Get your own Free Home PageLyme disease is a serious bacterial infection caused by a tick bite and affects humans and animals.
This page contains citations and highlighted extracts for medical and scientific articles from the National Institutes of Health (NIH), National Library of Medicine (NLM) MEDLINE database about Lyme disease authored or collaborated on by Raymond Dattwyler as of 23 Nov 99.
To see complete abstracts in the annotations below, click on link shown after "TITLE:" .
TITLE:
A rapid test for detection of Lyme disease antibodies.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10557850&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Gomes-Solecki M
AUTHOR AFFILIATION:
SUNY at Stony Brook, Department of Medicine 11794, USA.
RAYD@epo.som.sunysb.edu
SOURCE:
Am Clin Lab 1999 Jul;18(6):6
TITLE:
[Cardiac manifestations of Lyme borreliosis with special
reference to contractile dysfunction]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9681041&form=6&db=m&Dopt=b
AUTHORS:
Seinost G; Gasser R; Reisinger E; Rigler MY; Fischer L; Keplinger A;
Dattwyler RJ; Dunn JJ; Klein W
AUTHOR AFFILIATION:
Klinischen Abteilung fur Kardiologie, Medizinischen Universitatsklinik
Graz, Osterreich. gseinost@mail.som.sunysb.edu
SOURCE:
Acta Med Austriaca 1998;25(2):44-50
"Borrelia burgdorferi infection (BBI) is suggested to be associated
with dilated cardiomyopathy (IDC). ...11 (24%) patients showed
positive serology and a history of BBI; ...These 11 patients with BBI
received standard antibiotic treatment with intravenous ceftriaxone 2 g
bid for 14 days. 6 (55%) recovered completely and showed a normal LV-EF
after 6 months, 3 (27%) improved their LV-EF and 2 (18%) did not improve
at all."
TITLE:
Ceftriaxone compared with doxycycline for the treatment of acute
disseminated Lyme disease.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9233865&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Luft BJ; Kunkel MJ; Finkel MF Wormser GP; Rush TJ;
Grunwaldt E; Agger WA; Franklin M; Oswald D; Cockey L; Maladorno D
AUTHOR AFFILIATION:
Department of Medicine, State University of New York, Stony Brook,
11794-8161, USA.
SOURCE:
N Engl J Med 1997 Jul 31;337(5):289-94
ABSTRACT:
BACKGROUND: Localized Lyme disease, manifested by erythema migrans, is
usually treated with oral doxycycline or amoxicillin. Whether acute
disseminated Borrelia burgdorferi infection should be treated
differently from localized infection is unknown. METHODS: We
conducted a prospective, open-label, randomized, multicenter study
comparing parenteral ceftriaxone (2 g once daily for 14 days) with
oral doxycycline (100 mg twice daily for 21 days) in patients with
acute disseminated B. burgdorferi infection but without meningitis.
The erythema migrans skin lesion was required for study entry, and
disseminated disease had to be indicated by either multiple erythema
migrans lesions or objective evidence of organ involvement. RESULTS:
Of 140 patients enrolled, 133 had multiple erythema migrans lesions.
Both treatments were highly effective. Rates of clinical cure at the
last evaluation were similar among the patients treated with
ceftriaxone (85 percent) and those treated with doxycycline (88
percent); treatment was considered to have failed in only one patient
in each group. Among patients whose infections were cured, 18 of 67
patients in the ceftriaxone group (27 percent) reported one or more
residual symptoms at the last follow-up visit, as did 10 of 71
patients in the doxycycline group (14 percent, P > or = 0.05). Mild
arthralgia was the most common persistent symptom. Both regimens were
well tolerated; only four patients (6 percent) in each group withdrew
because of adverse events. CONCLUSIONS: In patients with acute
disseminated Lyme disease but without meningitis, oral doxycycline
and parenterally administered ceftriaxone were equally effective in
preventing the late manifestations of disease.
TITLE:
Azithromycin compared with amoxicillin in the treatment of
erythema migrans. A double-blind, randomized, controlled trial [see
comments]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8610947&form=6&db=m&Dopt=b
AUTHORS:
Luft BJ; Dattwyler RJ; Johnson RC; Luger SW; Bosler EM; Rahn DW;
Masters EJ; Grunwaldt E; Gadgil SD
AUTHOR AFFILIATION:
Department of Medicine, State University of New York at Stony Brook,
NY 11794-8160 USA.
SOURCE:
Ann Intern Med 1996 May 1;124(9):785-91
COMMENTS:
Comment in: Ann Intern Med 1997 Mar 1;126(5):408; discussion 408-9
"OBJECTIVE: To determine whether azithromycin or amoxicillin is more
efficacious for the treatment of erythema migrans skin lesions, which
are characteristic of Lyme disease. ...INTERVENTION: Oral treatment with
either amoxicillin, 500 mg three times daily for 20 days, or
azithromycin, 500 mg once daily for 7 days. Patients who received
azithromycin also received a dummy placebo so that the dosing schedules
were identical. RESULTS: Of 217 evaluable patients, those treated with
amoxicillin were significantly more likely than those treated with
azithromycin to achieve complete resolution of disease at day 20, the
end of therapy (88% compared with 76%; P=0.024). More azithromycin
recipients (16%) than amoxicillin recipients (4%) had relapse
(P=0.005)."
TITLE:
Complications of Lyme borreliosis.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1580609&form=6&db=m&Dopt=b
AUTHORS:
Cooke WD; Dattwyler RJ
AUTHOR AFFILIATION:
Guthrie Foundation for Medical Research, Sayre, Pennsylvania 18840.
SOURCE:
Annu Rev Med 1992;43:93-103
ABSTRACT:
Lyme borreliosis is the multisystem infectious disease caused by the
spirochete Borrelia burgdorferi. Complications of this infection can
involve many organ systems, especially the skin, joints, nervous
system, and heart. These manifestations may be acute, or evolve
slowly over months or years. Diagnosis is not always straightforward,
and is currently hampered by lack of a specific serologic assay. This
review discusses the syndromes associated with Lyme borreliosis and
addresses issues of diagnosis and treatment.
TITLE:
A perspective on the treatment of Lyme borreliosis.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2682965&form=6&db=m&Dopt=b
AUTHORS:
Luft BJ; Gorevic PD; Halperin JJ; Volkman DJ Dattwyler RJ
AUTHOR AFFILIATION:
Department of Medicine, University of New York, Stony Brook 11794-8153.
SOURCE:
Rev Infect Dis 1989 Sep-Oct;11 Suppl 6:S1518-25
ABSTRACT:
Lyme borreliosis has become the most common tick-borne infection in
the United States. Although both beta-lactam and tetracycline
antibiotics have been shown to be effective in the treatment of this
spirochetosis, the development of optimal therapeutic modalities has
been hampered by the lack of reliable microbiologic or immunologic
criteria for the diagnosis or cure of this infection. In vitro
sensitivity studies have been performed by several laboratories, but
there has been no standardization of the methodology for measuring
either inhibitory or bactericidal levels. Clinical studies have
documented the efficacy of antibiotics, but therapy has failed in as
many as 50% of cases of chronic infection. Although new antibiotic
regimens appear promising, the optimal treatment of this infectious
disease remains to be determined. In this report we review the
clinical and experimental rationale for the antibiotic regimens that
we currently use and the need for a more standardized approach to
treatment trials.
TITLE:
Antibiotic treatment of Lyme borreliosis.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2686769&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Luft BJ
AUTHOR AFFILIATION:
Department of Medicine, SUNY 11794.
SOURCE:
Biomed Pharmacother 1989;43(6):421-6
ABSTRACT:
Unlike most bacterial infections, where diagnosis is by identification
of the causal organism, diagnosis of infection by Borrelia
burgdorferi (Lyme's borreliosis) relies mostly upon indirect
techniques. This situation has some short-comings. As long as no
technology permits a microbiological diagnosis of this infection,
controversy will exist as to the clinical symptoms and the criteria
for the cure of the disease. Despite the lack of consensus upon both
the clinical definition and the treatment of Lyme's borreliosis, it
is widely agreed that the affection is best understood if regarded as
a progressive general infectious disease. Indeed, following a bite
with local infection, there occurs a fairly rapid dissemination of
the spirochaetes. In vivo therapeutic trials have shown the potential
effectiveness of beta-lactams and tetracyclines, but no treatment is
considered universally effective. Most of the first trials were
empirical, as antibiograms were not used. Antibiotic concentrations
reached with some oral therapies are too low for the protection of
certain sites such as the central nervous system. In vitro studies
conducted on various strains of B. burgdorferi both in the US and in
Europe are very enlightening. Among the more perplexing results of
some of these studies, it is worth noting the high resistance rate of
some B. burgdorferi strains to penicillin, reported by Johnson et al.
and by Preac Mursic et al. Therapy for Lyme's borreliosis is
discussed in light of both the in vivo and in vitro studies.
TITLE:
Seronegative Lyme disease. Dissociation of specific T- and
B-lymphocyte responses to Borrelia burgdorferi [see comments]
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3054554&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Volkman DJ; Luft BJ; Halperin JJ; Thomas J; Golightly MG
AUTHOR AFFILIATION:
Department of Medicine, State University of New York, School of
Medicine, Stony Brook 11794-8161.
SOURCE:
N Engl J Med 1988 Dec 1;319(22):1441-6
COMMENTS:
Comment in: N Engl J Med 1989 May 11;320(19):1279-80
"The diagnosis of Lyme disease often depends on the measurement of
serum antibodies to Borrelia burgdorferi, the spirochete that causes
this disorder. Although prompt treatment with antibiotics may
abrogate the antibody response to the infection, symptoms persist in
some patients. We studied 17 patients who had presented with acute
Lyme disease and received prompt treatment with oral antibiotics, but
in whom chronic Lyme disease subsequently developed. ...We conclude that
the presence of chronic Lyme disease cannot be excluded by the absence
of antibodies against B. burgdorferi and that a specific T-cell
blastogenic response to B. burgdorferi is evidence of infection in
seronegative patients with clinical indications of chronic Lyme
disease."
TITLE:
Treatment of late Lyme borreliosis--randomised comparison of
ceftriaxone and penicillin.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2897008&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Halperin JJ; Volkman DJ; Luft BJ
AUTHOR AFFILIATION:
Department of Internal Medicine, School of Medicine, State University
of New York, Stony Brook
SOURCE:
Lancet 1988 May 28;1(8596):1191-4
ABSTRACT:
23 patients with clinically active late Lyme disease were randomly
assigned to intravenous treatment with either penicillin or
ceftriaxone. Of the 10 treated with penicillin, 5 were judged
treatment failures; of the 13 who received ceftriaxone, only 1 did
not respond. An additional 31 patients were subsequently treated with
ceftriaxone 4 g/day (n = 17) or 2 g/day (n = 14); success rates in
both groups were comparable to those in the cohort randomised to
ceftriaxone. Patients unresponsive to ceftriaxone were more likely to
have received corticosteroid treatment.
TITLE:
New chemotherapeutic approaches in the treatment of Lyme
borreliosis.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3056203&form=6&db=m&Dopt=b
AUTHORS:
Luft BJ; Volkman DJ; Halperin JJ; Dattwyler RJ
AUTHOR AFFILIATION:
Department of Medicine, Health Science Center, SUNY, Stony Brook 11794.
SOURCE:
Ann N Y Acad Sci 1988;539:352-61
ABSTRACT:
1. It was demonstrated that while B. burgdorferi may be sensitive to
relatively small concentrations of penicillin and ceftriaxone, the
organism is killed slowly. This implies that, as in syphilis,
prolonged blood levels of these drugs may be necessary in order to
ensure cure. In contrast, the activity of tetracycline is more rapid
in its action but is more dependent on drug concentration achieved.
Unfortunately, the MIC and MBC for some strains are at or above the
peak level achieved under optimal conditions. 2. Increasing the
concentrations of penicillin or ceftriaxone above the MIC for the
organism has little effect on the rate of killing. In contrast, the
killing by tetracycline can be augmented by increasing concentrations
of the drug. 3. Ceftriaxone is more active than penicillin, as
measured by MIC, against the five strains of B. burgdorferi tested.
4. Ceftriaxone was efficacious in the treatment of Lyme borreliosis,
which was recalcitrant to penicillin therapy. In a randomized trial
comparing ceftriaxone to high-dose penicillin therapy, ceftriaxone
was significantly more efficacious than penicillin in the treatment
of the late complications of Lyme borreliosis.
TITLE:
Lyme meningoencephalitis: report of a severe, penicillin-
resistant case.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3649235&form=6&db=m&Dopt=b
AUTHORS:
Diringer MN; Halperin JJ; Dattwyler RJ
SOURCE:
Arthritis Rheum 1987 Jun;30(6):705-8
ABSTRACT:
Although Lyme disease frequently attacks the central nervous system,
this involvement is rarely severe, and high-dose intravenous
penicillin usually is adequate treatment. The patient we describe
developed severe Lyme meningoencephalitis despite receiving a full
course of penicillin, and his condition continued to deteriorate
after reinstitution of this treatment. Intravenous chloramphenicol
was used successfully and resulted in a substantial improvement.
TITLE:
Ceftriaxone as effective therapy in refractory Lyme disease.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3572042&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Halperin JJ; Pass H; Luft BJ
SOURCE:
J Infect Dis 1987 Jun;155(6):1322-5
[No abstract available.]
TITLE:
Failure of tetracycline therapy in early Lyme disease.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3580012&form=6&db=m&Dopt=b
AUTHORS:
Dattwyler RJ; Halperin JJ
SOURCE:
Arthritis Rheum 1987 Apr;30(4):448-50
ABSTRACT:
We describe the clinical courses of 5 patients with Lyme disease who
developed significant late complications, despite receiving
tetracycline early in the course of their illness. All 5 patients had
been treated for erythema chronicum migrans with a course of
tetracycline that met or exceeded current recommendations. The late
manifestations of Lyme disease included arthritis, cranial nerve
palsy, peripheral neuropathy, chronic fatigue, and changes in mental
function. Our findings suggest that the use of tetracycline at a
dosage of 250 mg, 4 times a day for 10 days, as a treatment for early
Lyme disease should be reconsidered. To determine optimal therapy for
early Lyme disease, a study that compares an increased dosage of
tetracycline with alternative treatments is indicated.
For more information about Lyme disease, see:
Lots Of Links On Lyme Disease
http://www.geocities.com/HotSprings/Oasis/6455/lyme-links.html
Last updated on 31 December 1999 by
Art Doherty
Lompoc, California
doherty@utech.net
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