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Middelveen, M.J., Sapi, E., Burke, J., Filush, K.R., Franco, A., Fesler, M.C., et al. (2018) Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease. Healthcare, 6, Article 33.
https://doi.org/10.3390/healthcare6020033

has been cited by the following article:

• TITLE: Persistent Borrelia Infection in Chronic Lyme Disease: A Review of the Medical Literature

  AUTHORS: Raphael B. Stricker, Melissa C. Fesler, Lorraine Johnson

  KEYWORDS: Lyme Disease, Borrelia burgdorferi, Cysts, Biofilms, Animal Models, Persistence, Chronic Lyme Disease, Post-Treatment Lyme Disease

  JOURNAL NAME: Advances in Infectious Diseases, Vol.16 No.1, January 26, 2026

  ABSTRACT: Chronic Lyme disease (CLD) remains a controversial illness. The controversy is based on a profound disagreement over the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, and the ability of this persistent infection to cause chronic symptoms in patients who are untreated or undertreated for the spirochetal disease. Based on a review of the medical literature, we identified 56 studies confirming B. burgdorferi persistence. In this article, we summarize evidence from animal models and human studies that support persistent spirochetal infection as the cause of CLD. Specifically, direct and functional testing using culture, histology and xenodiagnosis has shown viable organisms following antibiotic therapy, and the potential role of cysts (L-forms) and biofilms in this process is examined. Future studies are required to investigate the mechanism of persistent infection in CLD.