Posttreatment Lyme Disease Syndrome—What It Might Be and What It Is Not

Abstract

Lyme disease is a multisystem disease caused by Borrelia burgdorferi infection and accounts for well-defined manifestations, appearing either at an early or late stage. Appropriate antibiotic therapy generally leads to a favorable outcome.Still, unspecific persisting symptoms such as fatigue, myalgia, arthralgia or cognitive dysfunction are reported by several patients months to years after adequate treatment. Their underlying pathophysiologic mechanism is unclear. However, there is no evidence for microbiological persistence in these cases and attempts to resolve the symptoms by repeated or prolonged antibiotic treatment have not been convincingly successful, but they may rather be harmful. To narrow down the controversially handled entity of posttreatment Lyme disease syndrome (PTLDS) and to avoid overdiagnosis and overtreatment, case definitions have been proposed, acknowledging PTLDS as a complex of nonspecific, subjective symptoms, which are neither caused by ongoing infection nor by any other identifiable disease. PTLDS is mainly a diagnosis of exclusion and requires careful evaluation of differential diagnosis followed by counseling about optimal management in light of missing specific therapeutic options.

Immune Responses to Some Viral Infections That Have a High Evolutionary Potential—A Case Report with Literature Review

“…Some patients with Lyme disease have symptoms after months or years of antibiotic treatment, which is known as post-treatment Life 2022, 12, 940. https://doi.org/10.3390/life12070940 https://www.mdpi.com/journal/life Lyme disease syndrome (PTLDS). From the etiopathogenetic point of view, the syndrome is unclear and its management is not very well defined [2]. Lyme disease is common in Europe, North America, and Asia, and it affects 5-10% of tick-borne patients [3,4].…”