REVIEW - A critical appraisal of chronic Lyme disease

[Guest guest]

Volume 357:1422-1430 October 4, 2007 Number 14

A Critical Appraisal of " Chronic Lyme Disease "

Henry M. Feder, Jr., M.D., Barbara J.B. , Ph.D., O'Connell,

M.D., Eugene D. Shapiro, M.D., C. Steere, M.D., P. Wormser, M.D.,

and the Ad Hoc International Lyme Disease Group

Lyme disease, the most common tick-borne infection in the northern

hemisphere, is a serious public health problem. In North America, it is

caused exclusively by Borrelia burgdorferi sensu stricto (hereafter referred

to as B. burgdorferi), whereas in Europe it is caused by B. afzelii, B.

garinii, B. burgdorferi, and occasionally by other species of borrelia.1

This complex infection has a number of objective manifestations, including a

characteristic skin lesion called erythema migrans (the most common

presentation of early Lyme disease), certain neurologic and cardiac

manifestations, and pauciarticular arthritis (the most common presentation

of late Lyme disease), all of which usually respond well to conventional

antibiotic therapy.2 Despite resolution of the objective manifestations of

infection after antibiotic treatment, a minority of patients have fatigue,

musculoskeletal pain, difficulties with concentration or short-term memory,

or all of these symptoms. In this article, we refer to these usually mild

and self-limiting subjective symptoms as " post-Lyme disease symptoms, " and

if they last longer than 6 months, we call them " post-Lyme disease

syndrome. "

*************************

Read the rest of the article here:

http://content.nejm.org/cgi/content/full/357/14/1422

--

Not an MD