Diplopia (double vision) and heart block in early-disseminated Lyme disease

In the latest issue of Mayo Clinical Proceedings, a physician from Mayo Clinic describes a 49-year-old man from Minnesota with acute-onset diplopia (double vision) and heart block in early-disseminated Lyme disease. [1] “This patient met criteria for early-disseminated Lyme disease with multiple erythema migrans lesions and evidence of cardiac and neurologic involvement,” according to Blackwell from the Department of General Internal Medicine, Mayo Clinic. Over the course of a month, the patient’s rash grew to cover most of his chest.

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First report of Malaria with Lyme disease as a co-infection

Malaria and Lyme disease are common vector-borne illnesses. While malaria is caused by a tropical parasite, Lyme disease is transmitted by a non-tropical bacterium, Borrelia burgdorferi (Bb). In the 2017 issue of Clinical Case Reports, doctors in Portugal describe the case of a 42-year-old man who was initially diagnosed with malaria but later found to also be infected with Borrelia. [1]

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Young kids and the elderly in New Hampshire are at greatest risk of a tick bite

In the United States, young kids and the elderly are at the greatest risk of developing Lyme disease, according to the Centers for Disease Control and Prevention (CDC). Now, a study examining emergency room (ED) admissions has found that in New Hampshire they are also at the greatest risk of getting a tick bite. [1]

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Subacute parkinsonism as a complication of Lyme disease

Medicine is always on the lookout for reversible causes of common illnesses. And while parkinsonism has been reported in a few patients with Lyme disease, the relationship between the Borrelia burgdorferi (Bb) infection and parkinsonism has been questioned. In the review “Subacute parkinsonism as a complication of Lyme disease,” published in the Journal of Neurology, the authors describe two cases where patients “developed reversible subacute parkinsonism due to Lyme basal ganglia ischemic or inflammatory lesions.”

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Tracking ticks in Canada with digital images

Ticks capable of transmitting Lyme disease (LD) have been found in Quebec, Canada using the traditional specimen-based identification method, where submitted ticks are analyzed by the ‘gold standard’ method using a microscope. But now a study, published in Parasitology, demonstrates a novel approach to utilizing web-based submissions of digital images or photographs in tracking Ixodes scapularis ticks. [1]

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First case of reversible complete heart block due to Lyme disease reported in Canada

Complete heart block is an uncommon but important cause of morbidity in the United States. The cases of Lyme disease in Canada continue to climb in part due to the spread of the Ixodes Scapularis tick by birds. [1] In a recent issue of the American Journal of Medicine, doctors report on the first case of heart block due to Lyme disease (LD) in Canada. [2]

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Save the two-tier Lyme disease test

The western blot based two-tier test (TTT) is not that sensitive of a test. Only 25% of patients with early Lyme disease had a positive western blot TTT, according to a study published in the March 2017 issue of Clinical Infectious Diseases. And, only 55% of the early Lyme disease study participants had a positive western blot TTT on convalescence. [1]

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In culture, novel combinations of antibiotics prove effective for Lyme disease

Lyme disease can be difficult to treat. “One possibility is that persisting organisms are not killed by current Lyme antibiotics,” according to Feng and colleagues from the Department of Molecular Microbiology and Immunology, Johns Hopkins University. As reported in the journal Antibiotics, the authors examined the relative activity of drugs for activities against B. burgdorferi stationary phase cells. [1]

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Single dose prophylactic treatment of a tick bite only prevents a Lyme rash

In a recent review entitled “Lyme Disease: Emergency Department Considerations,” the authors recommend using a one-time, single dose of doxycycline for the prophylactic treatment of a tick bite, [1] despite the fact that there has been only one study exploring the effectiveness of such a limited dosage. The article also neglects to mention that there are doctors who take a different approach and advise against a one-time, single dose. [2]

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Temporary pacemaker effective in acute Lyme carditis patient with severe heart block

A 30-year-old man with acute Lyme carditis with severe heart block is successfully treated with a temporary pacemaker. “Quite frequently, these young patients are implanted with permanent pacemakers; given lack of knowledge on the transient nature of the cardiac conduction system inflammation,” according to researchers from Ontario, Canada. [1]

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