Chronic Lyme disease: Difference between revisions

Latest revision as of 13:23, 17 May 2021

Background

Possibly related to post-Lyme disease syndrome

Clinical Manifestations

Chronic fatigue syndrome-like presentation with fatigue, myalgias, and neurocognitive symptoms following possible Lyme exposure
However, chronic post-Lyme arthritis is well-defined lasting at least a year

Differential Diagnosis

Confirmed Lyme disease (12%)
Psychiatric disorders (25%): depression, post-traumatic stress disorder, burnout, harassment, and other
Rheumatologic disorders (16%): osteoarthritis, scoliosis, or other
Neurologic disorders (12%): amyotrophic lateral sclerosis, Parkinson disease, small fiber disease, multiple sclerosis, or other
Obstructive sleep apnea (5%)
Miscellaneous (17%): thyroid diseases, fibromyalgia, cardiomyopathy, infectious diseases, inflammatory diseases, and others
Unknown etiology (7%)

Management

RCT has shown that 30 days ceftriaxone followed by 60 days doxy does not improve symptoms in patients with documented history of Lyme disease and persistent symptoms

@@ Line 1: / Line 1: @@
+== Background ==
-* Possibly related to post-[[Lyme disease]] syndrome
+*Possibly related to post-[[Lyme disease]] syndrome
-= Clinical Presentation =
+==Clinical Manifestations==
-* Chronic fatigue syndrome-like presentation with fatigue, myalgias, and neurocognitive symptoms following possible Lyme exposure
-* However, chronic post-Lyme arthritis is well-defined lasting at least a year
+*Chronic fatigue syndrome-like presentation with fatigue, myalgias, and neurocognitive symptoms following possible Lyme exposure
-= Management =
+*However, chronic post-Lyme arthritis is well-defined lasting at least a year
+== Differential Diagnosis ==
-* RCT has shown that 30 days ceftriaxone followed by 60 days doxy does not improve symptoms in patients with documented history of Lyme disease and persistent symptoms
+* Confirmed [[Lyme disease]] (12%)
+* Psychiatric disorders (25%): [[depression]], [[post-traumatic stress disorder]], [[burnout]], harassment, and other
+* Rheumatologic disorders (16%): [[osteoarthritis]], [[scoliosis]], or other
+* Neurologic disorders (12%): [[amyotrophic lateral sclerosis]], [[Parkinson disease]], [[small fiber disease]], [[multiple sclerosis]], or other
+* [[Obstructive sleep apnea]] (5%)
+* Miscellaneous (17%): thyroid diseases, [[fibromyalgia]], [[cardiomyopathy]], infectious diseases, inflammatory diseases, and others
+* Unknown etiology (7%)
+==Management==
+*RCT has shown that 30 days ceftriaxone followed by 60 days doxy does not improve symptoms in patients with documented history of Lyme disease and persistent symptoms
+== Further Reading ==
+* Holistic Approach in Patients With Presumed Lyme Borreliosis Leads to Less Than 10% of Confirmation and More Than 80% of Antibiotic Failures. ''Clin Infect Dis''. 2019;68(12):2060-2066. doi: [https://doi.org/10.1093/cid/ciy799 10.1093/cid/ciy799]
 [[Category:Spirochetes]]