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Ceftriaxone appears to be just as effective in treating Lyme disease as doxycycline. A total of 140 patients with Lyme disease were randomly assigned to take oral doxycycline for 21 days or to receive intravenous or intramuscular ceftriaxone for 14 days. Cure rates were similar in both groups although 57% of the patients receiving ceftriaxone experienced side effects compared to 43% of those taking doxycycline. Patients receiving ceftriaxone were also more likely to have residual symptoms following the treatment.

Involvement of the central nervous system (CNS) may occur early in the course of infection in patients with Lyme disease. Lyme disease is an infection characterized by fever, headache and fatigue caused by the bacterium Borrelia burgdorferi. Samples of cerebrospinal fluid (CSF) from 12 patients with Lyme disease and 16 healthy individuals were tested for the presence of the bacterium. The CSF of eight of the patients with Lyme disease was infected by Borrelia burgdorferi compared to none of the healthy individuals. Of the eight patients with Borrelia burgdorferi in their CSF, only four had any symptoms of CNS infection. Four of the patients with CNS infection had skin lesions, and the other four had acute cranial neuritis, or inflammation of cranial nerves. Patients with Lyme disease should be given antibiotics that can treat infections in the CSF.

Some reports have suggested that there may be a relationship between Lyme borreliosis (Lyme disease), which is potentially treatable, and motor neuron disease, which is progressive and fatal. Although other studies have disputed the existence of a correlation, 19 patients with amyotrophic lateral sclerosis (ALS) living in Suffolk County, New York, were tested for antibodies to the Lyme disease spirochete Borrelia burgdorferi. Nine patients had evidence of exposure, as compared with 4 of 38 matched control subjects. None of the patients had Lyme disease. Curiously, although seven of the 19 patients were female, only one woman was positive for the antibodies. Patients from other regions where Lyme disease is not endemic had a lower incidence of antibodies. An analysis of the cerebrospinal fluid showed that antibodies reactive to the Lyme disease organism were present in 3 of 24 ALS patients who consented to lumbar puncture. All three patients had severe bulbar involvement. The peculiar connection with bacteria prompted antibiotic treatment for the patients with ALS; the three patients with bulbar involvement deteriorated rapidly, three others improved, and most were unaffected. Although it seems unlikely that Borrelia burgdorferi is a common cause of ALS, infection with the bacteria may play a role in modulating the course of the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract Background It has been proposed that outer surface protein A (OspA) of Borrelia burgdorferi sensu stricto contains a T helper 1 (Th1) cell epitope that could play a role in an autoimmune response to hLFA1. Methods We used two peptides, hLFAαL (aa326-345) and Borrelia burgdorferi OspAB31 (aa164-183), as stimulating antigens to measure Th1 proinflammatory IFNγ cytokine production in peripheral blood of Lyme disease patients presenting with EM without history of arthritis, as well as in peripheral blood of healthy individuals. Results IFNγ responses to hLFA1 peptide were observed in 11 of 19 Lyme disease patients and in 3 of 15 healthy controls. In contrast, only 2 of 19 of the Lyme disease patients and none of the controls responded to the homologous OspAB31 peptide. Conclusions IFNγ was produced in response to stimulation with peptide hLFAαL (aa326-345) in peripheral blood of 58% of patients with early Lyme disease without signs of arthritis, as well as in peripheral blood of 20% of healthy individuals, but not in response to stimulation with the homologous OspAB31 (aa164-183) peptide (p < 0.05). Our results suggest that reactivity to the hLFA1 peptide in peripheral blood may be the result of T cell degeneracy.

Lyme disease, caused by some Borrelia burgdorferi sensu lato , is the most common tick-borne illness in the Northern Hemisphere and the number of cases, and geographic spread, continue to grow. Previously identified B. burgdorferi proteins, lipid immunogens, and live mutants lead the design of canonical vaccines aimed at disrupting infection in the host. Discovery of the mechanism of action of the first vaccine catalyzed the development of new strategies to control Lyme disease that bypassed direct vaccination of the human host. Thus, novel prevention concepts center on proteins produced by B. burgdorferi during tick transit and on tick proteins that mediate feeding and pathogen transmission. A burgeoning area of research is tick immunity as it can unlock mechanistic pathways that could be targeted for disruption. Studies that shed light on the mammalian immune pathways engaged during tick-transmitted B. burgdorferi infection would further development of vaccination strategies against Lyme disease. [ABSTRACT FROM AUTHOR]

Lyme disease, or borreliosis, is caused by the tick-borne bacteria Borrelia burgdorferi, which causes inflammation of one or more systems, including skin, joints, nervous system, and heart. A classic rash occurs in 70 percent of patients, but many symptoms are nonspecific and reminiscent of other systemic disorders. Detection of Lyme disease is often accomplished by measuring blood levels of antibodies formed against the bacteria. Four cases are described of patients who were diagnosed with Lyme disease on the basis of blood antibody levels. However, further testing indicated that they had bacterial endocarditis, an infection of the membrane lining the heart. The patients lived in areas with a high prevalence of Lyme disease, and one had developed the classic rash. Major symptoms included musculoskeletal complaints, fever, and malaise. Antibiotic treatment for Lyme disease provided temporary relief, but did not relieve the underlying endocarditis. Although intensive analysis of blood antibodies was suggestive of past infection with borrelia in two patients, positive results from the two remaining patients may have resulted from cross-reactivity of standard tests with other bacteria. The authors conclude that positive blood tests for Lyme disease may indicate previous exposure to the bacteria and past Lyme disease, but not active infection. In addition to laboratory testing, patients suspected of having Lyme disease require thorough clinical evaluation. Tests that actually identify B. burgdorferi, its DNA or its antigens are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)