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Have chronic Fatigue and some neurological sickness and test for Lyme is positive. Treatment?

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Internal Medicine Specialist
Practicing since : 2007
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do we have Lyme disease in India? I have chronic Fatigue and some neurological sickness and ellispot test for Lyme is positive( from infect lab in germany). Wondering how we treat it in India.
I think I have provided adequate information in medical lingo as I am medicine professional too. Only thing I wish to add is it is beleived here that Lyme always comes with co infections like babesia, bartonella, Ricketsia etc. I am on Moclobemide( for CFS), Hydroxychloroquine and clindamycin with azithromycin for Lyme's infection and I am expected to take many herbs like cats claw,artemisia, red root, srpsarella etc. I am having herxheimer reactions with these. Also of note, I have a few complex liver cysts( 4-2 cm), a thymus lump thats unclear but non enhancing, an arachnoid cysts of 2.5x4.5 cm that is believed to be a dandy walker variant and is left untouched. i question if my livers cysts which are gradually increasing in size could be from Lyme's and if removal or drainage will help. I also wonder if arachnaoid cyst needs some attention to address neurological symptoms like whoozy, dizzy feeling on and off, positional shift on and off( epilepsy has been ruled out thru a day EEG. MRI brain is otherwise N. I do have autoiimune menifestations like thyroiditis( antibodies high for 6 yrs now) but tsh on lower side, joint, bone( deep bone) pain, malaise and fatigue, frozen shoulder etc.
A fecal microbilogical analysis had shown high streptococci and lactobacilli but very low bifidobacterium strains and E coli gropu. Have recd antibiotics and probiotics to correct that. would do another bioscreen faecal analysis after i come of antibiotics that i am on to see if gut bacteria have stabilised.

in nutshell, have low Th1 immunity, high Th2 Immunity, Fatigue, bad aches and the recent diagnosis of lyme's is making me doubt its authenticity and am afraind of going along with the heavy treatment. So would like a second opinion please.
Posted Fri, 9 Aug 2013 in General Health
Answered by Dr. Venkat Sivayogi 3 hours later
Welcome to Healthcare Magic.
I am Dr. sivayogi

Directly coming to the point what I can say about the Lyme disease in India, it’s very un-common. Being a health professional, you may be knowing that Lyme disease is transmitted by Ixodes deer ticks. And this Lyme disease is commonly seen in geographical locations USA, Europe.

Coming to the clinical manifestations, you must have the history of Tick bite or else you might have travelled to area endemic of Lyme disease. Majority will notice EM (erythema Migrans} also known as "bulls eye" lesion and patient initially suffers from high-grade fevers, myalgia, arthralgias.

Diagnosis is mainly based on clinical manifestations, so we cannot completely rely on lab tests, which are done through detection of antibodies. But high false positive results are common in ELISA and other spot tests. Keep in mind antibody tests are only to support your clinical diagnosis.

Coming to the treatment aspect, it is same globally and we also recommend Doxycycline for 20-28days but in case of pregnancy we prefer Azithromycin or Ceftriaxone.

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