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

Abstract

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.

Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

“…It is known that CXCL13 can also be elevated in other infectious, inflammatory, and neoplastic conditions. The measurement of CXCL13 for neuroborreliosis diagnostics is currently not being recommended because it has not been sufficiently studied or standardized [31].…”

Association between statin use and clinical course, microbiologic characteristics, and long-term outcome of early Lyme borreliosis. A post hoc analysis of prospective clinical trials of adult patients with erythema migrans

“…Multiple EM was defined as the presence of two or more skin lesions, at least one of which had to fulfill the size criterion for solitary EM [ 18 ]. At enrollment, patients were prescribed antibiotics according to treatment guidelines [ 2 ]. We defined statin use as consistent statin therapy for hyperlipidemia and/or comorbidities requiring primary or secondary prophylaxis of cardiovascular disease at the time of enrollment, followed by ongoing use for the duration of the study.…”

“…[ 1 ]. Manifestations of LB usually resolve without sequelae when well-studied, safe and effective antibiotic regimens are used [ 1 , 2 ]. Still, in a small minority of cases, post-LB symptoms such as malaise, fatigue, neurocognitive dysfunction and diffuse pain, may persist for months to years despite otherwise microbiologically successful antibiotic treatment [ 1 – 3 ].…”

Ticks and Tick-Borne Diseases in Central America and the Caribbean: A One Health Perspective

“…Concerning Lyme borreliosis, oral amoxicillin and doxycycline are considered equally efficient for the first stage of the disease (i.e., erythema migrans), while intravenous administration of ceftriaxone is recommended in cases of neuroborreliosis [193,194] and Lyme carditis [195]. However, it is important to mention that Lyme borreliosis is not commonly reported in the CAC [97,100].…”