What I see in practice

Two strains of Borrelia are positively identified by PCR in the practice case load, Burgdorferi and Garinii. As to whether there is any difference in symptomatology I can not comment. The former is the predominant organism. Further we have Azelii which is known to cause both the acrodermatitis chronica atrophicans and also a nummular truncal and limb rash occasionally seen in Lyme disease. Here is an excellent photo of the latter:

 

There is no arthritic disease as in North America. Rather we follow a disease pattern of marked neurological symptomatology which is the European and Asian pattern of the disease. There is also a biotoxin (refer Burruscano document) produced by the Borrelia which produces sometimes marked asymmetric muscle spasm and twitching. Cranial nerve involvement followed by upper cervical nerves accounts for most symptomatology.

It is quite striking the number of cranial nerves involved by chronic Borellia infection. I find in most patients there are numbers of 6 to 10 involved. Of particular note are the 9th 10th 11th and 12th nerves in regard to pharyngeal laryngeal and anterior neck musculature. The number of distinct cranial nerves involved far outweighs the few seen in MS and from seeking neurological opinion on this, I am advised that the only other diseases that match this number of cranial nerve involvement are Sarcoid and neurological autoimmune diseases.

In the same way as AIDS reduces the CD 4 cells there is a specific marker for Lyme disease CD57 (Burruscano again) which is reduced. Only Lyme disease suppresses this marker and like AIDS there is a marked propensity to harbour other important chronic infections in this state.

In practice I am finding Mycoplasma including mycoplasma fermentans and Chlamydia Pn infections in a number of patients. I have two with babesia and one with bartonella. In the US there is quite a long list but I will just present these latter two here. It is most essential to look for these in every suspect case of Lyme disease. Even the standard IgG and M markers can be negative but the PCR's will be positive for Mycoplasma and chlamydia. 

These infections are called Co-infections and most are believed to be transmitted with the tick bite. There is a page on the Patient site regarding co-infections. It is of fundamental importance to clear any co-infection early rather than later because the Borrelia infection just simply wont respond unless these others have been eradicated. We do not understand why this is so, it is simply observation.