Lyme Disease Questions & Answers

Updated: Aug 01, 2019
  • Author: John O Meyerhoff, MD; Chief Editor: Herbert S Diamond, MD  more...
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Questions & Answers

Overview

What is Lyme disease?

What are the signs and symptoms of Lyme disease?

Which physical findings are characteristic of early disseminated Lyme disease?

What is the CDC recommended serologic testing for Lyme disease?

What is the role of Western blot testing in the diagnosis of Lyme disease?

Which tests may be performed in the evaluation of Lyme disease?

What is the focus for the treatment of Lyme disease?

What are the treatment options for Lyme disease?

What are the treatment options for Lyme arthritis?

What are the treatment options for Lyme carditis?

What is Lyme disease?

What is the clinical presentations of Lyme disease?

How is Lyme disease diagnosed and treated?

What is the historical background of Lyme disease?

Which areas in the US are commonly affected by Lyme disease?

What is the infectious cycle of Borrelia burgdorferi?

What is the mode of transmission of Lyme disease?

What is the pathogenesis of Lyme disease?

What is the clinical progression of Lyme disease?

What are the signs and symptoms of Stage 1 (early localized) Lyme disease?

What is Stage 2 (early disseminated) Lyme disease?

What is Stage 3 (chronic) Lyme disease?

What causes Lyme disease?

Which species of Borrelia burgdorferi sensu lato that causes Lyme disease?

How does the clinical presentation of Lyme disease differ by causative agent?

Where is of Lyme disease endemic?

What is the incidence of Lyme disease in the US?

Which US states have the highest rates of Lyme disease?

What is the incidence of Lyme disease when does peak incidence occur?

What is the global prevalence of Lyme disease?

What are racial predilections of Lyme disease?

How does the incidence of Lyme disease vary by sex?

How does the incidence of Lyme disease vary by age?

What is the prognosis of Lyme disease?

What is the prognosis of post-treatment Lyme disease syndrome (PTLDS)?

What is included in patient education about Lyme disease?

How should inspection and tick removal be performed for the prevention of Lyme disease?

What is the role of repellents in the prevention of Lyme disease?

What is the role of prophylactic antibiotics in the prevention of Lyme disease?

What is the role of pets in the prevention of Lyme disease?

Presentation

Which clinical history findings are characteristic of Lyme disease?

What is the frequency of reinfection and recurrence of Lyme disease?

How does the clinical presentation of Lyme disease vary based on species of Borrelia?

What are the stages of Lyme disease progression?

How is erythema migrans (EM) characterized in Lyme disease?

What are the non-cutaneous signs and symptoms of Stage 1 (early) Lyme disease?

What is the prevalence of co-infection in Lyme disease?

What is the clinical presentation of Stage 2 (early disseminated) Lyme disease?

How does arthritis present in Lyme disease?

What are neurologic manifestations of Lyme disease?

What are cutaneous manifestations in Stage 2 (local disseminated) Lyme disease?

What are the signs and symptoms of Stage 3 (chronic) Lyme disease?

What are the signs and symptoms of acrodermatitis chronica atrophicans in patients with Lyme disease?

Which physical findings are characteristic of Lyme disease?

What are the physical characteristics of erythema migrans (EM) in patients with Lyme disease?

What are atypical presentations of erythema migrans (EM) in patients with Lyme disease?

Where are erythema migrans (EM) located in Lyme disease?

What is southern tick-associated rash illness (STARI) and how is it differentiated from Lyme disease?

How are hypersensitivity reactions differentiated from the erythema migrans (EM) of Lyme disease?

What is borrelial lymphocytoma in Lyme disease?

Which dermatologic manifestations of Lyme disease have been reported in European patients?

Which musculoskeletal findings suggest Lyme disease?

Which physical findings indicate arthritis in patients with Lyme disease?

Which neurologic findings suggest Lyme disease?

Which neuropsychiatric findings are characteristic of late-stage Lyme disease?

Which cardiac findings suggest Lyme disease?

Which ophthalmic findings suggest Lyme disease?

Which ocular findings are characteristic of Lyme disease?

DDX

How is Lyme disease diagnosed?

Which conditions should be included in the differential diagnosis of Lyme disease?

How are co-infections diagnosed in patients with Lyme disease?

What are the differential diagnoses for Lyme Disease?

Workup

What is the initial approach to evaluation of suspected Lyme disease?

What is the CDC recommended testing procedure for the diagnosis of Lyme disease?

What is the role of lab testing in patients with clinical findings of Lyme disease?

When is joint aspiration indicated in the evaluation of Lyme disease?

What is the role of cerebrospinal fluid (CSF) analysis in the evaluation of Lyme disease?

What is the Rule of 7's and how is it used to determine risk for Lyme disease?

What is the role of electrocardiograms (ECGs) in the workup of Lyme disease?

When are imaging studies indicated in the workup of Lyme disease?

What is the role of serologic testing in the evaluation of Lyme disease?

What are tiers of serologic testing in the evaluation of Lyme disease?

Which serologic findings confirm a diagnosis of Lyme disease?

What is the accuracy of serologic testing for the diagnosis of Lyme disease?

When is serologic testing indicated in the workup of Lyme disease?

What is the role of C6 peptide testing in the diagnosis of Lyme disease?

What is the role of polymerase chain reaction (PCR) testing in the diagnosis of Lyme disease?

What are role of blood studies in the workup of Lyme disease?

What is the role of synovial fluid analysis in the workup of Lyme disease?

What is the role of lumbar puncture in the workup of Lyme disease?

What are the diagnostic criteria for neuroborreliosis in patients with Lyme disease?

What is the role of imaging studies in the workup of Lyme disease?

What is the role of culture in the workup of Lyme disease?

What is the role of biopsy in the workup of Lyme disease?

Which histologic findings of erythema migrans are characteristic of Lyme disease?

Which histologic findings of borrelial lymphocytoma are characteristic of Lyme disease?

Which histologic findings of acrodermatitis chronica atrophicans are characteristic of Lyme disease?

Treatment

What guides the selection of treatment for Lyme disease?

How is cardiac involvement managed in Lyme disease?

How is persistent arthritis managed in Lyme disease?

How is neuroborreliosis managed in Lyme disease?

How is borrelial lymphocytoma managed in Lyme disease?

When is antibiotic prophylaxis indicated for the prevention of Lyme disease?

What are the treatment guidelines for Lyme disease?

What is the controversy surrounding the IDSA treatment guidelines for Lyme disease?

What are the treatment options for early localized Lyme disease?

How is early Lyme disease managed in pregnant women?

What are the regimens for treatment of Lyme arthritis in adults?

What are the regimens for Lyme arthritis in pediatric patients?

What are the treatment options for Lyme arthritis following an initial antibiotic regimen?

What are the treatment options for Lyme carditis?

What are treatment options for neurologic manifestations of Lyme disease?

What are treatments options for ocular manifestations of Lyme disease?

How is acrodermatitis chronica atrophicans managed in patients with Lyme disease?

What are the treatments options for post-treatment Lyme disease syndrome (PTLDS)?

When should co-transmitted infective organisms be considered in patients with Lyme disease?

How is Lyme disease prevented?

How is tick removal performed to reduce the likelihood of contracting Lyme disease?

When is antibiotic prophylaxis indicated in the prevention of Lyme disease?

What are contraindications for doxycycline prophylaxis against Lyme disease?

What is the role of vaccination in the prevention of Lyme disease?

Which medical personnel provide consultations to patients with Lyme disease?

What is included in the long-term monitoring of patients with Lyme disease?

Medications

What is the role of antibiotic therapy in the treatment of Lyme disease?

Which medications in the drug class Aminoquinolines are used in the treatment of Lyme Disease?

Which medications in the drug class Cephalosporins, 2nd Generation are used in the treatment of Lyme Disease?

Which medications in the drug class Cephalosporins, 3rd Generation are used in the treatment of Lyme Disease?

Which medications in the drug class Macrolides are used in the treatment of Lyme Disease?

Which medications in the drug class Penicillins are used in the treatment of Lyme Disease?

Which medications in the drug class Tetracyclines are used in the treatment of Lyme Disease?