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Chronic Lyme disease
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'''Chronic Lyme disease''' is caused by a long-standing active ''Borrelia burgdorferi'' infection. There's an overwhelming amount of research, both ''in vitro'' and ''in vivo'', that supports the fact that B. burgdorferi can persist in the human body, not only in the spirochetal but also in the antibiotic-resistant biofilm form, even after antibiotic treatment.<ref>{{Cite web | url = https://www.dovepress.com/review-of-evidence-for-immune-evasion-and-persistent-infection-in-lyme-peer-reviewed-article-IJGM | title = Review of evidence for immune evasion and persistent infection in Lyme disease | last = Berndtson | first = Keith | date = 2013-04-23 | website = International Journal of General Medicine|language=English|doi=10.2147/ijgm.s44114|pmc = 3636972|pmid=23637552|access-date=2020-04-28}}</ref><ref name=":4">{{Cite journal | last = Stricker | first = Raphael B. | last2 = Johnson | first2 = Lorraine | date = 2013-04-22 | title = Persistent infection in chronic lyme disease: does form matter? | url = http://www.hoajonline.com/infectdis/2052-5958/1/2 | journal = Research Journal of Infectious Diseases|language=en | volume = 1 | issue = 1 | pages = 2 | doi=10.7243/2052-5958-1-2|issn=2052-5958}}</ref><ref>{{Cite journal | last = Sapi|first = Eva | last2 = Bastian | first2 = Scott L. | last3 = Mpoy | first3 = Cedric M. | last4 = Scott | first4 = Shernea | last5 = Rattelle | first5 = Amy | last6 = Pabbati | first6 = Namrata | last7 = Poruri | first7 = Akhila | last8 = Burugu | first8 = Divya | last9 = Theophilus | first9 = Priyanka A.S. | date = 2012-10-24 | title = Characterization of Biofilm Formation by Borrelia burgdorferi In Vitro | url = https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048277 | journal = PLOS ONE|language=en | volume = 7 | issue = 10| pages = e48277|doi=10.1371/journal.pone.0048277|issn=1932-6203|pmc = 3480481|pmid=23110225}}</ref><ref>{{Cite journal | last = Caskey|first = John R. | last2 = Hasenkampf | first2 = Nicole R. | last3 = Martin | first3 = Dale S. | last4 = Chouljenko | first4 = Vladimir N. | last5 = Subramanian | first5 = Ramesh | last6 = Cheslock | first6 = Mercedes A. | last7 = Embers | first7 = Monica E. | date = 2019 | title=The Functional and Molecular Effects of Doxycycline Treatment on Borrelia burgdorferi Phenotype | url =https://www.frontiersin.org/articles/10.3389/fmicb.2019.00690/full | journal = Frontiers in Microbiology|language=English | volume = 10|doi=10.3389/fmicb.2019.00690|issn=1664-302X |pmc = 6482230|pmid=31057493}}</ref><ref>{{Cite journal | last = Lacout | first = Alexis | last2 = Hajjam | first2 = Mostafa El | last3 = Marcy | first3 = Pierre-Yves | last4 = Perronne | first4 = Christian | date = 2018-07-01 | title = The Persistent Lyme Disease: “True Chronic Lyme Disease” rather than “Post-treatment Lyme Disease Syndrome” | url = http://www.jgid.org/article.asp?issn=0974-777X;year=2018;volume=10;issue=3;spage=170;epage=171;aulast=Lacout;type=0 | journal = Journal of Global Infectious Diseases|language=en | volume = 10 | issue = 3 | pages = 170|doi=10.4103/jgid.jgid_152_17|issn=0974-777X|pmc = 6100330|pmid=30166820}}</ref><ref>{{Cite journal | last = Middelveen | first = Marianne J. | last2 = Sapi | first2 = Eva | last3 = Burke | first3 = Jennie | last4 = Filush | first4 = Katherine R. | last5 = Franco | first5 = Agustin | last6 = Fesler | first6 = Melissa C. | last7 = Stricker | first7 = Raphael B. | date = Jun 2018 | title = Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease | url =https://www.mdpi.com/2227-9032/6/2/33 | journal = Healthcare|language=en | volume = 6 | issue = 2 | pages = 33|doi=10.3390/healthcare6020033|pmc = 6023324|pmid=29662016}}</ref><ref>{{Cite journal | last = Sharma | first = Bijaya | last2 = Brown | first2 = Autumn V. | last3 = Matluck | first3 = Nicole E. | last4 = Hu | first4 = Linden T. | last5 = Lewis | first5 = Kim | date = 2015-08-01 | title = Borrelia burgdorferi, the Causative Agent of Lyme Disease, Forms Drug-Tolerant Persister Cells |url =https://aac.asm.org/content/59/8/4616 | journal = Antimicrobial Agents and Chemotherapy|language=en | volume = 59 | issue = 8 | pages = 4616–4624|doi=10.1128/AAC.00864-15|issn=0066-4804|pmid=26014929}}</ref><ref>{{Cite journal | last = Feng|first = Jie | last2 = Auwaerter | first2 = Paul G. | last3 = Zhang | first3 = Ying | date = 2015-03-25 | title = Drug Combinations against Borrelia burgdorferi Persisters In Vitro: Eradication Achieved by Using Daptomycin, Cefoperazone and Doxycycline | url =https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117207 | journal = PLOS ONE|language=en | volume = 10 | issue = 3| pages = e0117207|doi=10.1371/journal.pone.0117207|issn=1932-6203|pmc = 4373819|pmid=25806811}}</ref><ref>{{Cite journal | last = Locke | first = Jonathan W. | date = Jun 2019 | title = Complement Evasion in Borrelia spirochetes: Mechanisms and Opportunities for Intervention | url =https://www.mdpi.com/2079-6382/8/2/80 | journal = Antibiotics|language=en | volume = 8 | issue = 2 | pages = 80|doi=10.3390/antibiotics8020080|pmc = 6627623|pmid=31200570}}</ref><ref>{{Cite journal | last = Wagemakers | first = A. | last2 = Visser | first2 = M.C. | last3 = de Wever | first3 = B. | last4 = Hovius | first4 = J.W. | last5 = van de Donk | first5 = N.W.C.J. | last6 = Hendriks | first6 = E.J. | last7 = Peferoen | first7 = L. | last8 = Muller | first8 = F.F. |last9 = Ang | first9 = C.W. | date = 2018-08-02 | title = Case report: persistently seronegative neuroborreliosis in an immunocompromised patient | url = https://doi.org/10.1186/s12879-018-3273-8 | journal = BMC Infectious Diseases | volume = 18 | issue = 1 | pages = 362|doi=10.1186/s12879-018-3273-8|issn=1471-2334|pmc = 6090844|pmid=30071836}}</ref><ref>{{Cite journal | last = Rudenko|first = Natalie | last2 = Golovchenko | first2 = Maryna | last3 = Kybicova | first3 = Katerina | last4 = Vancova | first4 = Marie | date = 2019-05-16 | title = Metamorphoses of Lyme disease spirochetes: phenomenon of Borrelia persisters |url =https://doi.org/10.1186/s13071-019-3495-7 | journal = Parasites & Vectors | volume = 12 | issue = 1 | pages = 237|doi=10.1186/s13071-019-3495-7|issn=1756-3305|pmc = 6521364|pmid=31097026}}</ref><ref>{{Cite journal | last = Aslam|first = Bilal | last2 = Nisar | first2 = Muhammad Atif | last3 = Khurshid | first3 = Mohsin | last4 = Farooq Salamat | first4 = Muhammad Khalid | date = 2017-09-15 | title = Immune escape strategies of Borrelia burgdorferi | url = https://www.futuremedicine.com/doi/10.2217/fmb-2017-0013 | journal = Future Microbiology | volume = 12 | issue = 13 | pages = 1219–1237|doi=10.2217/fmb-2017-0013|issn=1746-0913}}</ref><ref>{{Cite journal | last = Maloney|first = Elizabeth L. | date = Nov 2016 | title = Controversies in Persistent (Chronic) Lyme Disease | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102277/ | journal = Journal of Infusion Nursing | volume = 39 | issue = 6 | pages = 369–375|doi=10.1097/NAN.0000000000000195|issn=1533-1458|pmc=5102277|pmid=27755213}}</ref><ref>{{Cite journal | last = Cabello|first = Felipe C. | last2 = Godfrey | first2 = Henry P. | last3 = Bugrysheva | first3 = Julia V. | last4 = Newman | first4 = Stuart A. | date = 2017 | title=Sleeper cells: the stringent response and persistence in the Borreliella (Borrelia) burgdorferi enzootic cycle | url =https://sfamjournals.onlinelibrary.wiley.com/doi/abs/10.1111/1462-2920.13897 | journal = Environmental Microbiology|language=en | volume = 19 | issue = 10 | pages = 3846–3862|doi=10.1111/1462-2920.13897|issn=1462-2920|pmc = 5794220|pmid=28836724}}</ref><ref>{{Cite journal | last = DeLong|first = Allison K. | last2 = Blossom | first2 = Barbara | last3 = Maloney | first3 = Elizabeth L. | last4 = Phillips | first4 = Steven E. | date = Nov 2012 | title = Antibiotic retreatment of Lyme disease in patients with persistent symptoms: A biostatistical review of randomized, placebo-controlled, clinical trials |url =https://doi.org/10.1016/j.cct.2012.08.009 | journal = Contemporary Clinical Trials | volume = 33 | issue = 6 | pages = 1132–1142|doi=10.1016/j.cct.2012.08.009|issn=1551-7144}}</ref><ref>{{Cite journal | last = Sapi|first = Eva | last2 = Kasliwala | first2 = Rumanah S. | last3 = Ismail | first3 = Hebo | last4 = Torres | first4 = Jason P. | last5 = Oldakowski | first5 = Michael | last6 = Markland | first6 = Sarah | last7 = Gaur | first7 = Gauri | last8 = Melillo | first8 = Anthony | last9 = Eisendle | first9 = Klaus | date = Dec 2019 | title = The Long-Term Persistence of Borrelia burgdorferi Antigens and DNA in the Tissues of a Patient with Lyme Disease | url =https://www.mdpi.com/2079-6382/8/4/183 | journal = Antibiotics|language=en | volume = 8 | issue = 4 | pages = 183|doi=10.3390/antibiotics8040183|pmc = 6963883|pmid=31614557}}</ref> Despite this, parts of the medical community discard this disease in conflict with science.<ref name=":4" /> [[File:Borrelia burgdorferi-cropped.jpg|225px|thumb|right|Spirochete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi]] == Symptoms == == Treatment and management == == Notable research == *2013, [http://www.sciencedaily.com/releases/2013/03/130321205712.htm Quirky Lyme disease bacteria: Unlike most organisms, they don't need iron, but crave manganese]<ref>{{Cite news |url =http://www.sciencedaily.com/releases/2013/03/130321205712.htm | title = Quirky Lyme disease bacteria: Unlike most organisms, they don't need iron, but crave manganese | last = | first = | date = Mar 21, 2013 | work=ScienceDaily|access-date=2018-09-03| archive-url = | archive-date = |url-status = | publisher=Woods Hole Oceanographic Institution|language=en}}</ref> *2016, [http://www.sciencedaily.com/releases/2016/01/160118102524.htm Ticks that transmit Lyme disease reported in nearly half of all US counties.]<ref>{{Cite news |url =http://www.sciencedaily.com/releases/2016/01/160118102524.htm | title = Ticks that transmit Lyme disease reported in nearly half of all US counties | last = | first = | date = Jan 18, 2016|work=ScienceDaily|access-date=2018-09-03| archive-url = | archive-date = |url-status = | publisher=Entomological Society of America|language=en}}</ref> *2016, [https://www.ucsf.edu/news/2016/02/401581/gene-signature-could-lead-new-way-diagnosing-lyme? Gene Signature Could Lead To A New Way Of Diagnosing Lyme]<ref>{{Cite web | url = https://www.ucsf.edu/news/2016/02/401581/gene-signature-could-lead-new-way-diagnosing-lyme? | title = Gene Signature Could Lead To A New Way Of Diagnosing Lyme | last = Kurtzman | first = Laura | date = Feb 12, 2016 | website = UC San Francisco|language=en| archive-url = | archive-date = |url-status = | access-date=2018-09-03}}</ref> === Multiple Pathogens === *2016, [http://www.sciencedaily.com/releases/2016/02/160208135440.htm Researchers identify new Borrelia species that causes Lyme disease]<ref>{{Cite news |url =https://www.sciencedaily.com/releases/2016/02/160208135440.htm | title = Researchers identify new Borrelia species that causes Lyme disease: Until now, Borrelia burgdorferi was only species believed to cause Lyme disease in North America | last = | first = | date = Feb 8, 2016|work=ScienceDaily|access-date=2018-08-13| archive-url = | archive-date = |url-status = | publisher=|language=en}}</ref> ====Pathobiome Paradigm==== * 2015, Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.<ref name="VayssierT20152">{{citation | last1 = Vayssier-Taussat | first1 = M | author-link1 = | last2 = Kazimirova | first2 = M | author-link2 = | last3 = Hubalek | first3 = Z | author-link3 = | last4 = Hornok | first4 = S | author-link4 = | last5 =Farkas | first5 = R | author-link5 = | last6 = Cosson | first6 = JF | author-link6 = | last7 = Bonnet | first7 = S | author-link7 = | last8 = Vourch | first8 = G | author-link8 = | last9 = Gasqui | first9 = P | author-link9 = | last10 = Mihalca | first10 = AD | author-link10 = | last11 = Plantard | first11 = O | author-link11 = | last12 = Silaghi | first12 = C | author-link12 = | last13 = Cutler | first13 = S | author-link13 = | last14 = Rizzlo | first14 = A | author-link14 = | title = Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm | journal = Future Microbiol | volume = 10 | issue = 12 | page = 2033-43 | date = Nov 19, 2015 | pmid = 26610021 | doi = 10.2217/fmb.15.114 | url = http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114 }}</ref> === United States Congressional Report === * 2018, [https://drive.google.com/viewerng/viewer?url=https://www.hhs.gov/sites/default/files/tbdwg-report-to-congress-2018.pdf Tick-Borne Disease Working Group - 2018 Report to Congress]<ref>{{Cite web | title = Tick-Borne Disease Working Group - 2018 Report to Congress |url =https://drive.google.com/viewerng/viewer?url=https://www.hhs.gov/sites/default/files/tbdwg-report-to-congress-2018.pdf | website=drive.google.com|access-date=2018-11-26|language=en | date = 2018 | last = Aucott | first = John N|archive-url=|archive-date=|url-status= | last2 = Honey | first2 = Kristen T | last3 = Adams | first3 = Wendy | last4 = Beard | first4 = Charles Benjamin | last5 = Cooper | first5 = Captain Scott | last6 = Dixon | first6 = Dennis | last7 = Horowitz | first7 = Richard | last8 = Jones | first8 = Captain Estella | last9 = Nigrovic | first9 = Lisa E|others=Allen Richards; Robert Sabatino; Vanila Singh; Patricia Smith; Robert Smith}}</ref> == Blood and other laboratory tests == ===United States=== *[http://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html Two-step Laboratory Testing Process]<ref>{{Cite web | url = http://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html | title = Two-step Laboratory Testing Process{{!}} Lyme Disease {{!}} CDC | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-09-03}}</ref> *[http://lymediseaseguide.org/types-of-lyme-disease-tests Types of Lyme Disease Tests]<ref>{{Cite web | url = http://lymediseaseguide.org/types-of-lyme-disease-tests | title = Types of Lyme Disease Tests | last = | first = | date = May 27, 2011 | website = lymediseaseguide.org|language=en-US| archive-url = | archive-date = |url-status = | access-date=2018-09-03}}</ref> *[http://www.cdc.gov/lyme/diagnosistesting/LabTest/OtherLab/index.html Laboratory tests that are not recommended]<ref>{{Cite web | url = http://www.cdc.gov/lyme/diagnosistesting/LabTest/OtherLab/index.html | title = Laboratory tests that are not recommended{{!}} Lyme Disease {{!}} CDC | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-09-03}}</ref> === United Kingdom === *BBC1 Lyme Disease Discussion - Some patients have waited up to 30 years for a correct diagnosis. [[National Health Service]] (NHS) services have only correctly identified the disease in a quarter of the patients. The blood tests are unreliable and often come back negative. The development of an accurate blood test is in need of research funding.<ref>{{Cite web | url = https://www.youtube.com/watch?v=R1-a8kowVkE&app=desktop | title = BBC1 Lyme Disease 27.02.2016 | last = Loukas | first = Demetrios | date = Feb 27, 2016 | website = YouTube| publisher = Katherine Allman|via=| archive-url = | archive-date = |url-status = | access-date=}}</ref> *[[Department of Health and Social Care (UK)]] [http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_106528.pdf Testing for Lyme Disease]<ref name=":0">{{Cite web | url = http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_106528.pdf | title=Testing for Lyme Disease | last = Donaldson | first = Liam | date = 2009 | website = webarchive.nationalarchives.gov.uk| page=4|type=PDF| archive-url = | archive-date = |url-status = | access-date=}}</ref> ===False positives=== Several herpesviruses including [[varicella zoster virus]]<ref name="Feder1991" /><ref name="Woelfle1998" />, [[cytomegalovirus]], [[Epstein-Barr virus]],<ref name="Goossens1999" /> and [[Herpes simplex virus#HSV-2|HSV-2]]<ref name="Strasfeld2005" /> may cause false positives on Lyme Disease tests. === News media on unapproved tests === *2005, [http://www.nytimes.com/2005/08/23/health/policy/unproved-lyme-disease-tests-prompt-warnings.html?_r=0 Unproved Lyme Disease Tests Prompt Warnings]<ref>{{Cite news |url =http://www.nytimes.com/2005/08/23/health/policy/unproved-lyme-disease-tests-prompt-warnings.html?_r=0 | title = Unproved Lyme Disease Tests Prompt Warnings | last = Santora | first = Dan Hurley and Marc|access-date=2018-09-03|language=en}}</ref> *2013, [https://www.bostonglobe.com/lifestyle/health-wellness/2013/10/20/many-tests-diagnose-lyme-but-proof-they/ISjAcxmZxkk2disi94ENfI/story.html Many tests to diagnose Lyme, but no proof they work]<ref>{{Cite news |url =https://www.bostonglobe.com/lifestyle/health-wellness/2013/10/20/many-tests-diagnose-lyme-but-proof-they/ISjAcxmZxkk2disi94ENfI/story.html | title = Many tests to diagnose Lyme, but no proof they do - The Boston Globe | last = Daley | first = Beth | date = Oct 21, 2013|work=BostonGlobe.com|access-date=2018-09-03|archive-url=|archive-date=|url-status=}}</ref> *2013, [http://www.medscape.com/viewarticle/778482 Lyme Culture Test Causes Uproar]<ref>{{Cite web | url = http://www.medscape.com/viewarticle/778482 | title = Medscape Log In | last = Lyme Culture Test Causes Uproar | first = | date = | website = Medscape|url-access=registration| archive-url = | archive-date = |url-status = | access-date=2018-09-03}}</ref> *2014, [http://news.wgbh.org/post/federal-loopholes-compromise-lyme-disease-testing Federal Loopholes Compromise Lyme Disease Testing]<ref>{{Cite news |url =http://news.wgbh.org/post/federal-loopholes-compromise-lyme-disease-testing | title = Federal Loopholes Compromise Lyme Disease Testing | last = Daley|first = Beth | date = 2014-06-17|work=WGBH 89.7|access-date=2018-09-03| archive-url = | archive-date = |url-status = | language=en}}</ref> ==Co-infections== ===Herpesviruses=== Lyme may cause reactivation of latent [[herpesvirus]]es. At the same time, several herpesviruses including [[varicella zoster virus]],<ref name="Feder1991" /><ref name="Woelfle1998" /> [[cytomegalovirus]], [[Epstein-Barr virus|epstein-barr virus]],<ref name="Goossens1999" /> and [[Herpes simplex virus#HSV-2|HSV-2]]<ref name="Strasfeld2005" /> may cause false positives on lyme disease tests. === Pathobiome paradigm === Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.<ref name="VayssierT2015" /> == Lyme Disease vs Chronic Fatigue Syndrome == *2009, "The [[Department of Health and Social Care (UK)]] remains concerned about the growing number of patients, particularly those suffering from chronic conditions such as myalgic encephalopathy ([[myalgic encephalomyelitis|ME]]) or chronic fatigue syndrome, who receive a false diagnosis of Lyme disease from private laboratories offering unvalidated tests that lack the sensitivity and specificity to detect B. burgdorferi. A report of the Department’s investigation into the use of such tests in the diagnosis of Lyme disease is available at [http://webarchive.nationalarchives.gov.uk/20130107105354/http://dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4138917.pdf ''Report on Lyme Disease'': Unorthodox and Unvalidated Laboratory Tests in the Diagnosis of Lyme Borreliosis and in Relation to Medically Unexplained Symptoms]. Misinformation about Lyme disease is readily available to patients via the internet and can lead them to seek inappropriate diagnosis and treatment." <ref name=":0" /> *2011, Lyme Disease and [[Chronic Fatigue Syndrome]] are different diseases. Research is published on cerebrospinal fluid, and distinct differences were found.<ref name="Schutzer2011" /> *2016, [https://www.simmaronresearch.com/blog/2016/08/post-lyme-disease-and-chronic-fatigue-syndrome-mecfs-are-they-the-same Post Lyme Disease and Chronic Fatigue Syndrome (ME/CFS) – Are They The Same?]<ref>{{Cite news |url =https://www.simmaronresearch.com/blog/2016/08/post-lyme-disease-and-chronic-fatigue-syndrome-mecfs-are-they-the-same | title = Post Lyme Disease and Chronic Fatigue Syndrome (ME/CFS) - Are They The Same? - Simmaron Research | last = Johnson | first = Cort | date = 2016-08-06|work=Simmaron Research|access-date=2023-02-20| archive-url = | archive-date = |url-status = | language=en-US}}</ref> *There are [[many historical outbreaks]] of [[Myalgic Encephalomyelitis]] and [[Chronic Fatigue Syndrome]] that do not correlate with a tick-borne pathogen. ==See also== * [[Alpha-gal allergy]] *[https://www.nationalgeographic.com/animals/invertebrates/d/deer-tick/ About the Deer Tick]<ref>{{Cite news |url =https://www.nationalgeographic.com/animals/invertebrates/d/deer-tick/ | title = Deer Tick {{!}} National Geographic | date = 2010-04-11|access-date=2018-09-03}}</ref> * [[Borrelia burgdorferi]] * [[Lyme disease]] * [[Vagus nerve infection hypothesis]] ==Learn more== * [http://www.columbia-lyme.org/ Lyme and Tick-Borne Diseases Research Center]<ref>{{Cite web | url = https://www.columbia-lyme.org | title = Lyme Disease | last = | first = | date = | website = Columbia-lyme.org|language=en| archive-url = | archive-date = |url-status = | access-date=2018-08-13}}</ref> * [https://blausen.com/en/video/lyme-disease/ Lyme Disease]<ref>{{Cite web | url = https://blausen.com/en/video/lyme-disease/ | title = Lyme Disease | last = | first = | date = | website = blausen.com| publisher = Blausen| archive-url = | archive-date = |url-status = | access-date=}}</ref> Video Short * [https://www.nejm.org/doi/full/10.1056/NEJMp1807870#.W4x74fVA80g.twitter Tickborne Diseases - Confronting a Growing Threat]<ref>{{Cite journal | last = Paules | first = Catharine I. | last2 = Marston | first2 = Hilary D. | last3 = Bloom | first3 = Marshall E. | last4 = Fauci | first4 = Anthony S. | date = 2018-07-25 | title = Tickborne Diseases — Confronting a Growing Threat {{!}} NEJM | url = https://www.nejm.org/doi/full/10.1056/NEJMp1807870#.W4x74fVA80g.twitter | journal = New England Journal of Medicine|language=en|doi=10.1056/nejmp1807870#.w4x74fva80g.twitter}}</ref> == References == <references> <ref name="Feder1991">{{citation | last1 = Feder | first1 = HM Jr| author-link1 = | last2 = Gerber | first2 = MA | author-link2 = | last3 = Luger | first3 = SW | author-link3 = | last4 = Ryan | first4 = RW | author-link4 = | title = False-positive serologic tests for Lyme disease after varicella infection | journal = N Engl J Med | volume = 325 | issue = 26 | page = 1886-7 | date =Dec 1991 | pmid = 1961232 | url = http://www.ncbi.nlm.nih.gov/pubmed/1961232 }}</ref> <ref name="Goossens1999">{{citation | last1 = Goossens | first1 = HA | author-link1 = | last2 = Nohlmans | first2 = MK | author-link2 = | last3 = van den Bogaard | first3 = AE | author-link3 = | title = Epstein-Barr virus and cytomegalovirus infections cause false-positive results in IgM two-test protocol for early Lyme borreliosis | journal = Infection | volume = 27 | issue = 3 | page = 231 | date = May 1999 | pmid = 10378140 | url = http://link.springer.com/article/10.1007%2FBF02561539 }}</ref> <ref name="Schutzer2011">{{citation | last1 = Schutzer | first1 = SE | author-link1 = | last2 = Angel | first2 = TE | author-link2 = | last3 = Liu | first3 = T | author-link3 = | last4 = Schepmoes | first4 = AA | author-link4 = | last5 =Clauss | first5 = TR | author-link5 = | last6 = Adkins | first6 = JN | author-link6 = | last7 = Camp | first7 = DG | author-link7 = | last8 = Holland | first8 = BK | author-link8 = | last9 = Bergquist | first9 = J | author-link9 = | last10 = Coyle | first10 = PK | author-link10 = | last11 = Smith | first11 = RD | author-link11 = | last12 = Fallon | first12 = BA | author-link12 = | last13 = Natelson | first13 = BH | author-link13 = | title = Distinct Cerebrospinal Fluid Proteomes Differentiate Post-Treatment Lyme Disease from Chronic Fatigue Syndrome | journal = PLoS One | volume = 6 | issue = 2 | page = e17287 | date = Feb 23, 2011 | pmid = 21383843 | doi = 10.1371/journal.pone.0017287 | url = http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0017287 }}</ref> <ref name="Strasfeld2005">{{citation | last1 = Strasfeld | first1 = L | author-link1 = | last2 = Romanzi | first2 = L | author-link2 = | last3 = Seder | first3 = RH | author-link3 = | last4 = Berardi | first4 = VP | author-link4 = | title = False-Positive Serological Test Results for Lyme Disease in a Patient with Acute Herpes Simplex Virus Type 2 | journal = Clin Infect Dis | volume = 41 | issue = 12 | pages = 1826-1827 | date = 2005 | pmid = 16288417 | doi = 10.1086/498319 | url = http://cid.oxfordjournals.org/content/41/12/1826.full }}</ref> <ref name="VayssierT2015">{{citation | last1 = Vayssier-Taussat | first1 = M | author-link1 = | last2 = Kazimirova | first2 = M | author-link2 = | last3 = Hubalek | first3 = Z | author-link3 = | last4 = Hornok | first4 = S | author-link4 = | last5 = Farkas | first5 = R | author-link5 = | last6 = Cosson | first6 = JF | author-link6 = | last7 = Bonnet | first7 = S | author-link7 = | last8 = Vourch | first8 = G | author-link8 = | last9 = Gasqui | first9 = P | author-link9 = | last10 = Mihalca | first10 = AD | author-link10 = | last11 = Plantard | first11 = O | author-link11 = | last12 = Silaghi | first12 = C | author-link12 = | last13 = Cutler | first13 = S | author-link13 = | last14 = Rizzlo | first14 = A | author-link14 = | title = Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm | journal = Future Microbiol | volume = 10 | issue = 12 | page = 2033-43 | date = Nov 19, 2015 | pmid = 26610021 | doi = 10.2217/fmb.15.114 | url = http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114 }}</ref> <ref name="Woelfle1998">{{citation | last1 = Woelfle | first1 = J | author-link1 = | last2 = Wilske | first2 = B | author-link2 = | last3 = Haverkamp | first3 = F | author-link3 = | last4 = Bialek | first4 = R | author-link4 = | title = False-positive serological tests for Lyme disease in facial palsy and varicella zoster meningo-encephalitis | journal = Eur J Pediatr | volume = 157 | issue = 1 | page = 953-4 | date =Nov 1998 | pmid = 9835449 | url = http://www.ncbi.nlm.nih.gov/pubmed/9835449 }}</ref> </references> [[Category:Diagnoses]] [[Category:Potential comorbidities]]
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