Appendix 1.

Evidence for persistent infection following treatment of Lyme disease^a

Study/reference	Study origin	Persistence of B. burgdorferi shown by	Sample source
Weber et al1	Europe	Histology	Brain, liver (autopsy)b
Schmidli et al2	Europe	Culture	Synovial fluid
Cimmino et al3	Europe	Histology	Spleen
Preac-Mursic et al4	Europe	Culture	Skin Bx, CSF
Pfister et al5	Europe	Culture	CSF
Strle et al6	Europe	Culture	Skin Bx
Preac-Mursic et al7	Europe	Culture	Iris Bx
Haupl et al8	Europe	Culture	Ligament Bx
Strle et al9	Europe	Culture	Skin Bx
Preac-Mursic et al10	Europe	Culture	Skin Bx, CSF
Oksi et al11	Europe	Culture	CSF
		PCR	Brain Bx
		PCR	Brain (autopsy)
Priem et al12	Europe	PCR	Synovial Bx/fluid
Oksi et al13	Europe	Culture, PCR	Blood
Breier et al14	Europe	Culture	Skin Bx
Hunfeld et al15	Europe	Culture	Skin Bx
Hudson et al16	Australia	Culture, PCR	Skin Bx
Steere et al17	USA	Histology	Synovial Bx
Kirsch et al18	USA	Histology	LN (autopsy)
Liegner et al19	USA	Histology	Skin Bx
		PCR	Blood
Battafarano et al20	USA	Histology, PCR	Synovial Bx/fluid
Chancellor et al21	USA	Histology	Bladder Bx
Nocton et al22	USA	PCR	Synovial fluid
Shadick et al23	USA	Histology	Brain (autopsy)
Masters24	USA	Culture	Blood
Lawrence et al25	USA	PCR	CSF
Bayer et al26	USA	PCR	Urine
Nocton et al27	USA	PCR	CSF

Notes:

^aAll patients had received a minimum of 2 to 4 weeks of antibiotic therapy;

^bMother treated with antibiotics during pregnancy; newborn died.

Abbreviations: PCR, polymerase chain reaction; Bx, biopsy; CSF, cerebrospinal fluid; LN, lymph node.