A review of lyme disease persistence
Van, Matthew L.
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The tick-borne Lyme disease, caused by the bacterium Borrelia burgdorferi, as well as some other Borrelia species, is the subject of a dispute as to whether its conditions persist following recommended antibiotic treatment lasting no more than three weeks. Advocates for the existence of chronic Lyme disease point to numerous animal models that show some traces of the bacteria remaining after treatment and call for both the long term use of antibiotics and for the disease to be recognized as chronic and to be diagnosed more expediently. Opponents of the existence of chronic Lyme disease argue that the scientific evidence for these arguments is insufficient, citing that long term symptoms are actually signs of other diseases erroneously grouped with Lyme, that current antibiotic regimens suffice for Lyme disease treatment, and that additional antibiotics beyond current treatments provide no increase in beneficial outcomes. The evidence currently is insufficient to support many of the claims by supporters of chronic Lyme disease and further studies must be done before evidence from the animal models can be applied to human patients. The fact that Borrelia burgdorferi in particular, and perhaps other members of the Borrelia genus, has evolved many singularly peculiar traits such as a lack of reliance on iron and a large extrachromosomal genome suggest that it is not outside the realm of possibility that there is some other facet of Lyme disease not currently recognized or understood. Future exploration is needed to fully understand mechanisms of pathogenesis of this bacterium in order to either confirm or deny the ability of Lyme disease to persist in humans following treatment.
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