LYME SCI: Lyme spirochetes in an autopsied brain (despite treatment)
An important new study from Tulane University found Lyme bacteria in autopsied brain tissue of a woman who had been aggressively treated with antibiotics.
“These findings underscore how persistent these spirochetes can be in spite of multiple rounds of antibiotics targeting them,” says Dr. Monica Embers, of Tulane.
Dr. Embers’ team collaborated with Dr. Brian Fallon, of the Lyme and Tick-Borne Diseases Research Center at Columbia University Irving Medical Center.
In their study, published in Frontiers in Neurology, the researchers performed an in-depth autopsy on the brain tissues of an elderly woman who had been previously treated for neurological Lyme disease.
And guess what? They found intact Borrelia burgdorferi, the agent that causes Lyme disease, inside portions of the patient’s brain as well as DNA evidence in her spinal cord.
Obviously, you can’t take brain samples from a living person. Therefore, autopsy samples, such as used in this study, can demonstrate that Borrelia can remain in human tissues even after extensive treatment with antibiotics. Such studies are essential in the effort to develop better diagnostics and treatment.
Many academic researchers and physicians refer to the persistent symptoms of Lyme as post-treatment Lyme disease syndrome (PTLDS). But if you ask patients who are left disabled after being treated for Lyme, they will tell you it’s “chronic Lyme disease.”
Along with the difficulty of obtaining a proper diagnosis, the treatment for Lyme is complicated by the fact that the standard antibiotic is most effective when administered early in the disease.
Any delay in treatment allows the infection to spread throughout the body leading to a more severe chronic form of the disease. This chronic form of infection often necessitates stronger intravenous antibiotics, or longer-term antibiotics to clear infection. Even then, many patients remain ill.
Researchers from Tulane and Columbia universities want to develop better methods to detect and treat Borrelia burgdorferi.
Dr. Embers has been studying Lyme disease since 1998, mostly using animal models. Her early work demonstrated that at four months post-infection, neither a 28-day course of doxycycline nor a 90-day course of antibiotics (30 days IV Rocephin, followed by 60 days oral doxycycline) could eradicate Lyme disease. More recently, she found spirochetes in multiple organs after a 28-day course of doxycycline.
History of the patient
The new study focuses on a 69-year-old deceased woman who contracted Lyme disease at age 54. At the onset of her illness, she had a well-documented erythema migrans rash accompanied by severe headache, joint pain and a fever of 104º. Her standard two-tier tests for Lyme disease were positive on ELISA and both IgM and IgG Western blots.
She was prescribed 10 days of doxycycline which resolved her initial symptoms. Two years later, the patient developed many chronic symptoms consistent with late-stage Lyme disease, as well as dementia.
At age 60, the patient was treated with IV ceftriaxone for eight weeks, which led to 60% improvement in cognition and interpersonal engagement. Although oral amoxicillin was continued three times daily for the next six months, her symptoms gradually returned. Further antibiotic treatment with minocycline did not help. All the while her IgG Western blot for Lyme disease remained positive.
Over time, the patient’s visual, mental and executive functions continued to deteriorate. At age 62, a cerebrospinal fluid (CSF) study demonstrated a positive Western blot. Unfortunately, a comparison of serum and CSF by a diagnostic ELISA was not performed at that time so she did not meet the full diagnostic criteria for neuroborreliosis.
The authors suggest that the initial symptoms of the woman at age 54 (headache, high fever) indicate brain involvement at the time of the EM rash, consistent with a mild meningitis early in the disease process.
Fifteen years after the initial diagnosis of Lyme disease, she experienced severe movement disorders, sleep disorder, paranoia and personality changes leading to a clinical diagnosis of dementia with Lewy bodies. Before she died at age 69, she decided to donate her brain to Columbia University for the study of the disease.
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