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
Managem...
...Prevention...
...Protective MeasuresIndividuals at ri...
(B) Repellents to Prevent Tick Bit...
...oval of Attached Ticks...
...e recommend promptly removing attached tick...
...inst burning an attached tick (with a matc...
...nostic Tick Testing...
...Diagnostic Tick Testin...
...mend submitting the removed tick for species id...
...mmend against testing a removed Ixodes tick...
(B) Diagnostic Testing of Asymptomatic Patients...
...Antibiotic Prophylaxis...
...mmend that prophylactic antibiotic therapy be gi...
.... Antibiotic Regimen...
...h-risk Ixodes spp. bites in all age g...
.... Erythema Migrans Tes...
...with potential tick exposure in a Lyme...
...ients with 1 or more skin lesions sug...
...a Migrans Antibiotic Regimens...
...atients with erythema migrans, we reco...
...ema Migrans Antibiotic Duration...
We recommend that patients with erythe...
...Southern Tick-associated Rash Illness (STARI)...
...n patients who develop an erythema migrans-li...
...X. Lyme Neuroborrelio...
...patients for possible Lyme neurob...
...CSF testing is performed in patients with susp...
...Neurological Presentations...
...resenting with 1 or more of the followi...
In patients with typical amyotroph...
...patients with neurological syndrom...
...atients presenting with nonspecific magnetic reson...
...dult Psychiatric Illnesses
...ents with psychiatric illness, we recommend agains...
...I. Childhood Psychiatric Illness...
...presenting with developmental, behavio...
XIII. Acute Neurologic Manifest...
...ts with Lyme disease-associated meningi...
...V. Brain or Spina...
...s with Lyme disease-associated par...
...Facial Nerve Palsy...
...with Lyme disease-associated facia...
...Lyme Carditis Screen...
...performing an electrocardiogram (ECG)...
...yme Carditis Hospitalizat...
...patients with or at risk for severe...
...III. Lyme Carditis Pac...
...patients with symptomatic bradycardia due...
...e Carditis Antibiotics
...s with Lyme carditis, we suggest or...
...italized patient with Lyme carditis, we suggest in...
...ent of Lyme carditis, we suggest 14–21 day...
...yocarditis/Pericarditi...
...nts with acute myocarditis/pericarditis of unk...
...n patients with chronic cardiomyopathy...
...me Arthritis Testing...
...essing possible Lyme arthritis, we...
...sitive patients for whom the diagnosis...
...thritis Initial Antibiotics...
...with Lyme arthritis, we recommend using oral an...
...esolved Lyme Arthritis...
In patients with Lyme arthritis with par...
...patients with Lyme arthritis with no or min...
...Post-antibiotic Arthri...
...n patients who have failed one course of or...
...sistent Symptoms...
...s who have persistent or recurring nonspecif...
XXVI. Borrelial Lym...
...patients with borrelial lymphocytoma, we s...
...odermatitis Chronica Atrophicans...
...tients with acrodermatitis chronica atro...
...nfection with A. Phagocytophilum Or...
...ts with Lyme disease who have a hig...
Tables and Figures
...and Figures...
...1. Drug DosesHaving trouble viewing t...
...nt of Specific Manifestations of Lym...
...sonal Prevention MeasuresHaving troub...
...gement of a suspected Ixodes tick bite in the USA....
...igure 2. Dorsal View of Unfed Blac...
...3. Lyme Disease, Confirmed CasesBy mont...
...4. Reported Cases of Lyme Disease, U...
...Proper Tick RemovalProper removal...
...elative Sizes of Engorging Nymphal and Adul...
...igure 7. Early Lyme Ra...