Biology and neuropathology of dementia in syphilis and Lyme disease

It has long been known that Treponema pallidum, subspecies pallidum can in late stages of neurosyphilis cause dementia, cortical atrophy, and amyloid deposi- tion. The occurrence of dementia, including subacute presenile dementia, was also reported in association with Lyme disease caused by another spirochete, Borrelia burgdorferi.

The Need for Clinical Judgment in the Diagnosis and Treatment of Lyme Disease

Clinical practice guidelines are increasing in number. Unfortunately, when scientific evidence is uncertain, limited, or evolving, as is often the case, conflict often arises between guideline committees and practicing physicians, who bear the direct responsibility for the care of individual patients.