Treib, J, Fernandez, A, Haass, A et al. · Neurology · 1998 · DOI
Researchers followed 44 patients who had been treated for a tick-borne brain infection caused by Borrelia bacteria. Even though the patients' neurological symptoms improved after antibiotics, more than half continued to experience ongoing fatigue and other non-specific symptoms similar to chronic fatigue syndrome years later. Some patients also continued to show signs of Borrelia infection in their blood tests.
This study is relevant to ME/CFS research because it documents a cohort of patients with confirmed CNS infection who developed persistent fatigue-like symptoms after standard antibiotic treatment. The observation that >50% of treated neuroborreliosis patients experienced CFS-like symptoms suggests potential infectious triggers for fatigue syndromes and highlights the importance of investigating post-infectious sequelae in ME/CFS populations.
This study does not prove that Borrelia causes ME/CFS in the general population, nor does it establish causation between persisting antibodies and symptom persistence—the relationship could be coincidental or represent separate phenomena. The study also does not clarify whether persistent symptoms result from incomplete bacterial eradication, immune dysregulation, or other mechanisms. No comparison group of treated patients without persistent symptoms is presented.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Treib, J, Fernandez, A, Haass, A, Grauer, M T, Holzer, G, & Woessner, R (1998). Clinical and serologic follow-up in patients with neuroborreliosis.. Neurology. https://doi.org/10.1212/wnl.51.5.1489
BibTeX
@article{mecfsatlas-treib-1998-clinical-serologic,
author = {Treib, J and Fernandez, A and Haass, A and Grauer, M T and Holzer, G and Woessner, R},
title = {Clinical and serologic follow-up in patients with neuroborreliosis.},
journal = {Neurology},
year = {1998},
doi = {10.1212/wnl.51.5.1489},
note = {PubMed: 9818893},
url = {https://www.mecfsatlas.com/evidence/treib-1998-clinical-serologic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/treib-1998-clinical-serologic
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