Borrelia Burgdorferi: Dilemma of Whether It Is an Imitator or the Main Cause of a Large Number of Diseases of Unknown Etiology – a Case Study

Background: Lyme Borreliosis is a multisystem zoonosis caused by the spirochete Borrelia Burgdorferi and is widespread throughout the world. Borrelia is called the greatest imitator, because it can imitate any disease. The frequent presence of Borrelia in some neurological, dermatological, ophthalmological, cardiology and other patients points to a dilemma: is Borrelia burgdorferii really an imitator or is it the main actor of these diseases. Objective: The aim of this paper is to answer the question: is Borrelia burgdorferi the initiator and main cause of most diseases that are etiologically unexplained. Methods: The paper presents unusual clinical pictures of chronic borreliosis in 10 patients, who recovered on antibiotic therapy, and which are the most striking examples from a group of similarly ill patients. Case study presentation: A total of 10 interesting cases of borreliosis patients were presented. These are the cases: Scleroderma in a 29-year-old patient, generalized lymphadenitis with extreme leukocytosis in a 52-year-old woman, paraparesis in a 24-year-old professional soldier after mild serous meningitis, ALS in a 14-year-old schoolgirl, a case of bilateral migrating optic neuritis in a 13-year-old schoolgirl, retinal ablation in a 32-year-old patient, secondary sterility due to cystic ovaries in a 32-year-old shopkeeper with chronic urticaria, MS in a 20-year-old student, nightmares and moonwalking in a 7.5-year-old pupil complicated with left-sided bartonellosis lymphadenitis of the neck, recurrent syncope with attacks of tachypnea in a 19-year-old patient. All of these patients had normal routine findings, except for the patient with leukocytosis. Infectious disease diagnosis in all patients was made clinically, based on anamnestic data, clinical picture and verified white and/or pink borreliosis striae, and serological confirmation of the presence of the bacterium Borrelia burgdorferi using ELISA, WB and Immunoblot techniques. Conclusion: Based on the presented cases and 12 years of continuous experience with patients with Lyme disease, we conclude that Borrelia burgdorferi is in most cases the cause of the disease of “unknown cause” in neurology, dermatovenerology, ophthalmology, gynecology, internal medicine. The diagnosis of Borrelia is made primarily clinically (extensive anamnesis by organs + finding of new clinical markers on the skin). Serological confirmation of the presence of Borrelia in the body can be done in a small number of cases using the ELISA + WB technique, because these antibodies last for a short time. In older children and adults, it is necessary to use the advanced Immunoblot technique that searches for antibodies to B.B. protein sequences. and additionally search for Borrelia by light microscopy in a native serum preparation.