Lyme disease, often characterized as a readily treatable infection, can be a debilitating and expensive illness, especially when patients remain symptomatic following therapy for early disease. Identifying and promoting highly effective therapeutic interventions for US patients with erythema migrans (EM) rashes that return them to their pre-infection health status should be a priority. The recently released treatment recommendations by the Infectious Diseases Society of America/American Academy of Neurology/American College of Rheumatology (IDSA/AAN/ACR) for the treatment of US patients fall short of that goal. This paper reviews the US trial evidence regarding EM rashes, discusses the shortcomings of the IDSA/AAN/ACR recommendations in light of that evidence and offers evidence-based, patient-centered strategies for managing patients with erythema migrans lesions.
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http://dx.doi.org/10.3390/antibiotics10070754 | DOI Listing |
Microbiol Spectr
January 2025
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
is a vector of several human pathogens in the United States, including the cause of Lyme disease, and Powassan virus (POWV), an emerging cause of severe encephalitis. Skin biopsies from tick bite sites are frequently collected and tested for the presence of spirochetes ( spp.), which remain elusive.
View Article and Find Full Text PDFPediatr Infect Dis J
December 2024
From the Division of Infectious Diseases, Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, New York.
We conducted an exploratory study of plasma microbial cell-free DNA sequencing for the diagnosis of Lyme disease among pediatric patients. Low levels of Borrelia burgdorferi microbial cell-free DNA (<3-5 molecules per microliter) were observed in 6/9 serologically confirmed participants, including 4/5 with arthritis and 2/3 with multiple erythema migrans.
View Article and Find Full Text PDFTo determine the frequency of confirmed Lyme neuroborreliosis (LNB) cases in adult patients with three different clinical presentations consistent with early LNB. Data were obtained through routine health care at the UMC Ljubljana, Slovenia from 2005-2022, using clinical pathways. The patients were classified into three groups: i) radicular pain of new onset (N = 332); or ii) involvement of cranial nerve(s) but without radicular pain (N = 997); or iii) erythema migrans (EM) skin lesion(s) in conjunction with symptoms suggestive of nervous system involvement but without either cranial nerve palsy or radicular pain (N = 240).
View Article and Find Full Text PDFInfection
January 2025
Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Purpose: To determine the frequency of confirmed Lyme neuroborreliosis (LNB) cases in adult patients with three different clinical presentations consistent with early LNB.
Methods: Data were obtained through routine health care at the UMC Ljubljana, Slovenia from 2005 to 2022, using clinical pathways. The patients were classified into three groups: (i) radicular pain of new onset (N = 332); or (ii) involvement of cranial nerve(s) but without radicular pain (N = 997); or (iii) erythema migrans (EM) skin lesion(s) in conjunction with symptoms suggestive of nervous system involvement but without either cranial nerve palsy or radicular pain (N = 240).
Lancet Reg Health Eur
January 2025
Division of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
Background: Lyme disease (LD) is caused by and is the most common tickborne disease in the northern hemisphere. Although classical characteristics of LD are well-known, the diagnosis and treatment are often delayed. Laboratory diagnosis by serological testing is recommended for most LD manifestations.
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