Chronic Lyme disease

Chronic Lyme disease is caused by the bacterium Borrelia burgdorferi and transmitted through the bite of a deer tick or black legged tick. A bulls-eye rash can appear at the site of a deer tick bite but not always as the rash can be in different forms while some people never remember having a rash.

Symptoms
The signs and symptoms of Lyme disease vary and usually appear in stages.

Early Signs and Symptoms


 * Bull's eye rash (Not always present.)
 * Flu-like symptoms

Later Signs and Symptoms


 * Erythema migrans
 * Neurological problems

Less Common Signs and Symptoms


 * Heart problems, such as irregular heartbeat.
 * Eye inflammation
 * Liver inflammation (hepatitis).
 * Severe fatigue

United States

 * Two-step Laboratory Testing Process (CDC: EIA/IFA and Western Blot)
 * Types of Lyme Disease Tests (LymeDiseaseGuide.org)
 * Laboratory tests that are not recommended (CDC)

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.


 * Department of Health and Social Care (UK) Testing for Lyme Disease - Pg. 4

False positives
Several herpesviruses including varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and HSV-2 may cause false positives on Lyme Disease tests.

News media on unapproved tests

 * 2005, Unproved Lyme Disease Tests Prompt Warnings by Dan Hurley and Marc Santora via NY Times


 * 2013, Many tests to diagnose Lyme, but no proof they work by Beth Daley via Boston Globe


 * 2013, Lyme Culture Test Causes Uproar via Medscape (Login Needed)


 * 2014, Federal Loopholes Compromise Lyme Disease Testing by Beth Daley via WGBH 89.7

Treatment and management

 * 2018, Lyme Disease Treatment & Management - Approach Considerations by John O. Meyerhoff, MD via Medscape
 * 2018, Lyme Disease Treatment & Management - Treatment of Early Lyme Disease by John O. Meyerhoff, MD via Medscape
 * 2018, Lyme Disease Treatment & Management - Post-Treatment Lyme Disease Syndrome by John O. Meyerhoff, MD via Medscape


 * Post-Treatment Lyme Disease Syndrome via Centers for Disease Control and Prevention (CDC)

Herpesviruses
Lyme may cause reactivation of latent herpesviruses. At the same time, several herpesviruses including varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and HSV-2 may cause false positives on Lyme Disease tests.

Research

 * 2013, Quirky Lyme disease bacteria: Unlike most organisms, they don't need iron, but crave manganese, ScienceDaily, Woods Hole Oceanographic Institution


 * 2016, Ticks that transmit Lyme disease reported in nearly half of all US counties. ScienceDaily, Entomological Society of America


 * 2016, Researchers identify new Borrelia species that causes Lyme disease, ScienceDaily, Mayo Clinic


 * 2016, Gene Signature Could Lead To A New Way Of Diagnosing Lyme, UCSF News Center, Laura Kurtzman

Pathobiome paradigm
Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.

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 (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 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."
 * 2011, Lyme Disease and Chronic Fatigue Syndrome are different diseases. Research is published on cerebrospinal fluid, and distinct differences were found.
 * 2016, Post Lyme Disease and Chronic Fatigue Syndrome (ME/CFS) – Are They The Same?


 * There are many historical outbreaks of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome that do not correlate with a tick-borne pathogen.