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Borrelia burgdorferi (Lyme)

Name(s) of illness: Borrelia burgdorferi infection, Lyme Disease, Lyme Borreliosis

Caused by: infection with the spirochete bacterium Borrelia burgdorferi, spread through the bite of infected ticks. The blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central United States, and the western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast.

Bell's Palsy

Bell’s Palsy. Courtesy cdc.gov.

Symptoms of infection: red, expanding (bull’s-eye) rash called erythema migrans (EM), fatigue, chills, fever, headache, muscle and joint aches, swollen lymph nodes, facial or Bell’s palsy (loss of muscle tone on one or both sides of the face), severe headaches and neck stiffness due to meningitis (inflammation of the spinal cord), pain and swelling in the large joints (such as knees), shooting pains that may interfere with sleep, heart palpitations and dizziness due to changes in heartbeat

Long-term effects: chronic fatigue, intermittent bouts of arthritis, with severe joint pain and swelling; shooting pains, numbness or tingling in the hands or feet, problems with short-term memory, and joint deterioration.

TwoTieredTesting

Two-tiered testing procedure recommended by CDC.

Diagnostic tests:

Enzyme Immunoassay (EIA)

Immunofluorescence Assay (IFA)

IgM and IgG Western Blot

Treated with:

Early (without neurologic symptoms): Doxycycline (100 mg twice per day), amoxicillin (500 mg 3 times per day), or cefuroxime axetil (500 mg twice per day) for 14 days (range, 10–21 days for doxycycline and 14–21 days for amoxicillin or cefuroxime axetil)

Latent (with neurologic symptoms): intravenous ceftriaxone (2 g once per day) for 2 to 4 weeks.

Treatment controversies:

Many physicians disagree with the treatment guidelines established by the Infectious Diseases Society of America.

Physicians and patients disagree about whether “Chronic Lyme,” infection that persists post-treatment, exists (CDC and IDSA say it doesn’t.).

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Meet B. burgdorferi‘s neglected ugly stepsister

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