Prevention, Diagnosis and Treatment of Lyme Disease
Key Points
Key Points
- Lyme disease is the most common vector-borne infectious disease of humans in the temperate northern hemisphere.
- It is a complex infection, and clinical disease can manifest as early as days and as late as many months following an infectious tick bite.
- Presentations include a skin lesion at the site of the tick bite and disseminated disease resulting in skin lesions distant from the tick-bite site, neuropathy, meningitis, cardiac conduction abnormalities, and/or arthritis.
- Interpretation of diagnostic tests for Lyme disease presents certain challenges due to the dynamics of the serologic response following infection.
- Finally, treatment options, including the drug, route, and duration of treatment may differ for different disease manifestations.
Management
...M...
...sonal Protective MeasuresIndividuals at risk of...
...lents to Prevent Tick BitesFor the p...
(C) Removal of Attached T...
...promptly removing attached ticks by mechanical mea...
...ommend against burning an attached tick (with a...
...II. Di...
...gnostic Tick Testing
...ubmitting the removed tick for species...
...commend against testing a removed Ixodes tick...
...c Testing of Asymptomatic Patients Followi...
...III...
...that prophylactic antibiotic therap...
...IV. Antibiotic Regimen...
...k Ixodes spp. bites in all age groups, we...
...V....
...ients with potential tick exposure in a L...
...s with 1 or more skin lesions suggest...
...VI. Erythem...
...atients with erythema migrans, we rec...
...VII. Erythema M...
...that patients with erythema migrans be treated wi...
...VIII. The So...
In patients who develop an erythema migrans-...
...IX. Lyme Neurobor...
...g patients for possible Lyme neuroborreliosis...
...SF testing is performed in patients wit...
...X. Neur...
...nts presenting with 1 or more of the followin...
...with typical amyotrophic lateral sclerosis, re...
...tients with neurological syndromes other...
...tients presenting with nonspecific mag...
...XI. Adul...
...tients with psychiatric illness, we recommen...
...XII. Chil...
...en presenting with developmental, behavior...
...X...
...ith Lyme disease-associated meningitis, cran...
...XIV. Brain...
...ients with Lyme disease-associated pare...
...XV. Facial Nerve Palsy...
...ts with Lyme disease-associated facial nerve...
...XVI. Lyme...
...rforming an electrocardiogram (ECG) only in...
...XVII. Lyme Cardit...
In patients with or at risk for severe cardi...
...XVIII. Lym...
...tients with symptomatic bradycardia...
...XIX. Lyme...
...tpatients with Lyme carditis, we suggest oral a...
...lized patient with Lyme carditis, we suggest...
...the treatment of Lyme carditis, we...
...XX. Lyme Myocardi...
...n patients with acute myocarditis/pericarditis...
...ients with chronic cardiomyopathy of unknow...
...XXI. Lyme...
...ssessing possible Lyme arthritis, we recommend...
...sitive patients for whom the diagnosis of Lym...
...XXII. Lyme Arthrit...
For patients with Lyme arthritis, we recommend...
...XXIII. Unreso...
...n patients with Lyme arthritis with partial...
...h Lyme arthritis with no or minimal res...
...XXIV...
...nts who have failed one course of o...
...XXV. Persistent Symptoms...
...or patients who have persistent or recurring no...
...XXVI. Bo...
...nts with borrelial lymphocytoma, we suggest or...
...XXVII. Acroderm...
...with acrodermatitis chronica atrophicans, we sug...
...XXVIII. Co-Infecti...
...patients with Lyme disease who have a high-gr...
Tables and Figures
...Tabl...
...ble 1. Drug Doses Drug D...
...ment of Specific Manifestations of...
...rsonal Prevention Measures Before...
Table 4. Management of a suspected Ixodes tick...
...sal View of Unfed Blacklegged Tick (I...
...igure 3. Lyme Disease, Confirmed Cases By...
Figure 4. Reported Cases of Lyme Disease,...
...e 5. Proper Tick Removal Proper removal...
...elative Sizes of Engorging Nymphal and Adult Fem...
...igure 7. Early Lym...