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Lyme
disease: A lesson to be learned
Martina Ziska, MD. JSTD 1995; 2:47-49.
Guest editorial.
Talks about the history of Lyme disease.
Lyme
disease: A clinical challenge
San T. Donta, MD. JSTD 1995; 2:50-51.
Special editorial.
The controversies surrounding various aspects of Lyme disease
reflect that our knowledge in these areas is incomplete.
Lyme
arthritis in British Columbia
George E. Price, MD, FRCPC and S.N. Banerjee, PhD. JSTD
1995; 2:52-54.
The first
known locally acquired case of Lyme arthritis in British Columbia
is described. The patient had frequent tick exposure where he
lived, on a forested island on the south coast of the province.
The diagnosis was established by a clinical picture compatible
with Lyme arthritis and by multiple reactive bands for B.
burgdorferi on IgG and IgM western blot analysis of serum.
The arthritis, which had been intermittent for more than 6 months,
responded quickly to 1 month treatment of oral doxycycline, with
no recurrence after 2 years. Although tick exposure is common
and B. burgdorferi has been isolated from two species
of ticks and from rodents in many areas of British Columbia,
cases of Lyme disease and Lyme arthritis seem to be rare for
reasons that are not clear. Color four page pictorial also shown.
Lyme
disease, initially misdiagnosed as rheumatoid arthritis, successfully
treated with long-term azithromycin Guy A. Buonincontro, DO.
JSTD 1995; 2:55-56.
A 59-year-old
white male with a 10-year history of migratory and fixed joint
pains, was initially diagnosed and treated as having rheumatoid
arthritis (RA). When the patient failed to respond to nonsteroidal
anti-inflammatory drugs (NSAIDs), he was placed on hydroxychloroquine
sulfate (Plaquenil) and maintained on this for 8 more years,
despite nonimprovement. He was eventually diagnosed with Lyme
disease and treated with 5 months of azithromycin (Zithromax).
He has remained symptom free for 2 years.
Persistent
PCR positivity in a patient being treated for Lyme disease
Kornelia Keszler, MD and Richard C. Tilton, PhD. JSTD
1995; 2:57-58.
A 30-year-old
white female presented with worsening clinical symptoms suggestive
of Lyme disease while on antibiotic therapy. Results of enzyme-linked
immunosorbent assay (ELISA) and of western blot tests for IgG
and IgM antibody were equivocal. However, Borrelia burgdorferi
DNA detected by the polymerase chain reaction (PCR) was detected
in whole blood on two separate occasions, 1 month apart, while
the patient was on oral doxycycline, 100 mg b.i.d. This report
questions the significance of persistent Borrelia burgdorferi
DNA in a patient who is not responding to antibiotic therapy.
Neuroborreliosis
in Texas
Audrey Stein Goldings, MD. JSTD 1995; 2:59-61.
Chronic persistent
symptoms after treatment for Lyme disease (LD) are common. Early
effective treatment is the only known way to avoid this possibility.
despite early recognition of the infection, patients still may
not do well due to failure to eradicate the spirochete. This
is a case study of one such patient.
Chronic
Lyme-related Bell's palsy responsive to prolonged oral antibiotic
treatment
Michael A. Patmas, MS, MD, FACP. JSTD 1995; 2:62-63. Color
pictorial also included.
Letter to
the editor and case study.
Lyme-related
relapsing motor neuron disease
Gerald Ferencz, MD. JSTD 1995; 2:64.
Letter to
the editor and case overview of a person with symptoms of Parkinson's
disease and a positive ELISA to Lyme disease. There was a questionable
response to antibiotic treatment.
Lack
of transplacental transmission of Lyme disease spirochetes in
a mouse model
Charles K. Akintunde, BSc; David J. M. Wright, MD, FRCP; and
Leonard C. Archard, PhD, MRCP. JSTD 1995; 2:65.
Letter to
the editor. Researchers report on being unable to detect any
adverse outcomes in their mouse model for transplacental transmission.
Ixodes
scapularis
larvae: A possible vector of Lyme disease?
Kenneth Liegner, MD. JSTD 1995; 2:66.
Letter to
the editor. Encourages the further study of Ixodes scapularis
larvae and their role in the transmission of Lyme disease.
