Lyme disease
Updates to Article Attributes
Lyme disease, also known as Borreliosisborreliosis, is a infectious vector-bornecontroversial condition that is caused by the bacteria Borreliaburgdorferi, andwith infection being via a tick-borne vector.
Terminology
Controversy around Lyme disease centres on chronic infection with some author doubting its existence 3. There are some terms that help differentiate these patients with non-specific symptoms of fatigue, myalgia and arthralgia, from those with acute infection 3:
- post-Lyme disease symptoms: symptoms for <6 months
- post-Lyme disease syndrome: disabling symptoms lasting for >6 months
Epidemiology
Lyme disease is endemic in some areas of North America and Europe.
Clinical presentation
Three disease stages have been proposed manifesting after the north hemisphere. Ittick bite 2:
- stage 1: flu-like illness and enlarging skin lesion (erythema migrans) (2-30 days)
- stage 2: cardiac and neurological symptoms (1-4 months)
- stage 3: arthritis and neurological symptoms (many years)
Lyme disease has nonspecific symptoms with multisystemic involvement1,2:
Pathology
Lyme disease caused by the bacteria Borrelia burgdorferi and is transmitted by the bite of the ticks Ixodes scapularis and Ixodes pacificus.
Disease manifestations can be multisystem and nonspecific includes 1,2,4,5:
- cutaneous: erythema migrans
- CNS: peripheral neuropathy, radiculoneuropathy, myelopathy, encephalitis, meningitis, facial nerve palsy
- cardiac: myopericarditis, cardiac arrhythmia
- musculoskeletal: Lyme arthritis
Treatment and prognosis
Treatment is based with antibiotics depending on the stage of the disease and its severity1. There is no evidence that long-term antibiotic therapy is appropriate for patients with post-Lyme disease symptoms or syndrome 4.
-<p><strong>Lyme disease</strong>, also known as <strong>Borreliosis</strong>, is a infectious vector-borne condition caused by the bacteria <em>Borrelia </em><em>burgdorferi</em> and endemic in some areas of the north hemisphere. It has nonspecific symptoms with multisystemic involvement. Treatment is based with antibiotics depending on the stage of the disease and its severity. </p>- +<p><strong>Lyme disease</strong>, also known as <strong>borreliosis</strong>, is a controversial condition that is caused by the bacteria <em>Borrelia </em><em>burgdorferi,</em><em> </em>with infection being via a tick-borne vector. </p><h4>Terminology</h4><p>Controversy around Lyme disease centres on chronic infection with some author doubting its existence <sup>3</sup>. There are some terms that help differentiate these patients with non-specific symptoms of fatigue, myalgia and arthralgia, from those with acute infection <sup>3</sup>:</p><ul>
- +<li>post-Lyme disease symptoms: symptoms for <6 months</li>
- +<li>post-Lyme disease syndrome: disabling symptoms lasting for >6 months</li>
- +</ul><h4>Epidemiology</h4><p>Lyme disease is endemic in some areas of North America and Europe. </p><h4>Clinical presentation</h4><p>Three disease stages have been proposed manifesting after the tick bite <sup>2</sup>:</p><ul>
- +<li>stage 1: flu-like illness and enlarging skin lesion (erythema migrans) (2-30 days)</li>
- +<li>stage 2: cardiac and neurological symptoms (1-4 months)</li>
- +<li>stage 3: arthritis and neurological symptoms (many years)</li>
- +</ul><p>Lyme disease has nonspecific symptoms with multisystemic involvement <sup>1,2</sup>:</p><h4>Pathology</h4><p>Lyme disease caused by the bacteria <em>Borrelia </em><em>burgdorferi</em> and is transmitted by the bite of the ticks <em>Ixodes scapularis</em> and <em>Ixodes pacificus.</em></p><p>Disease manifestations can be multisystem and nonspecific includes <sup>1,2,4,5</sup>:</p><ul>
- +<li>cutaneous: erythema migrans</li>
- +<li>CNS: peripheral neuropathy, radiculoneuropathy, myelopathy, encephalitis, meningitis, <a title="facial nerve palsy" href="/articles/facial-palsy">facial nerve palsy</a>
- +</li>
- +<li>cardiac: myopericarditis, cardiac arrhythmia</li>
- +<li>musculoskeletal: Lyme arthritis</li>
- +</ul><h4>Treatment and prognosis</h4><p>Treatment is based with antibiotics depending on the stage of the disease and its severity <sup>1</sup>. There is no evidence that long-term antibiotic therapy is appropriate for patients with post-Lyme disease symptoms or syndrome <sup>4</sup>.</p>
References changed:
- 2. Agarwal R, Sze G. Neuro-lyme disease: MR imaging findings. Radiology. 2009;253 (1): 167-73. <a href="http://dx.doi.org/10.1148/radiol.2531081103">doi:10.1148/radiol.2531081103</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/19587309">Pubmed citation</a><span class="auto"></span>
- 3. Auwaerter P, Bakken J, Dattwyler R et-al. The Lancet Infectious Diseases. 2011;11 (9): . <a href="http://dx.doi.org/10.1016/S1473-3099(11)70034-2">doi:10.1016/S1473-3099(11)70034-2</a><span class="auto"></span>
- 4. Wormser GP, Dattwyler RJ, Shapiro ED et-al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin. Infect. Dis. 2006;43 (9): 1089-134. <a href="http://dx.doi.org/10.1086/508667">doi:10.1086/508667</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17029130">Pubmed citation</a><span class="auto"></span>
- 5. Smouha EE, Coyle PK, Shukri S. Facial nerve palsy in Lyme disease: evaluation of clinical diagnostic criteria. Am J Otol. 1997;18 (2): 257-61. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9093686">Pubmed citation</a><span class="auto"></span>
Tags changed:
- cases
- infectious disease
Systems changed:
- Musculoskeletal
- Cardiac