Excerpt:

IDSA knows that chronic Lyme exists

The IDSA is aware that chronic Lyme exists. We know this because
members of the 2000 and 2006 Lyme disease guideline panels wrote, in
research articles and patents, that chronic Lyme exists.

Evidence about the existence of chronic Lyme borreliosis has increased
since the 2006 LD guidelines were published.

Scientists in California recently reported that not only can Bb persist
in mice despite treatment with ceftriaxone, but the Borrelia can also
infect other ticks and mice. (1) This study buttresses previous
studies that showed that Borrelia can persist in mice (2, 3), dogs (4,
5, 6), and ponies (7).

Studies have also shown that Bb can persist despite antibiotic
treatment in the following human cells, tissues, organs, and body
fluids:

* Fibroblasts (8; Mark Klempner, an IDSA LD guideline panel member in
2006, is an author of this study)

Excerpt:

Lyme optic neuritis (ON) is a rare disease and only a few cases
have been reported. We describe two cases of isolated Lyme ON,
one with recurrence 9 months after the appearance of initial
symptoms. Diagnosis criteria for multiple sclerosis and
neuromyelitis optica were not met. The etiological diagnosis was
based on European case definition criteria for neuroborreliosis.
Both patients had positive serum and cerebrospinal fluid
serology, a positive intrathecal anti-Borrelia antibody index,
and a good outcome on ceftriaxone. Specific diagnosis of Lyme ON
is important since improvement of visual acuity is possible with
specific antibiotherapy, even after many months. Copyright (c)
2010 Elsevier B.V. All rights reserved.

Excerpt:

Lyme disease is a tick-borne spirochetal infection that may
affect the heart.
Cardiac manifestations include conduction disturbances and other
pathologies of the heart. We report on a 37-year old male, who
was admitted to the emergency department because of Cardiac manifestations Physical examination and the initial
laboratory values revealed no abnormalities. The patient’s
electrocardiogram on admission revealed newly diagnosed
bradycardia due to atrioventricular heart block. The ventricular
heart rate was 35/min. The patient was admitted to the ICU. Lyme
serology and Western blot were positive for Borrelia antibodies.
After institution of antibiotic therapy with ceftriaxone,
atrioventricular heart block resolved rapidly. We therefore have
to assume that in this patient Lyme carditis was the cause of
third-degree AV block.

Excerpt:

A 57-year-old man was referred for a painful acute inferior visual field defect in his right eye.
Fundus examination of the right eye revealed diffuse optic disc oedema compatible with a papillitis. Cerebrospinal fluid (CSF) findings were consistent with lymphocytic meningitis, and serologic tests for Lyme disease were positive in both serum and CSF.
After treatment with ceftriaxone and bolus of methylprednisolone, right eye inferior altitudinal visual field defect persisted despite resolution of papillitis, and fundus examination disclosed a superior optic atrophy in the right eye.
To our knowledge, it is the first reported case of a unilateral Lyme optic neuritis occurring simultaneously to neuroborreliosis and further complicated by non-arteritic anterior ischaemic optic neuropathy

http://www.springerlink.com/content/b8x4742136623114/

Excerpt:

Abstract Dilated cardiomyopathy (DCM) represents the third most common cause of heart failure and the most frequent cause of heart transplantation. Infectious, mostly viral, and autoimmune mechanisms, together with genetic abnormalities, have been reported as three major causes of DCM. We hypothesized that Lyme disease (LD), caused by spirochete Borrelia burgdorferi (Bb), might be an important cause of new-onset unexplained DCM in patients living in a highly endemic area for LD such as the Czech Republic.

The effectiveness of a new first in class antibiotic, tigecycline
(glycylcycline), was evaluated during the early dissemination (1 week), early
immune (3 weeks), or late persistent (4 months) phases of Borrelia burgdorferi
infection in C3H mice. Mice were treated with high or low doses of tigecycline,
saline (negative-effect controls), or a previously published regimen of
ceftriaxone (positive-effect controls). Infection status was assessed at 3
months after treatment by culture, quantitative ospA real-time PCR, and
subcutaneous transplantation of joint and heart tissue into SCID mice. Tissues
from all saline-treated mice were culture- and ospA PCR-positive; tissues from
all antibiotic-treated mice were culture-negative; and some of the tissues from
most of the mice treated with antibiotics were ospA PCR-positive, although the
DNA marker load was markedly decreased compared to saline-treated mice.
Antibiotic treatment during the early stage of infection appeared to be more
effective than treatment that began during later stages of infection. The
viability of non-cultivable spirochetes in antibiotic-treated mice (demonstrable
by PCR) was confirmed by transplantation of tissue allografts from treated mice
into SCID mice, with dissemination of spirochetal DNA to multiple recipient
tissues, and by xenodiagnosis, including acquisition by ticks, transmission by
ticks to SCID mice, and survival through molting into nymphs and then into
adults. Furthermore, PCR-positive heart base tissue from antibiotic-treated mice
revealed RNA transcription of several B. burgdorferi genes. Results extended
previous studies with ceftriaxone, indicating that antibiotic treatment is
unable to clear persisting spirochetes, which remain viable and infectious, but
are non- or slowly dividing.

http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=19995919&retmode=ref&cmd=prlinks
PMID: 19995919  [PubMed – as supplied by publisher]

Antimicrob Agents Chemother. 2009 Dec 7; [Epub ahead of print]

Ineffectiveness of Tigecycline Against Persistent Borrelia burgdorferi.

Barthold SW, Hodzic E, Imai DM, Feng S, Yang X, Luft BJ.

Center for Comparative Medicine, Schools of Medicine and Veterinary Medicine,
University of California at Davis, One Shields Avenue, Davis, California 95616;
Division of Infectious Diseases, Department of Medicine, State University of New
York at Stony Brook, Stony Brook, New York 11794.