Patients can die when Lyme carditis is not treated

Lyme carditis can cause a broad range of symptoms. Patients may initially appear to have only a flu-like illness, however the severity of symptoms can change rapidly. In the article “Fatal Lyme carditis in New England: Two case reports,” Marx and colleagues highlight the importance of early recognition and treatment, even empirically, as Lyme carditis can be deadly when left untreated.

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Pros and cons of doxycycline for children with Lyme disease

There are times when doctors need to consider whether or not to prescribe doxycycline for children with Lyme disease. The antibiotic is indicated for other tick-borne illnesses including Rocky Mountain Spotted Fever, Ehrlichia and Anaplasmosis. But doctors often avoid prescribing doxycycline to young children for fear that it may cause tooth staining, particularly when used in children less than 8 years old.

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Atypical case: Bannwarth syndrome and weight loss

Bannwarth syndrome is a neurological disease caused by an infection with Borrelia burgdorferi, the bacterial agent of Lyme disease. The disease causes intense nerve pain and is characterized by “painful radiculopathy, neuropathy, varying degrees of motor weakness, lower motor neuron (LMN) facial nerve palsy and cerebrospinal fluid (CSF) lymphocytic pleocytosis,” writes Diaz et al. in the journal Clinical Neurology and Neurosurgery.

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Editorial: Newly proposed Lyme disease guidelines strike out

In 2000, the Infectious Diseases Society of America (IDSA) published the first set of guidelines for the treatment of Lyme disease. The guidelines were criticized for not recognizing the existence and severity of chronic Lyme disease. The second set of guidelines, released by IDSA in 2006, again failed to recognize chronic Lyme disease. [1] Now, it would appear that the next set of soon-to-be-released guidelines are in danger of striking out again and not recognizing the existence and severity of chronic Lyme disease.

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Study identifies 189 children with Lyme carditis

In reviewing medical records from a Pediatric Health Information System (PHIS) database between 2007 and 2013, clinicians identified 189 children diagnosed with Lyme carditis. “The burden of Lyme disease and Lyme carditis in U.S. children’s hospitals has increased in recent years,” writes Beach and colleagues in Pediatric Cardiology.

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Radiologic findings in Lyme disease

Infectious pathogens, including viral, bacterial and parasitic, can impact the central nervous system (CNS), resulting in neurologic disease. “The infections caused by these pathogens often show a variety of neuroimaging patterns that can be identified [on a] CT scan and MRI,” explains Alves Simão and colleagues. ¹ Radiology, they argue, is central to the diagnosis and follow-up of these conditions. Therefore, “radiologists should be familiar with these infections.”

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C6 peptide test for Lyme disease may indicate Borrelia miyamotoi infection

The C6 enzyme immunoassay (EIA) is often used to diagnose Lyme disease. The test is based on the C6 peptide of the Borrelia burgdorferi sl VlsE protein. But a recent study suggests the C6 peptide test may also indicate an infection with Borrelia miyamotoi, another tick-borne disease.

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Pros and cons: Disease-modifying antirheumatic drugs (DMARD) for Lyme Arthritis

Editorial: I am concerned with the subgroup of Lyme arthritis (LA) patients described by Dr. Steere, who “developed a marked inflammatory, proliferative synovitis lasting months to several years after antibiotic treatment.”

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Could advanced imaging reveal cognitive impairment in Lyme patients?

Clinicians can now measure neurotransmitter levels in the brains of patients with mild cognitive impairment using magnetic resonance spectroscopy (MRS) with advanced 7 Tesla technology. MRS, also referred to as Nuclear Magnetic Resonance (NMR), shows the “levels of gamma-aminobutyric acid (GABA), glutathione and other neurotransmitters in brain regions of interest with greater precision than previous, lower-strength imaging systems,” explains Oeltzschner and colleagues. ¹

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Opinion: Consequences of antibiotic stewardship for Lyme disease patients?

Could antibiotic stewardship lead to delayed treatment for Lyme disease? In a recent article, researchers in England describe the potential consequences of antibiotic stewardship in an elderly population with urinary tract infections (UTI).

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