Treatment Of Lyme Disease Research Articles

“I Can Do Anything if I’ve Overcome That”: A Collaborative Case Study of an Adolescent with Symptoms of Lyme Disease in Canada

This qualitative case study explored the experiences of one Canadian adolescent with symptom-persistent Lyme disease. Lyme disease is the most prevalent vector-borne illness in North America, and infection rates are rising across Canada. Peak incidence occurs in children aged 5–9 years, making it a significant childhood infectious disease. This involves collaboration with an adolescent with symptom-persistent Lyme disease in Canada to address a gap in the literature. This empirical research was guided by the central research question: “What is the experience of an adolescent with symptom-persistent Lyme disease in Canada?” The purpose of this study was to understand the unique experiences of symptom-persistent Lyme disease in Canada by emphasizing one adolescent’s unique voice. The findings of this case study demonstrate the challenges this adolescent faced in receiving appropriate diagnosis and treatment for Lyme disease, pointing to a need for increased awareness among health professionals regarding the impact and prevalence of tick-borne illnesses for young people, their caregivers, and their healthcare providers. Additional findings suggest that collaborative healthcare may be beneficial for patients with symptom-persistent Lyme disease, and health researchers should continue to engage young people to ensure accurate representation of their experiences.

Plants supporting the treatment of Lyme disease

Plants supporting the treatment of Lyme disease

Identifying Trusted Sources of Lyme Disease Prevention Information Among Internet Users Connected to Academic Public Health Resources: Internet-Based Survey Study.

Misinformation about Lyme disease and other tick-transmitted pathogens circulates frequently on the internet and can compete with, or even overshadow, science-based guidance on tick-borne disease (TBD) prevention. We surveyed internet users connected to academic tick-related resources to identify trusted sources of Lyme disease prevention information, explore confidence in tick bite prevention information, and examine associations of these responses with answers to commonly disputed issues. The survey was conducted through social media and website pages for Western Connecticut State University Tickborne Disease Prevention Laboratory and the University of Rhode Island TickEncounter Resource Center. Respondents (N=1190) were predominantly female (903/1190, 76.3%), middle-aged (574/1182, 48.6%), and resided in New England states (663/1190, 55.7%). In total 984 of 1186 (83%) respondents identified conventional experts (eg, the Centers for Disease Control [CDC] or other government health agencies, physicians who follow Infectious Diseases Society of America guidelines for Lyme disease treatment guidelines, and academics) as trustworthy TBD prevention resources. However, nearly one-fourth of respondents would first consult personal contacts and web-based communities regarding prevention information before consulting conventional expert sources. The opinions of public health experts and physicians were rated among the top motivators underlying personal prevention decisions; yet, more than 50% of participants revealed distrustful attitudes toward, or were uncertain about, CDC-supported statements related to time to transmission of Lyme disease (708/1190, 59.5%), the safety of diethyltoluamide-based repellents for children (604/1183, 51.1%), and recommended use of antibiotic prophylaxis (773/1181, 65.4%). Multimodal regression models revealed that participants from high-Lyme-disease-incidence states were more likely to first seek TBD prevention information from personal networks and nontraditional sources before approaching conventional sources of TBD prevention information. We found that those reporting high rates of social media usage were more than twice as likely to first seek traditional expert sources of prevention information but were overall more likely to reject CDC-promoted Lyme disease information, in particular the established time to transmission of Lyme disease bacteria. Models also predicted that those participants who disagreed with the conventional scientific view on the antibiotic prophylaxis prevention statement were less likely to be confident in their ability to protect themselves from a tick bite. Overall, uncertainty in one's ability to protect oneself against tick bites was strongly associated with uncertainty about beliefs in CDC-promoted TBD prevention information. Self-reported trust in experts and frequency of social media use suggest that these platforms may provide opportunities to engage directly with the public about TBD prevention practices. Using strategies to improve public trust and provide information where the public engages on social media may improve prevention communication and adoption of best practices.

Which trial do we need? Treatment of multiple erythema migrans with doxycycline for 7 days versus 14 days

Which trial do we need? Treatment of multiple erythema migrans with doxycycline for 7 days versus 14 days

Lyme disease and the pursuit of a clinical cure.

Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne illness in the United States. Many aspects of the disease are still topics of controversy within the scientific and medical communities. One particular point of debate is the etiology behind antibiotic treatment failure of a significant portion (10-30%) of Lyme disease patients. The condition in which patients with Lyme disease continue to experience a variety of symptoms months to years after the recommended antibiotic treatment is most recently referred to in the literature as post treatment Lyme disease syndrome (PTLDS) or just simply post treatment Lyme disease (PTLD). The most commonly proposed mechanisms behind treatment failure include host autoimmune responses, long-term sequelae from the initial Borrelia infection, and persistence of the spirochete. The aims of this review will focus on the in vitro, in vivo, and clinical evidence that either validates or challenges these mechanisms, particularly with regard to the role of the immune response in disease and resolution of the infection. Next generation treatments and research into identifying biomarkers to predict treatment responses and outcomes for Lyme disease patients are also discussed. It is essential that definitions and guidelines for Lyme disease evolve with the research to translate diagnostic and therapeutic advances to patient care.

Outpatient Treatment of Lyme Disease.

Lyme disease, also called Lyme borreliosis, is caused by the spirochete Borrelia burgdorferi sensu stricto (B burgdorferi) in the Upper Atlantic Coast and Borrelia mayonii in the Upper Midwest and West Coast. It can cause a range of manifestations including erythema migrans, cranial nerve palsies, meningitis, carditis, and arthritis. Recent guidelines advocate for outpatient treatment for many of these conditions. Scenarios will be presented that outline treatment of these manifestations.

Outpatient Treatment of Lyme Disease

Outpatient Treatment of Lyme Disease

Disulfiram—Mitigating Unintended Effects

Lyme disease caused by infection with a multitude of vector-borne organisms can sometimes be successfully treated in its very early stages. However, if diagnosis is delayed, this infection can become disseminated and, like another spirochetal infection syphilis, can affect multiple organ systems in the body, causing a wide variety of life-altering symptoms. Conventional antibiotic therapy may not be effective in eradicating the symptoms of the disease we know as Lyme disease. The recent literature has suggested that disulfiram (DSM) may be a potent drug in the armamentarium of physicians who treat chronic Lyme disease. The use of disulfiram in the treatment of Lyme disease started with a researcher who determined that DSM is bactericidal to spirochete. Encouraged by published case reports of apparent recovery from chronic Lyme disease, having prescribed DSM ourselves in the past for alcoholics who had a desire to stop drinking and prescribing it now for patients with chronic Lyme disease, we observed both predictable and potentially avoidable side effects not necessarily related to the ingestion of alcohol. We reviewed the published literature in PubMed and Google Scholar, using the following key words: Lyme Disease; Borrelia burgdorferi treatment; and disulfiram toxicity. This paper outlines the results of that research to help avoid some of the pitfalls inherent in this novel use of an old and established medication in the practice of clinical medicine.

Lyme Disease: A Zoonosis Tick-Borne Borrelia Bacterium [2/4

Lyme disease is present worldwide but is most prevalent in the temperate regions of the hemisphere, where it is the primary vector-borne illness. Every year, numerous individuals in Europe and the United States receive a diagnosis and undergo treatment for Lyme disease. The transmission of tick-borne diseases is a complex process, and it is challenging to identify the factors that contribute to their spread. Epidemiology provides a means of analyzing the distribution of Lyme disease within a population and identifying risk factors

1335. Retrospective evaluation of doxycycline for the treatment of Lyme disease among young children

Abstract Background Lyme disease is the most common pediatric tickborne infection. Due to largely disproven concerns of doxycycline-related dental staining among patients < 8 years old, no prospective data exist on efficacy and adverse effects in young children with Lyme disease. Based on emerging data, our institution has used doxycycline during the past decade when alternatives cannot be given. Our study aims to describe short-term adverse effects and treatment failures among young children receiving oral doxycycline for Lyme disease. Methods Retrospective chart review of patients < 8 years old within the Stony Brook Medicine system from 2010-2020. Patients were identified by ICD-9/-10 codes for Lyme disease prescribed doxycycline at the same visit. We excluded those lacking an objective finding of Lyme disease, including single or multiple erythema migrans (EM), facial nerve palsy, carditis, meningitis (headache with pleocytosis >5 WBC/μL), and/or arthritis, those with an alternative diagnosis, and those receiving post-tick exposure prophylactic doxycycline. Data collected included demographics, symptoms, laboratory results, treatments, and outcomes. Descriptive statistics were calculated. Results 32 charts were included. Average age was 5.1 years. 66% were male. The majority of the patients presented with a single EM (Table for presenting symptoms). Initial antibiotics were doxycycline (63%) or a beta-lactam (37%). Rationale for doxycycline included beta-lactam allergy or intolerance (47%), required for treatment of clinical syndrome (such as CNS disease) (28%), concern for alternative tickborne infection (3%), and no reason given (22%). There were no severe adverse reaction to doxycycline; 2 patients stopped due to nausea/vomiting and 1 due to refusal of oral medications. Among the 29 patients who completed doxycycline, there were no known Lyme disease treatment failures. Presenting symptoms of children <8 years old treated with doxycycline for Lyme disease Total percent exceeds 100% due to patients presenting with multiple symptoms. Percent calculation based on all included patients (n = 32). Conclusion In this small cohort of young children with Lyme disease, doxycycline was generally well-tolerated, without severe short-term adverse effects, and resulted in no treatment failures. As there is no prospective data evaluating doxycycline in this population and future randomized trials are unlikely, the data presented provides reassurance that doxycycline is effective and safe for this indication. Disclosures All Authors: No reported disclosures.

Clinical presentation and Treatment of Lyme Disease

Clinical presentation and Treatment of Lyme Disease Abstract. Lyme borreliosis is a tick-born disease caused by Borrelia burgdorferi sensu lato characteristically occurring in the northern hemisphere. Typically, the first manifestation is a localized infection of the skin with an expanding rash, commonly referred to as Erythema migrans. Early disseminated infections typically affect the central nervous system and, less commonly, the heart causing carditis. Late manifestations include arthritis and skin involvement, the so called "Acrodermatitis atrophicans". However, the chronology of signs and symptoms is not a necessity: late manifestations of the disease might also present as the first symptoms and need to be considered accordingly. With the exemption of Erythema migrans, which does not require serology, the diagnosis of infection with Borrelia relies on a synthesis of signs and symptoms and a positive serology. Infection with Borrelia can be treated with appropriate antibiotic regimens, especially beta-lactam derivatives and tetracyclines. Despite successful treatment, post-infectious symptoms may develop in a fraction of patients.

A multimodal neuroimaging study of brain abnormalities and clinical correlates in post treatment Lyme disease.

Lyme disease is the most common vector-borne infectious disease in the United States. Post-treatment Lyme disease (PTLD) is a condition affecting 10–20% of patients in which symptoms persist despite antibiotic treatment. Cognitive complaints are common among those with PTLD, suggesting that brain changes are associated with the course of the illness. However, there has been a paucity of evidence to explain the cognitive difficulties expressed by patients with PTLD. This study administered a working memory task to a carefully screened group of 12 patients with well-characterized PTLD and 18 healthy controls while undergoing functional MRI (fMRI). A subset of 12 controls and all 12 PTLD participants also received diffusion tensor imaging (DTI) to measure white matter integrity. Clinical variables were also assessed and correlated with these multimodal MRI findings. On the working memory task, the patients with PTLD responded more slowly, but no less accurately, than did controls. FMRI activations were observed in expected regions by the controls, and to a lesser extent, by the PTLD participants. The PTLD group also hypoactivated several regions relevant to the task. Conversely, novel regions were activated by the PTLD group that were not observed in controls, suggesting a compensatory mechanism. Notably, three activations were located in white matter of the frontal lobe. DTI measures applied to these three regions of interest revealed that higher axial diffusivity correlated with fewer cognitive and neurological symptoms. Whole-brain DTI analyses revealed several frontal lobe regions in which higher axial diffusivity in the patients with PTLD correlated with longer duration of illness. Together, these results show that the brain is altered by PTLD, involving changes to white matter within the frontal lobe. Higher axial diffusivity may reflect white matter repair and healing over time, rather than pathology, and cognition appears to be dynamically affected throughout this repair process.

The Spectrum of Erythema Migrans in Early Lyme Disease: Can We Improve Its Recognition?

Background and objective Diagnosis of early Lyme disease (LD) often relies on clinical recognition of the skin lesion, erythema migrans (EM), a diagnostic sign of disease when laboratory testing is insensitive.Because EM can present in morphologically distinct forms, its recognitionby clinicians can be challenging.This study aimed to characterize the clinical spectrum of lesions in patients presenting with suspected early LD in an ambulatory care setting to identify features that might help clinicians to be better prepared to recognize EM lesions. Methods Images of lesions from 69 participants suspected to have early LD were retrospectively evaluated by a dermatologist and a family practitioner with expertise in early LD.Reviewers made determinations on the diagnoses and morphological features of lesions.Agreement between reviewers and associations among lesion types and participant demographics, symptomology, and laboratory evidence of infection were examined using the kappa statistic and contingency tables, respectively. Results Challenges in diagnosing EM were evident in our study:initial concordance between reviewers was moderate [kappa statistic (95% CI): 0.45 (0.245 - 0.657)]. The final classification included 35 lesions (51%) that were agreed to be EM; 23 lesions (30%) were considered to be possible early EM or tick bite reactions, and 11 (16%) were thought notto be EM, but rather other diagnoses, including ringworm, allergic contact dermatitis, and mosquito bites.Only two lesions (6%) were observed with a classic bull's eye or ring-within-a-ring pattern.Most EM lesions were uniform (51%), pink (74%), oval lesions (63%), with well-demarcated borders (92%).Early EM or tick bite reactions were typically <5 cm in size (74%), red (52%), round lesions (61%), with a punctum present (100%).Lesions thought notto be EM also tended to be pink or red (64%), round (55%), or uniform (45%) lesions, but also had raised (25%) or irregular borders (33%), which were not commonly observed in the reviewer-classified EM or tick bite reaction lesions.Participants with lesions classified as EM reported that they had the lesions for more days (p = 0.043) and reported more symptoms (p = 0.017) than participants with other lesions.Only 14 (20%) participants overall had positive laboratory evidence for LD; these included 13 (37%) of the participants with EM-classified lesions. Conclusions EM commonly occurs in forms that are not the classic bull's eye.Patients often present with lesions that may represent the very early stage of EM or tick bite reactions, and most patients will test negative on currently available laboratory tests, challenging clinicians in making an LD diagnosis or treatment decisions.Additional studies to further characterize the morphological features of EM and how variation in skin lesions may be perceived among clinicians would be helpful for developing guidelines onimproving clinician recognition of EM.

Analysis of the Causes for Renal Dysfunction during Antibiotic Therapy in a Patient with Lyme Disease

Adverse drug reactions (ADRs) are recorded throughout the lifecycle of a medicinal product. In the post-marketing period, new ADRs are primarily identified via drug safety signals. In order to assess a signal and establish causality between an adverse drug reaction and a suspected medicinal product, it is necessary to evaluate the signal strength and quality.The aim of the study was to analyse the information submitted to Russian regulatory authorities by a patient and check it for a potential causal association of acute tubulointerstitial nephritis (ATIN) with the use of ceftriaxone and with the patient’s principal diagnosis, Lyme disease.Materials and methods: the authors analysed the patient’s submission received by the Ministry of Health of the Russian Federation in 2022 with a complaint that the treatment of Lyme disease with ceftriaxone had caused ATIN. The probability of a causal relationship between the medicinal product and the ADR was evaluated using the Naranjo algorithm.Results: according to the review of literature and the spontaneous reports collected in Pharmacovigilance 2.0, the database in the Automated Information System of the Russian Federal Service for Surveillance in Healthcare, both ceftriaxone and the underlying condition (Lyme disease) may cause renal abnormalities. Ceftriaxone is potentially nephrotoxic; it mainly affects the tubular system of the kidneys. Borreliosis may cause kidney damage as well; such damage manifests clinically as rapidly progressing and fatal damage to the glomeruli.Conclusions: the probability of a causal relationship between the development of ATIN in the complainant and the use of ceftriaxone was categorised as “possible”. However, the information available did not allow for establishing a definite relationship between kidney damage and the use of the medicinal product. Further monitoring of similar cases is necessary to minimise the risks of developing this pathology during treatment with ceftriaxone.

Inhibition of Borrelia burgdorferi by 3,3-Diindolylmethane: A Research Protocol

Introduction: The spread of Borrelia burgdorferi is greatly exacerbated by the climate crisis. Rising global temperatures have increased the geographic range of B. burgdorferi-carrying ticks. 3,3-diindolylmethane (DIM) is a widely used estrogen supplement with a highly concentrated positive charge on one side, potentially inhibiting bacterial growth by attracting the negatively charged bacterial membranes, causing membrane tearing. DIM could allow for more comfortable treatment of Lyme Disease, as it displays no significant side effects when consumed up to 200 mg/L. Conversely, current antimicrobial protein-based drugs may induce side effects at their minimum inhibitory concentration. Methods: To determine whether DIM displays antimicrobial properties and could therefore be an inexpensive and ergonomic treatment, its effect on membrane-enclosed vesicles will be compared with polymyxin B, which is known to inhibit membrane structural integrity. This will be analyzed by filling vesicles with red aniline dye, then establishing three groups with different treatments. The test, positive control, and negative control groups will be treated with DIM, polymyxin B, and no treatment respectively. The resulting absorbencies of the test, positive control, and negative control groups will be compared. Results: The test group could show significant absorbance differences when compared to the positive and negative control groups, or no significant absorbance differences when compared to these groups. Positive and negative control groups should be compared with each other to ensure the groups display substantial and negligible dye release respectively. Discussion: If the test group shows a significant absorbance difference from the negative or both positive and negative control groups, it can be concluded that DIM displays significant antimicrobial properties. Because the results illustrate DIM is as effective or more effective than polymyxin B at inhibiting B. burgdorferi cell membranes, DIM will be an effective treatment for Lyme disease. These results are only reliable if the standard deviations of each group do not overlap, and the positive control group has a significantly higher absorbance than the negative control group. Conclusion: If the results suggest DIM displays strong enough antimicrobial properties to treat Lyme disease, its structure should be modified to improve integration into the bloodstream and gastrointestinal tract.

Development of novel chemical probes for the treatment of Lyme disease

Development of novel chemical probes for the treatment of Lyme disease

Immune Responses to Some Viral Infections That Have a High Evolutionary Potential-A Case Report with Literature Review.

Viral infections are a key issue in modern medicine. SARS-CoV-2 infection confirms that we are not sufficiently prepared for these unforeseen infections. The COVID-19 pandemic has cultivated a great sense of fear and distrust in patients. If viral infections, in this case, SARS-CoV-2, overlap with another infection, the symptoms are prolonged and worsened, and complications may occur. Starting from an objective clinical finding of a patient they had in follow-up and treatment, the authors present the problems of the diseases the patient suffered from. These are described as reviews so that readers can get an idea of the clinical methods of expression and the therapeutic possibilities. Therefore, this article describes Lyme disease and post-treatment Lyme disease syndrome, SARS-CoV-2 infection, and multisystem inflammatory syndrome in children (MISC-C), as the patient suffered from an incomplete form of Kawasaki disease. During the treatment for Lyme disease, the patient also contracted the influenza type A virus. Although any of these diseases could have the potential for serious evolution, our patient still went through these infections relatively well. This can be explained by the fact that the patient had a slow immune response to the aforementioned infections, which allowed him to survive these diseases relatively easily, unlike other individuals who have an exaggerated immune response or who suffer from serious immune involvement, e.g., hepatitis B with a fulminant response. The case was presented chronologically, but at the same time, all particular infection manifestations were accurately described. For these reasons, the article is presented in the form of a review, exemplified by the case itself. Of the 52 cases of MISC-C found in the Pediatrics Clinic II of Cluj-Napoca, we present the case of a male patient who presented with Lyme disease, post-treatment Lyme disease syndrome, Kawasaki disease, and MISC-C incomplete form.

Eradication of Borrelia Burgdoferi in vitro using Chlorine Dioxide: A Novel Approach

Lyme disease, which is caused by the spirochete Borrelia burgdorferi is the most prevalent tick-borne illness in the world today and has grown into a major public health problem during the last decade, irrelevant to decades of efforts from various health professionals. The conventional treatment for Lyme disease is the use of a variety of antibiotics, but relapse often occurs when antibiotics are discontinued. There are several reasons why this relapse may occur, given that B. burgdorferi is a pleomorphic microorganism that can convert from vegetative spirochetes to a variety of different round bodies and biofilm colonies. Therefore, there is an urgent need for novel approaches that can eliminate all these different morphologies. This has challenged many health practitioners around the world, not to mention the suffering of many afflicted people. In this study, Chlorine dioxide (CD) at different concentrations was tested for its effectiveness in vitro against B. burgdorferi using combined fluorescent and darkfield microscopy with Live-or-Dye staining methods. Our experiments demonstrated that it is possible to completely eradicate all forms of B. burgdorferi at specific concentrations of Chlorine dioxide. Our extensive research has shown that Chlorine dioxide can be used for the eradication of B. burgdorferi morphologies. At certain concentrations of chlorine dioxide above 2 ppm the Borrelia morphologies appear to be eradicated as there is no motility of either spirochetes or round bodies, only biofilms visible. However, incubating again for another 7 days resulted in the Borrelia being motile again as they come out of the biofilms. We, therefore, decided to conduct each experiment with what we termed the Regrowth Kill Test (RKT) by incubating the initial sample with the CD in an incubator at 37 degrees centigrade in the Campypack for 7-days. It appeared that the biofilms that are quickly formed as soon as the CD is added in the initial experiment, broke up and released small spirochetes and round bodies of different morphologies. After numerous RKT experiments, it was determined that the concentration that resulted in a near complete disinfection of the spirochetes as well as round bodies was 30 ppm CD.

Rare case of acute transverse myelitis associated with Lyme neuroborreliosis.

Acute transverse myelitis is a neurological disorder that leads to acute spinal cord injury due to inflammation caused by autoimmune disorders or by parainfectious etiologies. Among the many different infectious causes of transverse myelitis, one of the rare ones is Lyme disease. Here we describe a case of a 62 year old male who presents with bilateral paresthesia and weakness. MRI imaging of the cervical and thoracic spine led to the initial diagnosis of cervical cord edema leading to the symptoms associated transverse myelitis. However further workup of different infectious causes lead to positive Lyme titers with positive confirmatory ELISA testing. Initiation of Lyme disease treatment with IV ceftriaxone led to the gradual resolution of the symptoms.

A Small Cohort of Patients with Post Treatment Lyme Disease Syndrome Treated with HIFEM

A Small Cohort of Patients with Post Treatment Lyme Disease Syndrome Treated with HIFEM