Prevention, Diagnosis and Treatment of Lyme Disease

Publication Date: January 1, 2021

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

...anagement...

...Prevention

...Personal Protective MeasuresIndivi...

...nts to Prevent Tick BitesFor the prevent...

...) Removal of Attached Tick...

...recommend promptly removing attached ticks...

...ommend against burning an attached tick (with a...


...ostic Tick Testing

...gnostic Tick Testing...

...e recommend submitting the removed tick...

...inst testing a removed Ixodes tick for B....

...) Diagnostic Testing of Asymptomatic...


.... Antibiotic Prophy...

...recommend that prophylactic antibiotic therapy b...


...Antibiotic Reg...

...xodes spp. bites in all age groups, we reco...


V. Erythema Migrans Testing

...tients with potential tick exposure in...

...with 1 or more skin lesions suggestiv...


...Erythema Migrans Antibiotic Regimens...

...tients with erythema migrans, we reco...


...ma Migrans Antibiotic Duration...

...hat patients with erythema migrans be treated w...


...thern Tick-associated Rash Illness (STARI)...

...nts who develop an erythema migrans-...


.... Lyme Neuroborre...

...atients for possible Lyme neuroborre...

...F testing is performed in patients with suspec...


...urological Presentations...

...tients presenting with 1 or more of the follow...

...ts with typical amyotrophic lateral scle...

...nts with neurological syndromes ot...

...tients presenting with nonspecific magnetic r...


...Adult Psychiatric Illnesses...

...tients with psychiatric illness, we recommend a...


...hildhood Psychiatric Ill...

...enting with developmental, behavioral or ps...


...Neurologic Manifestations...

...ients with Lyme disease-associated mening...


...Brain or Spinal Co...

...with Lyme disease-associated parenchyma...


...Facial Nerve Palsy...

...th Lyme disease-associated facial...


...I. Lyme Carditis Screeni...

...erforming an electrocardiogram (ECG...


...Carditis Hospitalization...

...atients with or at risk for severe cardiac compl...


XVIII. Lyme Carditis...

...h symptomatic bradycardia due to L...


...Lyme Carditis Antibiotic...

...atients with Lyme carditis, we suggest oral a...

...he hospitalized patient with Lyme carditis,...

...treatment of Lyme carditis, we suggest 14–2...


...Lyme Myocarditis/Pericardit...

...patients with acute myocarditis/pericardi...

...nts with chronic cardiomyopathy of...


...e Arthritis Testing...

...possible Lyme arthritis, we recommend serum ant...

...eropositive patients for whom the d...


XXII. Lyme Arthritis Initial Ant...

...patients with Lyme arthritis, we recommend...


...resolved Lyme Arthritis...

...tients with Lyme arthritis with parti...

...th Lyme arthritis with no or minimal r...


.... Post-antibiotic Arthritis...

...n patients who have failed one course of...


...ersistent Symptoms...

...patients who have persistent or recu...


XXVI. Borrelial Lymphocy...

...n patients with borrelial lymphocytoma, we s...


...I. Acrodermatitis Chronica Atrophicans...

...patients with acrodermatitis chronica a...


...ection with A. Phagocytophilum Or Microti?...

...Lyme disease who have a high-grade fever or...


Tables and Figures

...and Figures...

...sesHaving trouble viewing table? Expand...


...ment of Specific Manifestations of Lyme Disease...


...rsonal Prevention MeasuresHaving trouble viewin...


.... Management of a suspected Ixodes tick bite...


...Dorsal View of Unfed Blacklegged Tick (Ixode...


...Disease, Confirmed CasesBy month of disease on...


...4. Reported Cases of Lyme Disease, United S...


...e 5. Proper Tick RemovalProper removal requires...


...ative Sizes of Engorging Nymphal and...


...7. Early Lyme Rash