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Textbook of Hyperbaric Medicine pp 171–181Cite as

Hyperbaric Oxygen Therapy and Chronic Lyme Disease: The Controversy and the Evidence

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Abstract

Lyme disease, a bacterial infection caused by Borrelia burgdorferi and transmitted to humans by the bite of infected blacklegged ticks, is the most common vector-borne disease in the United States. The hallmark manifestation of Lyme disease, an erythema migrans around the tick bite, is found on most infected persons. Less than optimal laboratory testing is an unreliable diagnostic option for up to 20 % who present without objective symptoms. Antibiotics administered early on in the disease cure up to 90 % of infected persons. Persistent symptoms and reinfection may occur after antibiotic therapy. Patient groups advocate for chronic Lyme disease (CLD), a condition of persistent symptoms in patients which may or may not be related to B. burgdorferi infection, a diagnosis that is not promoted by the general medical and scientific community. The protean nature of Lyme disease in its presentation and response to conventional therapy has challenged research and driven patients, especially those with CLD, to seek alternative therapies, including hyperbaric oxygen therapy (HBOT). Neither Lyme disease nor CLD is an approved indication for HBOT, and evidence is scarce to support the use of HBOT on this confusing disease, although some dramatic cases of improvement have been reported. An HBOT registry for Lyme disease and CLD would be an important tool to better understand the number of patients treated and whether or not HBOT has a beneficial effect on this puzzling and controversial condition. This registry could serve as the vehicle to perform the prospective trials that are needed to generate potential evidence to support the use of HBOT on Lyme disease.

Keywords

  • Lyme disease
  • Chronic Lyme disease
  • Hyperbaric oxygen therapy
  • Off-label
  • Registry

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Authors and Affiliations

  1. CHI St. Luke’s Wound Clinic, Lufkin, TX, 75904, USA

    Caroline E. Fife MD

  2. Baylor College of Medicine, Houston, TX, 77030, USA

    Caroline E. Fife MD

  3. Intellicure, Inc., 2700 Research Forest Dr., The Woodlands, TX, 77381, USA

    Caroline E. Fife MD

  4. Strategic Solutions, Inc., 1143 Salsbury Ave., Cody, WY, 82414, USA

    Kristen A. Eckert MPhil

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  1. Caroline E. Fife MD
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  2. Kristen A. Eckert MPhil
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Correspondence to Caroline E. Fife MD .

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This chapter is dedicated to the memory of William P. Fife, PhD

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Fife, C.E., Eckert, K.A. (2017). Hyperbaric Oxygen Therapy and Chronic Lyme Disease: The Controversy and the Evidence. In: Textbook of Hyperbaric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-47140-2_15

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  • DOI: https://doi.org/10.1007/978-3-319-47140-2_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-47138-9

  • Online ISBN: 978-3-319-47140-2

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