Since culture of Borrelia burgdorferi from patients with chronic Lyme disease has been an extraordinarily rare event, clarification of the nature of the illness and proving its etiology as infectious have been difficult. A method for reliably and reproducibly culturing B. burgdorferi from the blood of patients with chronic Lyme disease was therefore sought by making a controlled blood culture trial studying 47 patients with chronic Lyme disease. All had relapsed after long-term oral and intravenous antibiotics. 23 patients with other chronic illness formed the control group. Positive cultures were confirmed by fluorescent antibody immuno-electron microscopy using monoclonal antibody directed against Osp A, and Osp A PCR. 43/47 patients (91%) cultured positive. 23/23 controls (100%) cultured negative. Although persistent infection has been, to date, strongly suggested in chronic Lyme disease by positive PCR and antigen capture, there are major problems with these tests. This new method for culturing B. burgdorferi from patients with chronic Lyme disease certainly defines the nature of the illness and establishes that it is of chronic infectious etiology. This discovery should help to reestablish the gold standard in laboratory diagnosis of Lyme disease.

• MeSH
• bakteriemie diagnóza   farmakoterapie   mikrobiologie   MeSH
• bakteriologické techniky normy   MeSH
• Borrelia burgdorferi komplex izolace a purifikace   ultrastruktura   MeSH
• chronická nemoc MeSH
• diferenciální diagnóza MeSH
• lidé MeSH
• lymeská nemoc diagnóza   farmakoterapie   mikrobiologie   MeSH
• neúspěšná terapie MeSH
• prediktivní hodnota testů MeSH
• recidiva MeSH
• reprodukovatelnost výsledků MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Česká republika MeSH
• City of New York MeSH
• Connecticut MeSH
• Texas MeSH

A total of 35 patients with late stage Lyme borreliosis with involvement of the joints was followed up until 3 years after a 14 day course of 2 g ceftriaxone once daily i.v. Diagnosis was confirmed by indirect and direct microbiological methods as well as clinical signs and symptoms. Long term clinical results in 26 patients at 36 months were complete response or marked improvement in 19, relapse in six and new manifestations in four of the cases, respectively. Possible mechanisms for non-responding to therapy are discussed. Therapy was well tolerated; in no case discontinuation of treatment was necessary due to adverse drug reactions. The treatment results in this group of 35 patients with Lyme arthritis are considered successful. The data obtained are consistent with expectations based on the published experiences with ceftriaxone in this indication.

• MeSH
• Borrelia burgdorferi komplex imunologie   izolace a purifikace   MeSH
• časové faktory MeSH
• ceftriaxon terapeutické užití   MeSH
• dospělí MeSH
• infekční artritida komplikace   farmakoterapie   imunologie   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymeská nemoc komplikace   farmakoterapie   imunologie   patologie   MeSH
• následné studie MeSH
• protilátky bakteriální krev   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spotřebitelská bezpečnost produktů MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• ceftriaxon MeSH
• protilátky bakteriální MeSH