Chronic fatigue syndrome is a diagnosis of exclusion for which there are no markers. Lyme disease is the most common vector borne illness in the United States for which chronic fatigue is a frequent clinical manifestation. Intervention of patients with Lyme disease with appropriately directed antimicrobials has been associated with improved outcomes.
Of the total 210 included in the analysis, 209 or 99% were felt to represent a high likelihood of “seronegative Lyme disease.” Initiating various antimicrobial regimen, involved at least a 50% improvement in clinical status in 130 or 62%. Although not achieving the 50% threshold according to the criteria discussed, another 55 patients subjectively identified a beneficial clinical response to antimicrobials, representing a total of 188 or 88% of the total identified as having a high potential for seronegative Lyme disease.
A potentially substantial proportion of patients with what would otherwise be consistent with internationally case defined CFS in a Lyme endemic environment actually have a perpetuation of their symptoms driven by a persistent infection by Borrelia burgdorferi. By treating this cohort with appropriately directed antimicrobials, we have the ability to improve outcomes.
More available at the above link.
Comments (briefly now, as I am headed out the door - may comment more later):
Kudos to Samuel Shor and his team for this research. Thank you for including potential limitations, future directions for research, and disclosures in your report.
Additional studies on this patient group need to be conducted, and I would like to see more such studies as these conducted and shared with the Lyme patient community, even if they are only retrospective and not controlled studies...
Use the clinical data you have on all of us, anonymously - at least we have some idea what sort of outcomes you are seeing?
This looks like the way to go, Dr. Shor:
"Obtain microarray analysis for Borrelia burgdorferi on the “seronegative” Lyme patients. Perform a prospective randomized placebo controlled trial for which a protocol and IRB are already in place and funding being pursued."
Yes. Thank you. More sir, may we have another?
It's a start...
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