Chronic Lyme disease: misconceptions and challenges for patient management

摘要: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside appropriate antimicrobial therapy. Nervous system involvement occurs in 10%–15% of patients typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; some rare cases, have parenchymal inflammation brain or spinal cord. is similarly highly responsive to therapy, including oral doxycycline. Nonspecific symptoms fatigue, perceived cognitive slowing, headache, others occur disease are indistinguishable from comparable occurring innumerable other inflammatory states. There no evidence that these reflect nervous damage, they any way diagnostic this infections. When also after treatment, although may take time. Chronic fatigue states been reported following number infections, disease. The mechanism underlying association unclear, there infections posttreatment attributable ongoing B. burgdorferi identified organism. Available appropriately controlled studies indicate additional prolonged courses therapy do not benefit fatigue-like state treated