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Open AccessArticle

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease

Atkins Veterinary Services, Calgary, AB T3B 4C9, Canada
Department of Biology and Environmental Science, University of New Haven, West Haven, CT 06516, USA
Australian Biologics, Sydney, NSW 2000, Australia
School of Health Sciences, Universidad Catolica Santiago de Guayaquil, Guayaquil 090615, Ecuador
Union Square Medical Associates, 450 Sutter Street, Suite 1504, San Francisco, CA 94108, USA
Author to whom correspondence should be addressed.
Healthcare 2018, 6(2), 33;
Received: 7 March 2018 / Revised: 27 March 2018 / Accepted: 11 April 2018 / Published: 14 April 2018
Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. Methods: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Results: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined. View Full-Text
Keywords: Lyme disease; Borrelia burgdorferi; tickborne disease; chronic infection; spirochete culture Lyme disease; Borrelia burgdorferi; tickborne disease; chronic infection; spirochete culture
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Middelveen, M.J.; Sapi, E.; Burke, J.; Filush, K.R.; Franco, A.; Fesler, M.C.; Stricker, R.B. Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease. Healthcare 2018, 6, 33.

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