Chronic Lyme disease and co-infections: inpatient treatment in Germany

The Lyme program consists of modules, and each patient receives the modules that match the diagnostic findings. Dr. Julian Douwes, Chief Medical Officer, develops the protocols. Dr. Angelina Svircev supervises the treatment on the ward.

1. Diagnostics

The program starts with a medical history, a physical and neurological examination and laboratory tests. The laboratory tests include a Borrelia ELISpot, a Western blot with expanded band analysis, a CD57 natural killer cell analysis, a co-infection panel and an assessment of immune function. These tests go beyond the standard two-step test (ELISA and Western blot). Lyme disease remains a clinical diagnosis that laboratory tests support. How the hospital diagnoses Lyme disease

2. Core Lyme module (2 weeks, inpatient)

The core Lyme module combines two sessions of whole-body hyperthermia with antibiotic therapy. The hospital calls this protocol antibiotic-augmented thermoeradication (AAT); the name describes the method. Each session reaches 41.6–41.8 °C / 106.9–107.2 °F for 120 minutes, under sedation, with core temperature, heart rate, oxygen level and blood pressure monitored throughout; 41.6 °C / 106.9 °F is the protocol minimum because laboratory studies show that Borrelia is sensitive to heat. The hospital offers whole-body hyperthermia only within the inpatient program. The antibiotic therapy uses individually selected combinations, given intravenously and orally, for 2 weeks, with supportive infusions and daily physical therapy. The Lyme treatment protocol in detail and what a session of whole-body hyperthermia involves

3. Co-infection module (2 additional weeks, only if co-infections are confirmed)

The co-infection panel tests for Bartonella, Babesia, Ehrlichia, Anaplasma, Rickettsia, Chlamydia pneumoniae, Mycoplasma pneumoniae and Yersinia. If a co-infection is confirmed, the co-infection module adds 10 sessions of intravenous laser therapy, apheresis and antimicrobial agents that the physician selects for the identified pathogen. Co-infections that the hospital tests for and what intravenous laser therapy involves

4. Apheresis, if indicated

Apheresis is a group of procedures that filter the blood outside the body. In the Lyme program the physician may recommend H.E.L.P. apheresis. For patients with elevated autoantibody levels the physician may recommend immunoadsorption. The decision depends on your laboratory findings. What H.E.L.P. apheresis involves and what immunoadsorption involves

5. Microbiome restore week (1 additional week, optional)

Antibiotic therapy over several weeks disrupts the bacteria in the gut. This module addresses the gut after the antibiotic therapy. It includes a gastroscopy and a colonoscopy with a microbiome transfer. The physician discusses with you whether this module is appropriate for you. What microbiome transfer involves

6. One coordinated plan

The program addresses the domains of Lyme disease in one plan: the Borrelia infection and the co-infections, inflammation, the immune system, detoxification, the gut microbiome, mobility and pain, mental health and nutrition. One team plans all therapies, reviews your findings and your response every day and adjusts the plan. How the Lyme therapies combine. Whole-body hyperthermia, intravenous laser therapy and apheresis are therapies outside standard care; the hospital performs them as individual treatment attempts, decided with you after medical consultation. The Lyme disease center page describes the condition, the diagnosis and the therapies in more depth.