Lyme disease is an infectious disease with global impact caused by the bacterium Borrelia burgdorferi carried by ticks. In Taiwan, a laboratory-confirmed case of human Lyme disease was reported in 1998, and spirochetes related to the pathogen B. Burgdorferi sensu lato were first isolated from rodents in Taiwan. The medical diagnosis of Lyme disease is based on a variety of findings, including skin, rheumatic, neurologic, and cardiac abnormalities, as well as laboratory tests. Evidence suggests that it can be successfully treated with antibiotic drugs if intervention occurs immediately after infection. However, some patients continue to have chronic Lyme disease (CLD) despite adequate treatment. The exact mechanism of CLD symptoms is unknown. Hyperbaric oxygen treatment can be used as primary or adjunctive therapy for a range of medical and surgical conditions and has been used in the treatment of CLD since the 1990s.
There are several complementary therapies, including immune system therapy, ozone therapy, vaccinations, and hyperbaric oxygen treatment. Among these therapies, hyperbaric oxygen treatment has been recommended for the treatment of Lyme borreliosis, especially in patients who are treated with antibiotics but still suffer from Lyme-related symptoms. Hyperbaric oxygen therapy, a treatment in which the patient breathes 100% oxygen intermittently while the treatment room is pressurized to a pressure above sea level, is increasingly used in many areas of medical practice. Although the method of action of this unique intervention is not satisfactorily understood, some mechanisms such as competition for anaerobic bacteria by increasing tissue oxygen tension, inhibiting bacterial metabolic function by increasing oxygen free radical production, and enhancing leukocyte killing of bacteria by promoting oxygen free radicals. Reliance on the peroxidase system and improved oxygen-dependent transport of certain antibiotics have been established to be effective. Austin described the effect of oxygen on B. burgdorferi in 1993 and showed that ambient O2 and CO2 levels can affect the infectivity of B. burgdorferi. Researchers at Texas A&M University have since reported the role of hyperbaric oxygen treatment in CLD. 84.8% of treated patients (n=91) showed significant improvement in symptoms, including confusion, pain, depression and fatigue, and approximately 70% of patients showed durable benefit at follow-up examinations. CLD is a complex disease. Although hyperbaric oxygen treatment is not routinely recommended for CLD, it may be an effective adjunctive therapy when clinicians are dealing with patients with CLD.