source: JAMA, Oct. 24/31. 1986--Vol. 256, No. 1
Borrelia in the Brains of Patients Dying of Dementia
"To the Editor.--I have identified spirochetes in serial subculture of autopsy
brain tissues from two patients with dementia. Indirect immunofluorescence,
using monoclonal antibodies specific for Borrelia species, resulted in
fluorescence of spirochetes that had previously been identified by darkfield
microscope examination (figures 1 through 4).
"Case 1 was a 74-year old woman with mild dementia of less than one year's
duration. She had resided in New York and Florida. Case 2 was a 69-year-old man
who died in a nursing home in Texas after a four-to five- year history of
progressive dementia. Parkinsonian symptoms were noted during his last year of
life. Neither patient had symptoms of the skin, joint, or cardiac disorders
described in Borrelia infection.
"Recent reports have described patients with various chronic degenerative
disorders whose blood or cerebrospinal fluid contains antibodies against B.
burgdorferi (1) Individuals with cognitive impairment were found within the
larger group of patients with chronic borreliosis. (2, 3) Borrelia species seem
to share with Treponema pallidum " (syphilis) " the potential to survive in
host tissues for prolonged periods of time and to cause disease in various
organ systems after months or years of clinical latency. Pachner and Steere (4)
have classified the neurological manifestations of B. burgdorferi infection
into primary, secondary, and tertiary forms. If Borrelia infection can be
linked to cases of dementia by serology or culture, a group of patients will be
canidates for intensive parenteral" (iv) "antimicrobial therapy analogous to
the treatment now used for neurosyphilis."
Alan B. MacDonald, MD
Southampton Hospital (NY)
1. Kohler J, Kasper J, Kern U, et al: Borrelial encephalomyelitis. Lancet
2. Reik L. Jr, Smith LM, Khan A, et al: Demyelinating encephalopathy in lyme
disease. Neurology 1985;35:267-269.
3. Hansen K, Rechnitzer C, Pederson NS, et al: Borrelia meningitis and
demyelinating CNS disease, Int J Microbiol Hyg 1986: in press
4. Pachner AR, Steere AC, Tertiary Lyme disease: Central Nervous System
manifestations of long standing infection with Borrelia burgdorferi, Int. J
Microbiol Hyg 1986: in press.