The disease process of Lyme disease has so many similarities
to syphilis, and as a microbiologist I cannot help but be fascinated
by it. Although one is sexually transmitted disease (STD) and the other a
zoonosis ( a disease of animals transmitted to man) they are both caused
by spirochaete bacteria and both have 3 stages of infection exhibiting similar
stages.
Though there is no link between the two infections I believe
that we can gain a lot of understanding by comparing the disease process of the
very ancient disease of syphilis to the more recently identified Lyme disease.
Some of the similarities and differences are tabulated
below:
Feature
|
Syphilis
|
Lyme
Disease
|
Causative
Organism
|
Treponema pallidum
A spirochete
bacteria
|
e.g. B. burgdorferi
A spirochete
bacteria
|
Transmission
|
Human to
Human
Via Sexual
Contact
Congenital transmission occurs
|
Zoonosis
Rodent to
Tick to Human
Congenital
transmission debatable
|
Primary
Disease
|
Occurs 3- 90
days after exposure
Local chancre
- a firm, painless, non-itchy
skin ulceration. Not all patients develop or notice the initial chancre
Lasts 3-6 weeks untreated
|
Occurs 2 days
to a few weeks after exposure
Local Bulls
Eye Rash. Not all patients develop or notice the initial rash
Lasts 1 to 4
weeks untreated
|
Secondary
Disease
|
Occurs about
10 weeks after exposure
Becomes
disseminated and causes a diffuse rash which frequently involves the palms of
the hands and soles of the feet, together with flu-like symptoms
Lasts 3-6
weeks untreated
|
Occurs 2 days
to a few weeks after exposure
Becomes
disseminated and causes flu-like Symptoms. May involve heart, nervous system
and joints.
Lasts 1 to 4
months untreated
|
Latent Phase
|
No symptoms
are apparent, but there may be relapses in the early latent phase
|
Though not
officially described as the latent phase Lyme disease can resurface months to
years after the initial symptoms.
During the this
period the person may not have symptoms.
|
Tertiary
Disease
|
Occurs 3 to
46 years after exposure (average 15)
Invades
various organs of the body and causes damage to the tissues causing
gummas which are soft, tumor-like balls of inflammation which may vary
considerably in size. They typically affect the skin, bone, and liver, but
can occur anywhere. Also causes neurological,
or cardiac symptoms
Tissue damage
is irreparable
|
Occurs months
to years after exposure
If left
untreated or if inadequately treated, Lyme disease disseminates fully
throughout the body and can develop into severe and chronic infection with a
wide variety of symptoms affecting every organ system, including the joints,
heart and brain.
Can be cured
with extensive log-term antibiotics
|
Occurs with antibiotic treatment
|
Occurs with antibiotic
treatment
|
Lyme disease
is also a great imitator as the wide variety of symptoms mimic other
diseases.
|
Diagnosis
|
Clinical history. Early infections difficult to diagnose
Serological blood tests
|
Clinical
history early infections difficult to diagnose
Serological
tests
|
Treatment
|
Antibiotics – penicillin, cephalosporins, tetracyclines
|
Antibiotics –
penicillins, cephalosporins, tetracyclines
|
Jarisch-Herxheimer
reaction
|
Fever, muscle, joint pains, tachycardia etc. may occur with
initial antibiotic treatment
|
Fever, muscle, joint pains, tachycardia etc. may occur with
initial antibiotic treatment
|
Serological
Cross Reactivity
|
You may get a false positive test for Lyme disease if you
have syphilis
|
You may get a false positive test for syphilis if you have Lyme
disease
|
The following book has all the information you need to fully understand Lyme disease and the controversy surrounding it.

