Thoughts and questions of a clinician related to the infection with borrelia and co-infections

Scientific Essay from the year 2016 in the subject Medicine - Other, , language: English, abstract: Handling patients with possible Lyme disease and co-infections in clinic and practice, the author reflects on the justifications of his actions as he is constantly drawn into the discussion between theoreticians and practitioners. The representatives of these two opposing camps are organised by the IDSA (Infectious Disease Society of America) and the corresponding European organisations such as EUCALB (European Union Concerted Action on Lyme Borreliosis) on the one hand, and the ILADS (International Lyme and Associated Diseases Society) and the DBG (Deutsche Borreliose Gesellschaft) on the other hand. As a clinician that the author is, who witnesses the suffering of his patients on a daily basis, he appeals for the collaboration of all parties involved. He asks questions about the infection with borrelia, the possibility of a chronic Lyme disease, the existence of chronic infections generally in patients with weaker immune systems, the symptoms of an infection with borrelia (of different strains) and other tick-borne diseases, the sensitivity and specificity of the determination of antibodies in the everyday practice, the validity of EliSpot and the CD57 values for diagnosis, the treatment with antibiotics, the measures to control and support the patient's metabolism (adjuvants) before and during treatment, the phenomenon of erythema migrans, the biofilms that are complicating treatment and the other phenomenon of pleomorphic, slowly growing bacteria types (so called persister forms and L-forms) that may cause possible relapses. This contribution relies on a thorough study of literature. You will find a comprehensive list of references and links in the annex to prompt and inspire every reader interested in this topic. The author shares his thoughts and questions with the only purpose to stimulate factual discussions.