Diagnosing Lyme disease can be extremely challenging as the disease mimics many other illnesses and testing is not always accurate. The authors of a new study, Accuracy of Clinician Suspicion of Lyme Disease in the Emergency Department, discovered this firsthand as they examined “the accuracy of clinician suspicion for Lyme disease in children undergoing evaluation for Lyme disease.” 
Ever wonder what the outcome might be if a patient were prescribed a single dose of oral doxycycline for Lyme disease? Not so good, according to a case report by Ebner and colleagues from the Mayo Clinic in Rochester, Minnesota. 
Until now, scientists have known little about the evolutionary history of Borrelia burgdorferi, the causative agent of Lyme disease. This lack of knowledge “limits our ability to track and predict the direction of ongoing spread and implement public health interventions,” state the authors of a new study “Genomic insights into the ancient spread of Lyme disease across North America.” 
“Despite weeks of symptoms, a patient did not seek treatment until his illness rendered him unconscious,” writes Sharma from the Department of Cardiovascular Medicine at Lahey Hospital Medical Center in Massachusetts.
Dogs can be effective sentinels in assessing the risks of Lyme disease to humans in non-endemic regions. “Domestic pets, such as dogs, are significant risk factors for disease acquisition, and six times more likely to be exposed to infected ticks due to the increased potential exposure time in tick habitat,” explains Hendricks and colleagues in the journal Geospatial Health. 
If the Borrelia spirochete were actively dividing and spreading during infection, it would be easier to detect Lyme disease and possibly diagnose it earlier, says Embers and colleagues.  “Bacterial pathogens are well known to cause tissue damage by colonization, induction of intense inflammation, invasion of host cells, and production of toxins.”
“A previously healthy 48-year-old woman living in rural Maryland presented in early June with a 2-week history of neck pain, fatigue, anorexia, nausea, and intermittent fevers and chills,” states Novak from the Division of Rheumatology at Johns Hopkins University School of Medicine.
“An 80-year-old patient was admitted to the hospital after a fall, and subsequently developed an acute confused state requiring transfer to a neuropsychiatric unit,” writes Karrasch and colleagues in the journal Ticks and Tick-borne Diseases. 
by Daniel J. Cameron, MD, MPH
Following is a list of the most popular All Things Lyme blogs for 2017. Click on the headline to read the complete article.
1) 12-year-old boy suffers cardiac arrest due to Lyme disease
In the February 2017 issue of HeartRhythm Case Reports, doctors describe what they believe is the first case of a Lyme disease patient presenting as fulminant myocarditis and cardiac arrest.
“The patient is a 12-year-old previously healthy boy with a recent history of participation in an outdoor camp for 2–3 weeks who began to gasp for air while riding as a passenger in a car, with subsequent cyanosis and cardiac arrest, ...
“The town of Lyme in Connecticut was the first spot that LD [Lyme disease] was recognized in the U.S.,” writes Mollalo and colleagues in the journal Geospatial Health.  In 1977, Steere et al. described the initial cluster of cases in children. Today, 40 years later, Lyme disease continues to be a burden for Connecticut.