A Review of Antibiotic-Tolerant Persisters and Their Relevance to Posttreatment Lyme Disease Symptoms

Several well-controlled clinical trials have shown that prolonged antibiotic therapy has no benefit in relieving posttreatment Lyme disease symptoms. However, some insist that such symptoms are due to a persistent Borrelia burgdorferi infection requiring prolonged antibiotic therapy to resolve. This unproven view is bolstered by the results of in vitro experiments where small numbers of viable B. burgdorferi can be detected after treatment with antibiotics. The results described in the present work suggest that the presence of persisters can best be explained by classic biochemical kinetics and that there are alternative explanations for this phenomenon that appears to have no clinical significance.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research

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Five clinical trials show that prolonged antibiotic therapy has no clear and lasting benefit in relieving post-treatment Lyme disease symptoms, a condition often called “chronic Lyme disease”1-4; no evidence of active infection was found in any of these studies by culture or molecular methods. Despite such findings, as well as the fact that evidence of harm was unambiguous,2,3 some still insist that these symptoms are due to a persistent Borrelia burgdorferi in fection that can be eliminated only by several months of additional treatment with different kinds of antibiotics, given either singly or in combination.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research
Rationale: Both Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae (SFGR) are pathogens carried by ticks. There is a possibility of co-infection with these tick-borne diseases. Patient concerns: Male patient, 63 years-of-age, admitted to hospital with skin rash presenting for 1 week and fever with cough and expectoration for 3 days before admission. Diagnoses: We diagnosed that the patient was co-infected by B burgdorferi sl and SFGR using laboratory test results and the patient's clinical manifestations. Interventions: The patient started therapy with oral minocycline, then levofloxacin by intr...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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
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
Publication date: Available online 15 June 2017 Source:Microbes and Infection Author(s): Jorge Cervantes Lyme disease is a zoonosis caused by infection with Borrelia burgdorferi (Bb). A great amount of research has attempted to elucidate the mechanisms by which Bb causes inflammation and chronic symptomatology in some patients. Patients often seek unconventional treatments that lack scientific evidence, as medical care is unable to effectively explain and treat their illness. Bb-DNA can persist for long periods of time in some individuals, even after antibiotic therapy. Herein, scientific rationale is presented for a new ...
Source: Microbes and Infection - Category: Infectious Diseases Source Type: research
Conclusions: During active infection, microRNA expression in SF reflected an immune response associated with bacterial killing, whereas in post‐infectious LA, microRNA expression in SF and synovial tissue reflected chronic inflammation, synovial proliferation, and breakdown of wound repair processes, showing that the nature of the arthritis was altered after spirochetal killing. This article is protected by copyright. All rights reserved.
Source: Arthritis and Rheumatism - Category: Rheumatology Authors: Tags: Full Length Source Type: research
Authors: Brás A, Marques N, Santiago B, Matos A, Moreira F Abstract Neurological manifestations of Lyme disease are reported in 3% - 12% of patients, with the most common form of presentation being meningoradiculitis. Other symptoms involving the central nervous system, such as myelitis or encephalitis, are rare (
Source: Acta Medica Portuguesa - Category: Journals (General) Tags: Acta Med Port Source Type: research
Purpose of review: Lyme disease is a multistage and multisystem disease. Neurological manifestations [termed Lyme neuroborreliosis (LNB)] occur in about 10% of patients with Lyme disease. Diagnostics and treatment of early and late LNB are widely established. However, the management of persistent symptoms is still fraught with controversies, and therefore is the focus of this review. Recent findings: The incidence of Lyme disease seems to be much higher than previously assumed. Laboratory methods (namely serological tests) are essential for diagnosing LNB, but only when performed according to the guidelines of scientific ...
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: CNS INFECTIONS: Edited by Matthijs C. Brouwer Source Type: research
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