Arthritis is most common presentation of early disseminated Lyme occurs in of cases

Submitted by vgreene on Fri, 06/18/2021 - 15:24
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<sup>1</sup> <b>CDC 2021.</b> Lyme Disease. Last reviewed 3/5/21. <a href=https://www.cdc.gov/lyme/index.html><u>Accessed 5/17/21</u></a>
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<sup>2</sup> <b>NICE 2018.</b> Lyme Disease - NICE Guideline (NG95). National Institute for Health and Care Excellence. Published 4/11/18. Last updated 10/17/18. <a href=https://www.nice.org.uk/guidance/NG95><u>Accessed 5/17/21</u></a>
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<sup>3</sup> <b>IDSA/AAN/ACR 2020.</b> Lantos PM, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. <i>Clin Infect Dis.</i> 2021. Jan 23;72(1):1-8. <a href=https://www.idsociety.org/practice-guideline/lyme-disease/><u>Accessed 5/17/21</u></a>
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<b>IDSA/AAN/ACR 2020.</b> IDSA includes doxycycline as an option in children <8 yo, noting that, “a growing consensus accepts the safety of doxycycline use children for at least up to 14-days duration, but more data on safety would be desirable.” Consider risks/benefits of other abx when deciding to use doxycycline.
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<sup>*</sup> <b>ILADS 2021. </b> ILADS diverges from CDC, IDSA, and NICE, recommending extended tx of at least 4-6wk w/ doxycycline, amoxicillin, or cefuroxime axetil for EM, and stating that pts w/ disseminated dz may need even longer courses & possibly combinations of multiple abx.
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Lyme Disease Basics for Providers: A Brief Primer by International Lyme and Associated Diseases Society. <a href=https://www.ilads.org/research-literature/lyme-disease-basics-for-providers/><u>Accessed 5/27/21</u></a>
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<b>Concern has been raised about the quality, validity, and inherent bias of International Lyme and Associated Diseases Society (ILADS) guidance by numerous groups, incl the Infectious Diseases Society of America (IDSA). ILADS guidance does not meet epocrates editorial standards. We include their recommendations here not as an endorsement of their validity, but in order to help provide context when confronted w/ pt questions arising from ILADS recommendations.</b>
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Arthritis is most common presentation of early disseminated Lyme, occurs in ¼ of cases