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Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
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Lyme neuroborreliosis
Uwe Koedel1, Hans-Walter Pfister
1Department of Neurology, Clinic of the Ludwig-Maximilians University of Munich, Munich, Germany.
Current Opinion in Infectious Diseases
|November 8, 2016
Summary
Persistent symptoms after Lyme disease treatment, known as post-treatment Lyme disease syndrome (PTLDS), remain controversial. Current evidence suggests PTLDS patients do not have persistent infection and do not benefit from further antibiotics.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Lyme disease is a complex, multisystem illness with neurological complications (Lyme neuroborreliosis, LNB) affecting approximately 10% of patients.
- While early and late LNB diagnostics and treatments are established, persistent symptoms post-treatment present ongoing challenges.
Purpose of the Study:
- To review the controversial management of persistent symptoms in Lyme disease, focusing on post-treatment Lyme disease syndrome (PTLDS).
- To clarify the current understanding and evidence regarding PTLDS, its pathogenesis, and treatment efficacy.
Main Methods:
- Review of current scientific literature and guidelines regarding Lyme neuroborreliosis (LNB) and post-treatment Lyme disease syndrome (PTLDS).
- Analysis of diagnostic criteria and therapeutic outcomes for patients with persistent symptoms after Lyme disease treatment.
Main Results:
- Lyme disease incidence may be underestimated; accurate diagnosis of LNB relies on guideline-adherent serological tests.
- Most LNB patients achieve good outcomes, but some develop PTLDS with nonspecific symptoms.
- Evidence suggests PTLDS patients do not harbor persistent Borrelia burgdorferi infection and do not benefit from additional antibiotic therapy.
Conclusions:
- Acute and late LNB are recognized conditions, but the disease entity of PTLDS requires further investigation.
- Unproven alternative therapies for Lyme disease lack evidence of efficacy and tolerability.
- Management of persistent symptoms in Lyme disease remains a complex area needing further research.
