness caused by the bacterial genus Borrelia and spread by bites of infected ticks. Although most patients are successfully treated by timely antibiotic therapy, ...
Source: BMC Public Health - Category: Consumer Health News Authors: Tags: Research article Source Type: research
Authors: Feng J, Li T, Yee R, Yuan Y, Bai C, Cai M, Shi W, Embers M, Brayton C, Saeki H, Gabrielson K, Zhang Y Abstract Although most patients with Lyme disease can be cured with a 2-4 week antibiotic therapy, about 10-20% of patients continue to suffer prolonged persistent symptoms, a condition called post-treatment Lyme disease syndrome (PTLDS). The cause for PTLDS is unclear and hotly debated. Borrelia burgdorferi develops morphological variants under stress conditions but their significance is not clear. Here we isolated the biofilm-like microcolony (MC) and planktonic (spirochetal form and round body) (SP) var...
Source: Discovery Medicine - Category: Research Tags: Discov Med Source Type: research
Authors: Weiss T, Zhu P, White H, Posner M, Wickiser JK, Washington MA, Barnhill J Abstract 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, asp...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Contributors : Jerome Bouquet ; Charles Y ChiuSeries Type : Expression profiling by high throughput sequencingOrganism : Homo sapiensMost Lyme disease patients treated with appropriate antibiotics recover rapidly and completely, but a minority of patients develop persistent symptoms correlating with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy. When lingering or recurrent symptoms are associated with a functional decline and persist for greater than 6 months, patients are considered to meet clinical criteria for post-treatment Lyme disease syndrome (PTLDS), although th...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Homo sapiens Source Type: research
We report a 37-year-old female with systemic lupus erythematosus (SLE) who was repeatedly misdiagnosed for a chronic Lyme disease and treated with tetracycline antibiotics before she developed an acute exacerbation of SLE and finally died due to multi-organ failure.The internet encourages patients to ask physicians for serology testing for Lyme disease and to demand further antibiotic treatment. However, there is clear evidence that positive serology does not indicate infection with B.burgdorferi and most importantly, antibiotic therapy for PTLDS is potentially harmful for patients.It is crucial to follow the recent guidel...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
AbstractBackgroundThe clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.ObjectiveTo review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.MethodsAn IRB approved single-center retrospective study was conducted of all patients  
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
This study identified fundraising campaigns for unsubstantiated treatments, such as homeopathic remedies for cancer and antibiotic therapy for chronic Lyme disease, on GoFundMe and other crowdfunding platforms.
Source: JAMA - Category: General Medicine Source Type: research
This network meta-analyses of 19 randomized clinical trials conducted in the United States and Europe examines antibiotic agents and treatment modalities to assess treatment effectiveness and drug-related adverse outcomes in early cutaneous Lyme borreliosis.
Source: JAMA Dermatology - Category: Dermatology Source Type: research
Abstract Borrelia burgdorferi is the causative agent of Lyme borreliosis. Antibiotic therapy of early acute infection is effective for most patients, but 10-20% go on to develop Post-Treatment Lyme Disease Syndrome. The nature of PTLDS remains unknown, but currently approved antibiotics for treatment of Lyme disease do not appear to impact these symptoms after they have developed. We reason that minimizing the time the pathogen interacts with the host will diminish the probability of developing PTLDS, irrespective of its nature. This calls for an efficient eradication of the pathogen during acute infection. In sea...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
Abstract In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country. The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating dis...
Source: Infectious Disorders Drug Targets - Category: Infectious Diseases Authors: Tags: Infect Disord Drug Targets Source Type: research
More News: Antibiotic Therapy | Brain | Infectious Diseases | Lyme Disease | Neurology