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Essay written about a patient with probable Lyme meningitis
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Science-based medicine, studies, articles. I follow MedHelps rules about personal groups: Founders can choose to ban members from their Group or prohibit discussions on certain topics in their own Group. I can't imagine others joining this but I'm starting it for my own edification and may refer people to read certain topics. Sorry about the flower icon. I had to chose one. (grin)

Founded by cave76 on May 15, 2013
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Essay written about a patient with probable Lyme meningitis

http://s3.documentcloud.org/documents/368827/merced.pdf

Comments about the story-- not mine but by someone very well versed in medicine:
"The patient was treated IV ("shots") for three weeks, appeared to recover, but then died a few days after the IV treatment was finished, due to irreversible intracranial swelling - brain swelling - despite heroic intensive care treatment.

In the end, the physician-author seems to be convinced that the first Lyme test (presumably two-tier) was a false positive, because when admitted with brain swelling three weeks later, the next Lyme test was negative. This was described as a "Lyme titre", and it came back very quickly, so I assume it was the ELISA step that became negative. IgM or IgG is not mentioned.

Needless to say, I think that the two-tier test is so biased toward specificity at the expense of sensitivity, that a false positive is much more unlikely, than that a case of LD would unfold like this one. Since Lyme is so often said to be "never fatal", the mere fact that the patient died, is enough to convince most doctors that LD couldn't be the real diagnosis. The patient lived in NYC and had no travel history elsewhere, so that's another presumption of false positivity, which so many journal articles claim is the only problem with Lyme diagnostic tests.

It's worth reading this story for its depiction of medical culture, as well as what happened in this particular case."

And "It's very well written.

It's a case where I would have wanted to do a brain autopsy, and also culture the spinal fluid.

There's nothing written here which suggests either were done - unless I missed something."
(also not my comment)
Tags: Dr. Ofri, essay, lyme meningitis
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