Cardiovascular Manifestations of Lyme Disease
Burke A. Cunha in Tickborne Infectious Diseases, 2000
The cardiac manifestations of Lyme disease were first described in 1980 by Steere, who reported a series of 20 cases of Lyme carditis [1]. Cardiac involvement has since been observed in up to 10% of cases of Lyme disease. Clinical manifestations include atrioventricular block, myopericarditis, and transient left ventricular dysfunction. In addition, Lyme disease has been implicated as a cause of chronic dilated cardiomyopathy. This chapter reviews the epidemiology, clinical manifestations, diagnosis, and treatment of Lyme carditis.
Lyme Vaccine
Burke A. Cunha in Tickborne Infectious Diseases, 2000
Lyme borreliosis is the most common vectorborne disease in the United States; other parts of the world in which this infection occurs include Europe, Russia, Japan, and China [1]. The causal agent of infection is a spirochete, Borrelia burgdorferi, which is transmitted by Ixodes ticks. Clinical manifestations ascribed to this multisystem disease include erythema migrans, borrelial lymphocytoma, acrodermatitis chronica atrophicans, carditis, arthritis, and neurologic conditions such as seventh nerve palsy [2]. Lyme disease was first reported in the United States in 1977 [3,4]. Today, almost 25 years later, Lyme disease remains a significant cause of morbidity with an increasing incidence in some established endemic regions along with geographic spread to new areas [5]. In the United States alone, approximately 10,000 cases of Lyme disease are reported annually [6].
Microbiological, West Nile Virus, and Lyme Disease
William J. Rea, Kalpana D. Patel in Reversibility of Chronic Disease and Hypersensitivity, Volume 5, 2017
Many virus and bacteria are triggered by outdoor air conditions including such entities as West Nile virus (WNV) and Lyme disease. Mosquito-borne diseases involve the transmission of viruses and parasites from animal to animal, animal to person, or person to person, without afflicting the insect vectors with symptoms of disease. WNV, Eastern Equine Encephalitis, western equine encephalitis, St. Louis encephalitis, La Crosse encephalitis, dengue and yellow fever all of which are transmitted by mosquitoes. Arthropod-borne viruses are the most diverse, numerous, and serious diseases transmitted to susceptible vertebrate hosts by mosquitoes and other blood-feeding arthropods. According to Petersen, mosquito bites account for nearly all human infections. Persons infected through transplant of infected organs are at extreme risk of developing neuroinvasive disease; however, conflicting data exist regarding risk among previous organ recipients infected via mosquito bite. Controversy accompanied the decision to use wide-scale aerial pesticide applications to reduce exposure to disease-carrying mosquitoes.
Use of Electrocochleography for Assessing Endolymphatic Hydrops in Patients with Lyme Disease and Me´nie`re's Disease
Published in Acta Oto-Laryngologica, 2002
Ziane Selmani, Ilmari Pyykkö, Hisayoshi Ishizaki, Nureddin Ashammakhi
From an otological standpoint, Lyme disease can manifest itself as Ménière's disease both clinically and electrophysiologically. The aim of this study was to describe the findings of routine clinical, auditory and vestibular tests in patients with Ménière's and Lyme disease and to use electrocochleography (ECoG) to assess the presence of endolymphatic hydrops (EH) in both diseases. Transtympanic ECoG was performed in 91 patients with Ménière's disease and in 11 patients with confirmed Lyme disease. In both diseases the majority of patients had more than one complaint. There was one case with isolated hearing loss in the Lyme disease group. Typical clinical manifestations of Ménière's disease (vertigo, sensorineural hearing loss and tinnitus) were found in 6 11 patients (54.5%) in the Lyme disease group. The ECoG results indicated that there were 65 91 patients (71.4%) with Ménière's disease and 5 patients (45.5%) with Lyme disease who presented with EH. No statistically significant difference was found between the incidence of different symptoms of Ménière's and Lyme disease. On the basis of these results, patients with Lyme disease should undergo careful examination and investigation, especially in endemic regions. The presence of EH does not exclude the presence of infection with borreliosis as a cause of Ménière's disease-like symptoms.
Treatment of Lyme disease: a medicolegal assessment
Published in Expert Review of Anti-infective Therapy, 2004
Lorraine Johnson, Raphael B Stricker
Lyme disease is the most common tick-borne disease in the world today. Despite extensive research into the complex nature of Borrelia burgdorferi, the spirochetal agent of Lyme disease, controversy continues over the diagnosis and treatment of this protean illness. This report will focus on two aspects of the treatment of Lyme disase. First, the medical basis for diagnostic and therapeutic uncertainty in Lyme disease, including variability in clinical presentation, shortcomings in laboratory testing procedures, and design defects in therapeutic trials. Second, the standard of care and legal issues that have resulted from the clinical uncertainty of Lyme disease diagnosis and treatment. Specifically, the divergent therapeutic standards for Lyme disease are addressed, and the difficult process of creating treatment guidelines for this complex infection is explored. Consideration by healthcare providers of the medicolegal issues outlined in this review will support a more rational approach to the diagnosis and treatment of Lyme disease and related tick-borne illnesses.
Lyme disease: point/counterpoint
Published in Expert Review of Anti-infective Therapy, 2005
Raphael B Stricker, Andrew Lautin, Joseph J Burrascano
Lyme disease represents a growing public health threat. The controversial science and politics of Lyme disease have created barriers to reliable diagnosis and effective treatment of this protean illness. Two major clinical hurdles are the absence of a therapeutic end point in treating Borrelia burgdorferi, the spirochetal agent of Lyme disease, and the presence of tickborne coinfections with organisms such as Babesia, Anaplasma, Ehrlichia and Bartonella that may complicate the course of the disease. From a pathophysiologic standpoint, the affinity of Borrelia burgdorferi for multiple cell types and the presence of nonreplicating forms of the Lyme disease spirochete have contributed to persistent infection and failure of simple antibiotic regimens. Newer approaches to the treatment of Lyme disease should take into account its clinical complexity in coinfected patients and the possible need for prolonged combination therapy in patients with persistent symptoms of this potentially debilitating illness. The optimal antibiotic regimen for chronic Lyme disease remains to be determined.
Related Knowledge Centers
- Borrelia
- Borrelia Burgdorferi