Steroid use in Lyme disease-associated facial palsy is associated with worse long-term outcomes

Jowett, Nate; Gaudin, Robert; Banks, Colin; Hadlock, Tessa A.

doi:10.1002/lary.26273

Cited by 65 publications

(44 citation statements)

References 44 publications

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“…In pediatric literature, corticosteroids, therapeutic LP, VPs, and acetazolamide have been suggested as supplementary treatments to AB of the Bb‐induced PTC. Later studies have confirmed that treatment with corticosteroids does not belong in the treatment of any form of Lyme's disease …”

Section: Commentcontrasting

confidence: 63%

A rare case of pseudotumor cerebri in adult Lyme disease

Gimsing

Larsen

2019

Clinical Case Reports

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It is important to recognize the rare manifestations of chronic Lyme disease to prevent permanent disabilities. We present an adult case of chronic Lyme disease, who developed pseudotumor cerebri and who needed supplementary surgical treatment. We compare it to the existing published literature, reviewed by a systematic approach. K E Y W O R D Schronic borreliosis, chronic infection, Lyme disease, pseudotumor cerebri

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Section: Commentcontrasting

confidence: 63%

A rare case of pseudotumor cerebri in adult Lyme disease

Gimsing

Larsen

2019

Clinical Case Reports

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“…For example, a recent retrospective analysis of patients with Lyme borreliosis and facial palsy reported a worse long-term outcome in those who received antibiotics and prednisone than in those who received antibiotics alone 197 . However, these regimens have not been compared in a randomized clinical trial.…”

Section: Discussionmentioning

confidence: 99%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

648

697

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Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

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“…In vivo experimental studies in rhesus monkeys have shown that meloxicam does not decrease levels of inflammatory mediators, dorsal root ganglia‐apoptosis, and inflammatory neurodegenerative lesions in the nerve roots and dorsal root ganglia of B. burgdorferi ‐infected cells . Dexamethasone treatment in humans with B. burdorferi infection has likely been associated with both beneficial and harmful outcomes, with worse long‐term outcomes reported in one study . Although clinical signs could improve transiently, the committee does not recommend corticosteroids for equine Lyme disease except in some cases of uveitis or neuroborreliosis that are both acute and severe (Level 2).…”

Section: Lyme Consensus—ancillary Treatmentsmentioning

confidence: 99%

“…109,110 Dexamethasone treatment in humans with B. burdorferi infection has likely been associated with both beneficial and harmful outcomes, 110 with worse long-term outcomes reported in one study. 111 Although clinical signs could improve transiently, the committee does not recommend corticosteroids for equine Lyme disease except in some cases of uveitis or neuroborreliosis that are both acute and severe (Level 2). Acupuncture and herbal treatments have been used as adjunctive treatments in horses with Lyme disease.…”

Section: Lyme Consensus-ancillary Treatmentsmentioning

confidence: 99%

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

Divers

Gardner²,

Madigan

et al. 2018

Veterinary Internal Medicne

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Borrelia burgdorferi infection is common in horses living in Lyme endemic areas and the geographic range for exposure is increasing. Morbidity after B. burgdorferi infection in horses is unknown. Documented, naturally occurring syndromes attributed to B. burgdorferi infection in horses include neuroborreliosis, uveitis, and cutaneous pseudolymphoma. Although other clinical signs such as lameness and stiffness are reported in horses, these are often not well documented. Diagnosis of Lyme disease is based on exposure to B. burgdorferi, cytology or histopathology of infected fluid or tissue and antigen detection. Treatment of Lyme disease in horses is similar to treatment of humans or small animals but treatment success might not be the same because of species differences in antimicrobial bioavailability and duration of infection before initiation of treatment. There are no approved equine label Lyme vaccines but there is strong evidence that proper vaccination could prevent infection in horses.

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Steroid use in Lyme disease-associated facial palsy is associated with worse long-term outcomes

Abstract: 4. Laryngoscope, 127:1451-1458, 2017.

Cited by 65 publications

References 44 publications

A rare case of pseudotumor cerebri in adult Lyme disease

A rare case of pseudotumor cerebri in adult Lyme disease

Lyme borreliosis

Borrelia burgdorferiInfection and Lyme Disease in North American Horses: A Consensus Statement

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