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Which Lyme disease guidelines should you follow for Lyme Carditis?
Lyme carditis occurs when Borrelia burgdorferi spirochete penetrate the pericardium (a membrane that encloses the heart) or myocardium (muscular tissue of the heart). The infection triggers an inflammatory response, typically causing atrioventricular (AV) conduction abnormalities, such as a first, second or third-degree heart block.
Babies contracted Babesia, a Lyme disease co-infection, during pregnancy.. An Inside Lyme Podcast.
Welcome to an Inside Lyme case study. In this case study, I will be discussing two babies who contacted Babesia from their mothers. These cases were described in the Journal of the Pediatric Infectious Disease Society, written by Saetre and colleagues in 2017.
Psychiatric lyme disease
All too frequently patients with complex, multisystem illnesses are dismissed by clinicians, their symptoms often attributed to a psychiatric illness simply as “a diagnosis of default,” writes Bransfield in “Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty.”¹ This attitude can lead to tragic delays in identifying a correct diagnosis and appropriate treatment.
Conversion disorder, Guillain-Barré syndrome or neurologic Lyme disease?
The authors of “Atypical Lyme Neuroborreliosis, Guillain-Barré Syndrome or Conversion Disorder: Differential Diagnosis of Unusual Neurological Presentations” present a challenging diagnostic case involving a 62-year-old woman with symptoms consistent for multiple neurologic disorders.
Lyme disease in England
In a briefing on October 9th, 2019 in the UK, researchers dismissed the seriousness and prevalence of illness due to Lyme disease. Although they acknowledged that some patients exhibit persistent, chronic Lyme disease symptoms, the numbers, they say, are small. “Of these [Lyme disease] patients, fewer than one in 20 experience residual symptoms,” writes Harvey in the British Medical Journal.¹
A severe Babesia infection
Babesiosis is a parasitic disease transmitted primarily through the bite of an infected tick but it can also be spread through tainted blood transfusions or less frequently via organ transplantation or perinatally. The severity of Babesia can range from asymptomatic to life-threatening. In immunocompromised patients or in those who have contracted the disease through blood transfusions, a Babesia infection has a fatality rate of about 20%. [1,2]
Is prolonged antibiotics treatment for Lyme disease the new norm?
The Infectious Diseases Society of America (IDSA) guidelines recommend a 3- to 4-week course of antibiotics for the treatment of Lyme disease. But a new study by the Centers for Disease Control and Prevention (CDC) indicates that nearly 2 out of every 3 patients with Lyme disease are treated longer than 4 weeks.
Tick-borne encephalitis and Lyme disease can lead to chronic illness
Tick-borne encephalitis (TBE) is a virus transmitted by ticks, which affects the central nervous system and is typically found in Europe and Asia. TBE is best-known to cause meningitis, meningoencephalitis, and meningoencephalomyelitis. There is no treatment for TBE, but the disease is preventable through vaccinations.
Fatal case of Neuroborreliosis
In their article, Neuroborreliosis with Unusual Presentation: A Case Report, Khan and colleagues describe “a case of neuroborreliosis with very high cerebrospinal fluid (CSF) protein content and devastating neurological injury.” The patient, a 41-year-old woman, had been ill for two months with “headaches, nausea, vomiting, 30-lb weight loss, and newly developed bilateral vision loss and dysphonia.” ¹
Lyme carditis diagnosis – 18 cases.
In their article “Risk factors for Lyme Carditis: A case-control study,” published in Preventive Cardiology, researchers from Stony Brook University Hospital described a wide range of Lyme carditis cases seen between 2010 – 2016.¹ Out of 247 patients admitted for Lyme disease, 18 met the inclusion criteria for Lyme carditis.
