Abstract
We know the cause of Lyme disease. We know that the bacteria can be found in the initial rash, and occasionally in the blood in the subsequent 2–3 months, but after then, its subsequent location is unknown. Whereas diagnosis and treatment of early Lyme disease is generally straightforward, the etiology of relapsing or persisting symptoms is yet to be defined, and presents clinical challenges. There are no current tests to determine if the infection is still present or absent, thus complicating diagnosis and treatment. Presented here are approaches to the diagnosis and treatment of persisting Lyme disease, based on available published information, and the experience of the author.
Highlights
It has been more than 40 years since the discovery of the causative agent of Lyme disease
We know that Lyme disease is caused by the bacterium Borrelia burgdorferi, transmitted by the bite of an Ixodes tick
What We Know About Lyme Disease patients with recurring or persisting symptoms following initial antibiotic treatment using specific antibiotic regimens [7], lend strong support to the hypothesis that it is persistent infection by B. burgdorferi that is the likely cause of persisting symptomatology
Summary
It has been more than 40 years since the discovery of the causative agent of Lyme disease. There was recovery of non-cultivatable B. burgdorferi by xenodiagnosis in a few human patients who had had an erythema migrans rash and had had prior antibiotic treatment [3]. These results, plus observations by us and others that retreatment of. What We Know About Lyme Disease patients with recurring or persisting symptoms following initial antibiotic treatment using specific antibiotic regimens [7], lend strong support to the hypothesis that it is persistent infection by B. burgdorferi that is the likely cause of persisting symptomatology. Attribution of post-infectious symptoms to some post-infectious phenomena has only been speculative without any supporting evidence
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