Chronic Lyme disease

Chronic Lyme disease is a generally rejected diagnosis that encompasses "a broad array of illnesses or symptom complexes for which there is no reproducible or convincing scientific evidence of any relationship to Borrelia burgdorferi infection." Despite numerous studies, there is no clinical evidence that "chronic" Lyme disease is caused by a persistent infection. It is distinct from post-treatment Lyme disease syndrome, a set of lingering symptoms which may persist after successful treatment of infection with Lyme spirochetes. The symptoms of "chronic Lyme" are generic and non-specific "symptoms of life".

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 can be in different forms while some people never recall having a rash.

Symptoms

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

A bulls-eye rash from the bite of a deer tick

Early Signs and Symptoms

• Bull's eye rash (Rash can be in other forms and 30% of the time no rash is present.)
• Flu-like symptoms

Later Signs and Symptoms

• Erythema migrans
• Joint pain
• Neurological problems

Signs and symptoms may also include

• Nausea and vomiting
• Diffuse rashes (rather than a single bull's-eye rash commonly associated with Lyme disease) See: Images

Less Common Signs and Symptoms

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

Treatment and management

• 2018, Lyme Disease Treatment & Management - Approach Considerations
• 2018, Lyme Disease Treatment & Management - Treatment of Early Lyme Disease
• 2018, Lyme Disease Treatment & Management - Post-Treatment Lyme Disease Syndrome

• Post-Treatment Lyme Disease Syndrome

Notable research

Spirochete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi

• 2013, Quirky Lyme disease bacteria: Unlike most organisms, they don't need iron, but crave manganese

• 2016, Ticks that transmit Lyme disease reported in nearly half of all US counties.

• 2016, Gene Signature Could Lead To A New Way Of Diagnosing Lyme

Multiple Pathogens

• 2016, Researchers identify new Borrelia species that causes Lyme disease

Pathobiome Paradigm

• 2015, Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.

United States Congressional Report

• 2018, Tick-Borne Disease Working Group - 2018 Report to Congress

Blood and other laboratory tests

United States

• Two-step Laboratory Testing Process
• Types of Lyme Disease Tests
• Laboratory tests that are not recommended

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

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

• 2013, Many tests to diagnose Lyme, but no proof they work

• 2013, Lyme Culture Test Causes Uproar

• 2014, Federal Loopholes Compromise Lyme Disease Testing

Co-infections

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.

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.

See also

• About the Deer Tick
• Borrelia burgdorferi
• Lyme disease

• Vagus nerve infection hypothesis

Learn more

• Lyme and Tick-Borne Diseases Research Center

• Lyme Disease Video Short
• Tickborne Diseases - Confronting a Growing Threat

myalgic encephalopathy An alternate term that is sometimes used for myalgic encephalomyelitis, by people who believe the evidence for inflammation in ME is insufficient. This terminology reflects the belief that the "-itis" suffix implies inflammation.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.