Instructor
Kenneth B. Liegner, MD
Description
This presentation provides physicians with clinically useful information that will help them assist patients with manifestations of Chronic Lyme disease.
Learning objectives
- List some of the complexities regarding the diagnosis and treatment of Lyme disease.
- Recognize that Lyme disease can be ‘serovariable’ (results in some individuals can be seronegative, borderline or positive despite active Lyme infection).
- State that Chronic Lyme disease is a bona fide entity.
- Recall that Borrelia burgdorferi can exist within biofilm in patients.
- Recognize that long-term antimicrobial treatment is necessary for some individuals, however, current methods may fail to eradicate the infection.
- Recognize that improved methods of treatment for Lyme disease in all of its stages are urgently needed and should be a very high priority for the international biomedical research community.
This session, A historic case study on chronic Lyme disease, is approved for 0.5 enduring AAFP Prescribed credits.
AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)â„¢ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.
The AAFP has reviewed One Health Medical Education for a Changing Climate and deemed it acceptable for AAFP credit. Term of approval is from 01/02/2024 to 01/01/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
References
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Liegner KB, Rosenkilde CE, Campbell GL, Quan TJ, Dennis DT. Culture-confirmed treatment failure of cefotaxime and minocycline in a case of Lyme meningoencephalomyelitis in the United States. In: Program and abstracts of the Fifth International Conference on Lyme Borreliosis, Arlington, Va., May 30-June 2, 1992. Bethesda, Md.:Federation of American Societies for Experimental Biology, 1992:A11.
Liegner KB, Shapiro JR, Ramsay D, Halperin AJ, Hogrefe W, Kong L. Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting Borrelia burgdorferi infection. J Amer Acad Derm 1993;28:312-4.
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Klempner MS, Noring R, Rogers RA. Invasion of Human Skin Fibroblasts by the Lyme Disease Spirochete, Borrelia burgdorferi. J Infect Dis 1993;167:1074-81.
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Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, Thomas J, Golightly MG. Seronegative Lyme Disease. Dissociation of T- and B-Lymphocyte Responses to Borrelia burgdorferi. N Engl J Med 1988;319:1441-6
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Sapi E, Kasliwala RS, Ismail H, Torres JP, Oldakowski M, Markland S, Gaur G, Melillo A, Eisendle K, Liegner KB, Libien J, Goldman JE. The Long-Term Persistence of Borrelia burgdorferi Antigens and DNA in the Tissues of a Patient with Lyme Disease. Antibiotics (Basel). 2019 Oct 11;8(4):183. doi: 10.3390/antibiotics8040183. PMID: 31614557; PMCID: PMC6963883.
Shor, S.; Green, C.; Szantyr, B.; Phillips, S.; Liegner, K.; Burrascano, J.J., Jr.; Bransfield, R.; Maloney, E.L. Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group. Antibiotics 2019, 8, 269.
Sapi E, Balasubramanian K, Poruri A, Maghsoudlou JS, Socarras KM, Timmaraju AV, Filush KR, Gupta K, Shaikh S, Theophilus PA, Luecke DF, MacDonald A, Zelger B. Evidence of In Vivo Existence of Borrelia Biofilm in Borrelial Lymphocytomas. Eur J Microbiol Immunol (Bp). 2016 Feb 9;6(1):9-24. doi: 10.1556/1886.2015.00049. PMID: 27141311; PMCID: PMC4838982.
Clinical Courier. Vol 9, No 5. August 1991. NIH State-of-the-Art Conference. NIAID/NIAMSD. ISSN 0264-6684.Diagnosis and Treatment of Lyme DiseaseLiegner, KB In the Crucible of Chronic Lyme Disease. Xlibris. 2015. www.inthecrucibleofchroniclymedisease.com