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August 19, 1992

Borrelia burgdorferi in the Central Nervous System-Reply

Author Affiliations

State University of New York at Stony Brook

JAMA. 1992;268(7):873. doi:10.1001/jama.1992.03490070050034

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In Reply.  —We apologize for not realizing the convention that in Hispanic culture the middle name is included as part of the surname, and thank Dr Benach for the correct citation of their retrospective study. In regard to Dr Cameron, we raise the possibility that persistent CNS infection may act as a sanctuary for B burgdorferi. We also clearly point out in the article that "DNA from both viable and nonviable organisms" are measured by PCR. Clearly, the issue of the significance of the CNS as a sanctuary will require carefully conducted prospective studies. Finally, although not included in the article, in all instances tested, the CSF red blood cell count was less than 5×106/L. This fact, together with the low level of bacteremia known to occur with Lyme borreliosis, make contamination highly unlikely.