Lyme Disease Found in Brain Tissue After Years of Symptoms

Symptoms persisted for more than a decade
Testing was often inconclusive or borderline
Autopsy confirmed Borrelia in multiple brain regions

In their article, “Concurrent Infection of the Human Brain with Multiple Borrelia Species,” Golovchenko and colleagues describe a striking case involving post-mortem brain analysis in a man who suffered for more than 10 years with neurologic and psychiatric symptoms. :contentReference[oaicite:0]{index=0}

A Long and Difficult Clinical Course

The patient first presented in 2004 with an erythema migrans rash and was diagnosed with Lyme disease. Despite antibiotic treatment, his condition worsened over time.

He developed progressive neurological symptoms, including brain fog, slowed processing, and difficulty concentrating—patterns commonly described in our Lyme disease symptoms guide.

Testing over the years showed borderline or fluctuating results, and he underwent multiple courses of antibiotics without sustained improvement.

Neuropsychiatric Decline

By 2017, the patient had positive IgG and IgM antibodies to Borrelia. Months later, he was admitted to a psychiatric hospital and diagnosed with schizotypal personality disorder and somatoform disorder.

His symptoms continued to progress. One year later, the patient died by suicide.

Borrelia Found in Brain Tissue

Following his death, an autopsy was performed at the patient’s request.

PCR testing of brain tissue revealed DNA from two Borrelia species: B. burgdorferi and B. garinii.

Notably, each species was found in different regions of the brain:

• B. burgdorferi: temporal lobe, occipital lobe, parietal lobe, and choroid plexus
• B. garinii: basal ganglia and cerebellum

The organisms were present in distinct, non-overlapping areas of the brain.

Evidence of Persistent Infection

The authors concluded that intact spirochetes can persist in brain tissue even after extended antibiotic treatment.

These findings contribute to ongoing discussions about persistent infection versus immune response in Lyme disease.

They also reinforce concerns about long-term neurological involvement, as outlined in our Lyme disease and brain function guide.

Why This Matters

This case highlights the complexity of Lyme disease, particularly when neurological and psychiatric symptoms dominate the clinical picture.

Borderline or inconsistent test results can complicate diagnosis, while overlapping psychiatric symptoms may delay recognition of the underlying infection.

Lyme disease should remain a consideration in patients with unexplained, progressive neuropsychiatric symptoms—especially when symptoms evolve over time.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention