Management approaches for suspected and established Lyme disease used at the Lyme disease diagnostic center

Wiener klinische Wochenschrift
Gary P WormserJ Nowakowski

Abstract

2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for Lyme disease-related facial palsy and/or radiculopathy is a 2-week course of doxycycline. Patients who are hospitalized for Lyme meningitis are usually treated at least initially with ceftriaxone. We have not seen convincing cases of encephalitis or myelitis solely due to Borrelia burgdorferi infection in the absence of laboratory evidence of concomitant deer tick virus infection (Powassan virus). We have also never seen Lyme encephalopathy or a diffuse axonal peripheral neuropathy and suggest that these entities are either very rare or nonexistent.We have found that Lyme disease rarely presents with fever without other objecti...Continue Reading

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Citations

Nov 18, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Phillip J MolloyGary P Wormser
Apr 20, 2018·Environmental Health Perspectives·Catherine BouchardPatrick A Leighton
Aug 10, 2018·Wiener klinische Wochenschrift·Gerold Stanek
Jan 29, 2021·Clinical Microbiology Reviews·John A Branda, Allen C Steere

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