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Ticks live and thrive in the Alps
There are ticks in them thar hills. It appears that ticks are everywhere, even in the Alps. In the late 1980’s, ticks did not exist or were rare in Italy’s Piedmont region, located at the base of the Alps. But, “In recent years, a marked increase in tick abundance has been observed in several Alpine valleys, together with more frequent reports of Lyme borreliosis,” writes Garcia-Vozmediano and colleagues. [1]
Are doctors reluctant to diagnose Lyme disease?
A study by Tulloch and colleagues, published in the journal BJGP Open, examined the decision-making behavior of general practitioners (GPs) when applying Read codes to non-specific clinical presentations. The authors used Lyme disease as a case example and recruited GPs in the North West of England. [1]
Lyme disease misdiagnosed as shingles in a 62-year-old man
A recent article, published in the journal Clinical Case Reports, describes the case of a 62-year-old man, from Norway, who was initially diagnosed with shingles, a viral infection which produces a painful skin rash with blisters in a localized area on the body. [1] Shingles, also known as herpes zoster, is common in older individuals who have had chickenpox.
Six cases of neurological Lyme disease
Clinicians from Mayo Clinic describe 6 cases of neurological Lyme disease in the journal Open Forum Infectious Diseases. [1] Five of the cases presented with Bannwarth syndrome (BWS), an uncommon manifestation of neurologic Lyme disease.
Can Lyme disease cause dementia?
There have been reports of Borrelia burgdorferi (Bb), the bacterial agent of Lyme disease, triggering primary dementia, such as Alzheimer’s disease. Researchers who examined the records of 1,594 patients with dementia found that 1.25% had a positive intrathecal anti-Borrelia antibody index (AI), specific for neuroborreliosis. They concluded, “Pure Lyme dementia exists and has a good outcome after antibiotics.” 1
Successful treatment for Lyme arthritis after knee surgery
This published case report by Wright and colleagues features what the authors believe is the "first patient with late Borrelia burgdorferi sensu stricto arthritis-related prosthetic joint infection. They suggest "the case highlights how early, prompt diagnosis and adequate antimicrobial therapy may obviate the need for additional aggressive orthopedic surgical intervention."
Can Lyme disease cause jaundice?
Gastrointestinal complications are often seen in Lyme disease. But hyperbilirubinemia, a condition that causes yellow discoloration of the eyes and skin, referred to as jaundice, is a rare manifestation of Lyme disease. Only a handful of cases have been reported in the literature.
Atypical symptoms of Lyme disease: numbness, paresthesia and abdominal wall weakness
Doctors are beginning to consider Lyme disease as a possible diagnosis in patients who present with unusual symptoms. This case study, published in the New England Journal of Medicine, features a patient with unique manifestations of Lyme disease. Physicians presented the case at neurology grand rounds at Massachusetts General Hospital. [1]
Subacute transverse myelitis caused by Borrelia infection
Lyme neuroborreliosis can manifest as encephalitis or acute/subacute transverse myelitis. Only a handful of subacute transverse myelitis cases have been reported in the literature. In their article, “Subacute transverse myelitis with optic symptoms in neuroborreliosis: a case report,” Opielka et al. describe one of the few cases of subacute transverse myelitis (SaTM) associated with Lyme neuroborreliosis and involving the optic nerve.
Lyme disease infection triggers heart block in young man
Although Lyme carditis is reportedly an infrequent manifestation of Lyme disease, new-onset heart block in young patients is exceptionally rare. And a lack of objective Lyme disease symptoms, such as an erythema migrans rash, can make it challenging to diagnose Lyme carditis in this patient population. But a new tool, developed in 2018, may assist clinicians in identifying possible cases.