Borrelia burgdorferi - Revision history

Aidan at 13:32, 2 August 2024

2024-08-02T13:32:10Z

← Older revision		Revision as of 13:32, 2 August 2024
Line 227:		Line 227:
	**Does NOT cross-react with European Lyme (in Ontario)		**Does NOT cross-react with European Lyme (in Ontario)
	*Serology is most helpful when the pretest probability is >20%		*Serology is most helpful when the pretest probability is >20%
			*Serology remains elevated to months to years and should not be used to monitor response to treatment

	{\| class="wikitable"		{\| class="wikitable"

2024-05-29T16:01:43Z

Diagnosis: added MITT information

@@ Line 230: / Line 230: @@
 {| class="wikitable"
 !EIA
-!Western blot
+!Western Blot
 !Interpretation
 !Action
@@ Line 248: / Line 248: @@
 |Very early Lyme &lt;2 weeks<br />Negative
 |Treat if [[erythema migrans]]
 |}

2023-07-08T16:44:52Z

← Older revision		Revision as of 16:44, 8 July 2023
Line 299:		Line 299:
	*Can be considered in children and adults within 72 hours of tick removal if all of the following criteria are met:		*Can be considered in children and adults within 72 hours of tick removal if all of the following criteria are met:
	**[[Ixodes]] tick is identified		**[[Ixodes]] tick is identified
			***Small, tear-drop shaped
			***Plain oval shield
			***Lack of festoons
	**Occurs in a highly endemic area		**Occurs in a highly endemic area
	**Tick was attached for ≥36 hours		**Tick was attached for ≥36 hours
			***You can get a sense by asking if the tick was flat or engorged
⚫	*Use [[doxycycline]] 4.4 mg/kg (max 200 mg) for children or 200 mg for adults
			***If definitely flat, almost certainly attached less than 36 hours
			***However, still looks flat at 24 hours
		⚫	*Use a single oral dose of [[doxycycline]] 4.4 mg/kg (max 200 mg) for children or 200 mg for adults

	==Further Reading==		==Further Reading==

2023-07-08T16:38:36Z

Prevention

← Older revision		Revision as of 16:38, 8 July 2023
Line 293:		Line 293:
	*Remove ticks with clean fine-tipped tweezer inserted between the tick body and the skin		*Remove ticks with clean fine-tipped tweezer inserted between the tick body and the skin
	**Do not cover, spray, or burn the tick		**Do not cover, spray, or burn the tick
			**See [[tick removal]] for more information

	===Prophylaxis===		===Prophylaxis===

2023-07-08T16:33:12Z

← Older revision		Revision as of 16:33, 8 July 2023
Line 7:		Line 7:

	===Epidemiology===		===Epidemiology===

			*Most cases occur during June and July, when nymphal ticks are most active and people are outdoors
			*Infection is possible year-round, though, with ticks being active any time temperatures are above freezing

	====North America====		====North America====

2023-07-08T16:23:16Z

← Older revision		Revision as of 16:23, 8 July 2023
Line 26:		Line 26:

	*Tick bites host		*Tick bites host
	*''Borrelia'' migrates from ~~hidgut~~ to mouth over ~36 hours, then gets regurgitated into the wound		*''Borrelia'' migrates from hindgut to mouth over ~36 hours, then gets regurgitated into the wound
			**May take as little as 24 hours
	*Local multiplication followed by dissemination		*Local multiplication followed by dissemination

Line 37:		Line 38:
	*May not remember tick bite		*May not remember tick bite
	*There can be overlap between the three stages (early localized, early disseminated, late)		*There can be overlap between the three stages (early localized, early disseminated, late)
			*Requires minimum of 24 hours of tick attachment, but typically takes 36 hours or longer

	===Early Localized Disease (7 days)===		===Early Localized Disease (7 days)===

2022-10-12T13:56:12Z

Diagnosis

@@ Line 200: / Line 200: @@
 *Treatment should be based on symptoms and compatible exposure history
 **If erythema migrans is present, further testing is unhelpful outside of unusual cases and is not routinely recommended
-*Usually done by serology, with EIA followed by reflexive Western blot
+*The most commonly used test is serology from blood, with EIA followed by reflexive Western blot
 *CSF antibodies is useful for neuroborreliosis, but persist years after treatment
 *PCR may be helpful in cases where patients are from populations with high seroprevalence
@@ Line 216: / Line 206: @@
 ===Lyme Serology===
 {| class="wikitable"

2022-09-22T14:30:28Z

Diagnosis: links

← Older revision		Revision as of 14:30, 22 September 2022
Line 204:		Line 204:
	***Usually positive around 2 weeks		***Usually positive around 2 weeks
	***False negatives common early in clinical course		***False negatives common early in clinical course
	***False positives with HIV, hepatitis C, and syphilis		***False positives with [[HIV]], [[hepatitis C]], and [[syphilis]]
	***Cross-reacts with European Lyme		***Cross-reacts with European Lyme
	**Western blot split into IgM and IgG if positive or equivocal		**Western blot split into IgM and IgG if positive or equivocal
Line 231:		Line 231:
	\|–		\|–
	\|Early disease<br />Early disease, treated<br />European Lyme<br />False-positive		\|Early disease<br />Early disease, treated<br />European Lyme<br />False-positive
	\|If <8 weeks from exposure, repeat<br />If >8 weeks, look for other cause<br />Rule out HIV, hepatitis C, and syphilis<br />Assess for autoimmune diseases<br />Consider European Lyme		\|If <8 weeks from exposure, repeat<br />If >8 weeks, look for other cause<br />Rule out [[HIV]], [[hepatitis C]], and [[syphilis]]<br />Assess for autoimmune diseases<br />Consider European Lyme
	\|-		\|-
	\|–		\|–
	\|–		\|–
	\|Very early Lyme <2 weeks<br />Negative		\|Very early Lyme <2 weeks<br />Negative
	\|Treat if erythema migrans		\|Treat if [[erythema migrans]]
	\|}		\|}

2022-02-12T11:53:57Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 11:53, 12 February 2022
Line 286:		Line 286:

	*Can be considered in children and adults within 72 hours of tick removal if all of the following criteria are met:		*Can be considered in children and adults within 72 hours of tick removal if all of the following criteria are met:
	**[[Ixodes ~~species~~]] tick is identified		**[[Ixodes]] tick is identified
	**Occurs in a highly endemic area		**Occurs in a highly endemic area
	**Tick was attached for ≥36 hours		**Tick was attached for ≥36 hours

2021-02-17T13:29:43Z

Background

← Older revision		Revision as of 13:29, 17 February 2021
Line 1:		Line 1:
	==Background==		==Background==

			=== Microbiology ===

			* Spirochete
			* Lyme disease can also be caused by [[Borrelia mayonii]]

	===Epidemiology===		===Epidemiology===
	====North America====		====North America====