[vimy]

French study from 2023:

> This study aimed to demonstrate that severe neurological motor deficits in the context of late tick-borne disease with mixed microorganism involvement are eligible for long-term combined antibiotic/antiparasitic treatments. The inclusion criteria were: 1. neurological limb paralysis with a disability score >4 according to the EDSS Kurtzke disability scale; 2. serological tests pointing to an involvement of the main tick-borne microorganisms Borrelia burgdorferi s.l., Babesia, Anaplasma, and Bartonella; 3. a general disease for more than 6 months with fatigue, pain and subjective cognitive deficit. The patients were administered long-term treatments with repeated cycles (at least three) of 35-day IV ceftriaxone and repeated oral regimens of azithromycin–doxycycline and azithromycin–doxycycline–rifampicin. For Babesia, repeated courses of atovaquone–azithromycin were administered. Ten patients had intractable or severe motor deficits before treatment in the context of Borrelia (two cases) Borrelia–Babesia (four cases), Borrelia–Babesia–Anaplasma (two cases), Borrelia–Babesia–Anaplasma–Bartonella (one case) and Babesia–Anaplasma (one case). For several months, five had been in wheelchairs, and four had been walking with sticks. Seven patients out of 10 (70%) showed complete remission after a mean active treatment duration of 20.1 + 6.6 months, with a mean number of 4 ceftriaxone cycles. Three patients showed an initial remission but suffered secondary antibiotic/antiparasitic-resistant motor recurrences. Among the nine patients with Borrelia serologic positivity, treatments obtained complete remission in seven cases (77%). The findings of this ten-case series suggest the usefulness of long-term antibiotic/antiparasitic treatments in patients with severe late tick-borne neurological deficits with highly significant elements of tick-borne involvement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294829/

[cpncrunch]

This is a study into late untreated borreliosis (a real thing), which is very different from 'chronic lyme'.

[mschwarz]

Can you elaborate on the difference between the terms “late untreated borreliosis” and “chronic Lyme disease”? Borreliosis is just another name for Lyme disease. What distinction are you so sure about that I’m missing?

[cpncrunch]

Chronic lyme is a vague term that usually refers to people who have already been treated, but continue to have symptoms, and may not test positive. It's a grabbag of stuff.

[mschwarz]

I have heard this claim before but I couldn’t follow the logic, genuinely would like to understand your perspective.

So “late untreated borreliosis” is a “real thing” but if someone gets borreliosis, gets treated, yet their symptoms persist (this scenario is what people usually mean by the term chronic Lyme) then that is NOT a “real thing”?

Does this mean that treatment is 100% effective or that if it didn’t work, then it wasn’t borreliosis to begin with?

[byt143]

Don't expect a good answer. That brand of skepticism is performative rationality devoid of actual critical thinking.