Treatment of Erythema Migrans With Doxycycline for 10 Days Versus 15 Days

Stupica, Daša; Lusa, Lara; Ružić‐Sabljić, Eva; Cerar, Tjaša; Strle, Franc

doi:10.1093/cid/cis402

Cited by 79 publications

(56 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In agreement with our results, Seltzer and co-workers [ 10 ] reported that persons having suffered from LB generally did not report more symptoms than controls, including memory problems, numbness, fatigue, swollen joints, headaches, neck pain, or problems with sleeping and exercise. Also, supporting our findings, in two recent Slovenian studies of patients treated for erythema migrans, the researchers did not find any association between cases and controls in non-specific symptoms 6 months after treatment [ 15 , 16 ]. In long-term follow-up of patients with culture-confirmed LB, Wormser and co-workers did not find evidence of severe fatigue or fibromyalgia attributable to LB [ 11 , 12 ], and summary scores of physical and mental health were similar to those of the general population [ 14 ].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Subjective health complaints are not associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors in western Norway: a cross-sectional study

et al. 2015

View full text Add to dashboard Cite

BackgroundThere is controversy about chronic health consequences of tick-borne infections, especially Lyme borreliosis. This study aims to assess whether general function, physical fitness and subjective health complaints are associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors.MethodsSera from 1,213 blood donors at four different blood banks in Sogn and Fjordane county in western Norway were obtained during January to June 2010, and analysed for specific IgG and IgM antibodies. A questionnaire including questions on tick bites, subjective health complaints, general function and physical fitness was completed.ResultsTick bites had been experienced by 65.7 % of the study population. 78 (6.4 %) were positive for IgG (9.7 % in men, 2.4 % in women), and 69 (5.7 %) for IgM (6.1 % in men, 5.1 % in women), verified by immunoblot. No association between number of experienced tick bites or seropositivity for Borrelia antibodies and subjective health complaints, reduced general function or reduced physical fitness was found.ConclusionThe results do not support any association between tick bites or Borrelia antibodies and subjective health complaints in blood donors in an endemic area for Lyme borreliosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2026-5) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 92%

“…European studies have also shown that patients having suffered from early LB report a number of symptoms; however, these did not exceed the corresponding symptoms in matched controls [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Subjective health complaints are not associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors in western Norway: a cross-sectional study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In all but a few patients, the tick bites were in the closest vicinity of later BL, and EM lesions were as a rule in the area surrounding or very near BL, indicating that, like EM, BL also develops at the site of inoculation of borreliae into the skin. In the present study there was a median time interval of 21 days from the tick bite to the occurrence of BL; thus, the incubation period is longer than 14-17 days as reported for European EM [35,36]. However, BL may also appear before EM [9,33].…”

Section: Treatment Resultssupporting

confidence: 56%

Borrelial Lymphocytoma in Adult Patients

et al. 2016

View full text Add to dashboard Cite

Background. Information on the course and outcome of borrelial lymphocytoma (BL) is limited. Methods. The study comprised 144 adult patients (75 female, 69 male; median age, 49 years) who had BL diagnosed at a single center between 1986 and 2014 and were followed up for 1 year.Results. BL was located on the breast in 106 patients (73.6%), on the ear lobe in 27 (18.8%), and elsewhere in 11 (7.6%). The median duration of BL before diagnosis was 27 days (interquartile range [IQR], 9-68 days). Concomitant erythema migrans was registered in 104 of 144 patients (72.2%); other objective manifestations of Lyme borreliosis (LB) were present in 11 (7.6%). Immunoglobulin M and/or G borrelial serum antibodies were present in 72 patients (50%). Borreliae were isolated from BL lesions in 14 of 42 patients (33.3%) who had not received antibiotics before skin biopsy. Of 13 typed Borrelia strains, 11 were B. afzelii, 1 was B. garinii, and 1 was B. bissettii. The median duration of BL after starting antibiotic treatment was 21 days ([IQR], 10-30 days); the average duration was longer in patients who were older, had longer BL duration before treatment, or had signs of disseminated LB. Treatment failure occurred in 14 of 144 patients (9.7%). Patients with signs or symptoms of disseminated LB before treatment had nearly 4 times higher odds of treatment failure (95% confidence interval, 1.22-13.07) than those without such symptoms. All patients with treatment failure had uneventful outcome after retreatment.Conclusions. BL is a rare manifestation of early localized LB. Fourteen-day antibiotic treatment, as used for erythema migrans, is effective.

show abstract

“…In the United States, patients with erythema migrans can usually be treated successfully with a 10–14-day course of doxycycline, amoxicillin or cefuroxime axetil 101,137,138,143 (TABLE 1). In Europe, patients can also be treated with phenoxymethylpenicillin.…”

Section: Managementmentioning

confidence: 99%

Lyme borreliosis

Steere

Strle

Wormser

et al. 2016

Nat Rev Dis Primers

648

697

View full text Add to dashboard Cite

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.

show abstract

Treatment of Erythema Migrans With Doxycycline for 10 Days Versus 15 Days

Abstract: NCT00910715.

Cited by 79 publications

References 31 publications

Subjective health complaints are not associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors in western Norway: a cross-sectional study

Subjective health complaints are not associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors in western Norway: a cross-sectional study

Borrelial Lymphocytoma in Adult Patients

Lyme borreliosis

Contact Info

Product

Resources

About