Madison Area Lyme Support Group

Several post-mortem studies have demonstrated the presence of Borrelia spirochetes in the brain and central nervous system of patients with a history of Lyme disease. In this case report, investigators add to the growing evidence that Borrelia spirochete can reside in brain tissue even after prolonged antibiotic treatment.

In their article, “Concurrent Infection of the Human Brain with Multiple Borrelia Species,” Golovchenko and colleagues describe the case involving a post-mortem brain autopsy on a man who suffered for more than 10 years with neurologic and psychiatric symptoms due to Lyme disease.

The patient underwent repeated testing with “borderline positivity for Borrelia infection, followed by the prescription of several antibiotics, which provided no clinical improvements, followed by hospitalization at psychiatric clinics,” the authors state.

CASE REPORT

The 28-year-old patient visited his physician in 2004 after developing an erythema migrans (EM) rash. Subsequently, he was diagnosed with Lyme disease and treated with antibiotics.

However, his condition worsened and he began exhibiting neurological symptoms, including “brain fog,” reduced psychomotor performance and difficulties with concentration and processing of visual and auditory stimuli.

“Here we report the case of a patient who, after being infected by Borrelia and treated with antibiotics continuously, progressed toward neurologic/psychiatric symptoms over the subsequent 13 years.”

In 2017, test results were positive for Borrelia with both IgG and IgM anti-Borrelia antibodies in serum. Several months later, he was admitted to the Psychiatric Department of the University Hospital Olomouc in the Czech Republic.

On February 2018, testing revealed borderline positivity for Borrelia-specific IgM and strong positivity for IgG.

The IgM immunoblot was positive for the presence of OspC from B. afzelii, B. garinii, and B. burgdorferi s.s., and the IgG immunoblot was borderline positive for VlsE from B. afzelii, B. garinii, and B. burgdorferi s.s.

The patient was prescribed a combination of antibiotics which included: minocycline, azithromycin, and hydroxychloroquine.

Spirochetes found in brain tissue of Lyme disease patient

Seven months later, he was hospitalized again and diagnosed with schizotypal personality disorder and somatoform disorder and discharged.

One year later, the patient committed suicide.

“The patient left behind a letter expressing the urgent demand for scientists to analyze his brain for the presence of [Lyme disease] spirochetes.”

An autopsy was conducted.

“PCR analysis was performed on different parts of the brain to determine if Borrelia could be detected in the brain,” the authors state.

Testing confirmed the presence of DNA in 2 spirochete species – B. burgdorferi and B. garinii.

Each Borrelia species, however, was found in different parts of the brain.

“Even though both spirochete species were simultaneously present in human brain tissue, the brain regions where the two species were detected were different and non-overlapping,” the authors explain.

B. burgdorferi was detected in the temporal right lobe, choroid plexus, occipital lobe and parietal lobe. B. garinii DNA was found in the basal ganglia and cerebellum.

Authors conclude:

• “Our results confirmed the presence of two species of spirochetes from the B. burgdorferi sensu lato complex, B. garinii and B. burgdorferi s.s., in different areas of the human brain.”
• “Importantly, the DNAs of the two spirochete species were detected in distinct areas of the brain; in no case did we find infection with both in the same brain region.”
• “The detection of intact spirochetes in autopsy brain specimens of humans after extended treatments and those with a diverse history of disease manifestations, including widely recognized neurocognitive disorders, anxiety, depression, memory loss, brain atrophy, and progressive dementia, illustrates that persistent Borrelia infection can lead to a persistent disorder of the central nervous system (CNS) and the development of [Lyme neuroborreliosis].”