Much has been said of Lyme disease. The more obvious manifestations of rash & flu-like symptoms are related to acute localized infection – they do not occur in all patients and might be absent in up to 30% of all who are infected. As the Borrelia infection spreads, nervous system (central and radicular) or cardiac troubles might appear – these can be life-threatening. Inadequately treated patients can develop severe and chronic troubles afflicting the nervous system, cardiovascular system, eyes, visual perception, or creating rheumatologic disease. A chronic (sometimes progressive) inflammation of the brain and spinal cord can cause neuropsychiatric illness or other disability.
The inflammation can become chronic even if the infection is fully treated – these are called post-infectious inflammatory illnesses and can take many forms including treatment resistant disorders of mood & anxiety, schizophrenia-like illnesses, or a dementia-like condition. It is often mis-diagnosed as multiple sclerosis, autoimmune illness, CRPS/RSD, Crohn’s disease or fibromyalgia/chronic fatigue syndrome.
It is important to remember that many other diseases can be transmitted along with those Borrelia that can cause Lyme Disease. Lyme is apparently the most common of the tick-borne illnesses and is one of the fastest growing of all infectious diseases in this country. Just as Syphilis (caused by another spirochete named Treponema palladium) was a great imitator in times past, Lyme Disease is also a confusing and potentially vicious adversary.
Diagnosis can be very difficult – most of all because there is a kind of denial – a notion that being in the “great outdoors” is always “for the better”. Deforestation may have driven the disease way from population centers, and then our burgeoning desire for outdoor recreation may have invited the zoonotic cycle back to everyday life. There are a variety of blood tests available to measure immune system responses to Borrelia, and there are tests to measure the actual presence of Borrelia genetic material, and now we can actually culture body fluids for Borrelia. In addition, brain scanning by SPECT can be helpful in evaluating the presence of a neuroborreliosis.