Vartiovaara I. 1995 Living with Lyme. Lancet, 345:842-4 A Finnish physician ’s account of his experiences that beginning with a tick bite in Vancouver in 1987. Dr. Vartiovaara resigned from his position with the Finnish Medical Journal in 1992, due to disabilities caused by Lyme disease. [Persistence:] After that [a positive result on a T-cell proliferation test at Stony Brook Hospital] I had two months’ heavy treatment with oral doxycycline 300mg a day. I was a little better after it, but only for about two months. Then it started all over again, and got worse. ..We sent blood and spinal fluid to Dr. Oksi and they turned out to be positive [by PCR]--in other words, the spirochaete was still alive in my body after six years, despite the antibiotics. Dr. Vartiovaara was then treated aggressively with a combination of antibiotics, including four weeks of ceftriaxone, for six months. Some time after the cessation of treatment however, he found that .My symptoms are on the move again. [Diagnosis:] What should be done when a patient has the typical Lyme disease history but negative serology? This is still a hot question especially in the USA. My strong opinion is that oral antibiotics should be given in such cases. Ordinary laboratory tests cannot be relied upon and the PCR is too expensive for routine use. When the whole picture leans towards Lyme borreliosis it is both ethically and medically right to treat
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