Herbert B. Allen*, Rina M. Allawh, Katherine Gresham, Kevin Donnelly and Kavita Goyal
Tertiary syphilis is a well-defined spirochete disease occurring many years after the primary infection. It occurs in approximately 30% of untreated syphilis patients and is mostly seen in the cardiovascular system, the brain and the skin. Other organs such as liver of joints show much less frequent involvement. In this discussion, we consider monoarticular arthritis and Alzheimer’s disease as tertiary Lyme disease, another spirochete malady. Our patient with so called “Montauk knee” had a positive Lyme serology and negative clinical and laboratory findings of other arthritis’s. Treatment with amoxicillin and rifampin led to a cure of her arthritis. We postulate that our patient with dementia had tertiary Lyme disease because Lyme spirochetes have been cultured from Alzheimer’s disease brains and because PCR findings have also confirmed the presence of Borrelia burgdorferi. We have shown how the spirochetes are likely responsible for the biofilms in the organs involved; such biofilms are integral to the pathology noted in the disorders in question. We discuss how biofilm dispersers together with bactericidal antibiotics are or are not effective in treatment.