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CABI Book Chapter

Lyme disease: an evidence-based approach.

Book cover for Lyme disease: an evidence-based approach.

Description

This second edition provides up-to-date evidence-based research and covers the significant advances in our understanding of the disorders referred to as Lyme disease or Lyme borreliosis. Consisting of 17 chapters, this book explores the causative organism, its requisite ecosystem, disease epidemiology, host-Borrelia interactions, diagnostic testing, clinical manifestations, therapeutic options, th...

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Chapter 16 (Page no: 247)

Chronic Lyme disease.

Despite being widely used by both the lay and medical communities, chronic Lyme disease (CLD) is a very complicated term, used as a label for quite different patient groups. These include patients with late Lyme disease (e.g. arthritis and late neuroborreliosis), as well as patients described as having post-treatment Lyme disease syndrome (PTLDS), and, especially, patients with non-specific complaints of unclear aetiology who received this diagnosis based on unproven and non-validated clinical and laboratory criteria. This chapter describes the 4 different categories of CLD, including case definitions, diagnosis and treatment. Patients in category 1 have symptoms of unknown cause, with no evidence of Borrelia burgdorferi infection. Patients in category 2 have a well-defined illness unrelated to B. burgdorferi infection. Patients in category 3 have symptoms of unknown cause, with antibodies against B. burgdorferi but no history of objective clinical findings that are consistent with Lyme disease. Patients in category 4 are those considered to have PTLDS. At this point, evidence shows that antibiotic therapy, as tested in 6 randomized placebo-controlled studies, does not offer durable or significant benefit in treating patients with PTLDS and has considerable risk of treatment-related adverse events. In assessing this group of patients, it is important that other comorbid conditions be fully assessed and treated.

Other chapters from this book

Chapter: 1 (Page no: 1) Ticks: the vectors of Lyme disease. Author(s): Smith, R. P.
Chapter: 2 (Page no: 29) Biology of the Lyme disease agents: a selective survey of clinical and epidemiologic relevance. Author(s): Barbour, A. G.
Chapter: 3 (Page no: 45) Borreliella: interactions with the host immune system. Author(s): Sperber, K. Dattwyler, R. J.
Chapter: 4 (Page no: 58) Diagnostic testing for Lyme disease. Author(s): Auwaerter, P. G.
Chapter: 5 (Page no: 76) Global epidemiology of Borreliella burgdorferi infections. Author(s): Mead, P. S.
Chapter: 6 (Page no: 93) Antibiotic therapy for infection caused by Borrelia burgdorferi sensu lato. Author(s): Wormser, G. P.
Chapter: 7 (Page no: 105) Lyme borreliosis: the European perspective. Author(s): Strle, F. Stanek, G. Strle, K.
Chapter: 8 (Page no: 124) Lyme neuroborreliosis: a European perspective. Author(s): Dersch, R.
Chapter: 9 (Page no: 139) Medically unexplained symptoms and Lyme neuroborreliosis - not the same: a study in an endemic area of Norway. Author(s): Roaldsnes, E. Eikeland, R. Berild, D.
Chapter: 10 (Page no: 142) Erythema migrans. Author(s): Nadelman, R. B. Hu, L.
Chapter: 11 (Page no: 168) Lyme carditis. Author(s): Salik, J. R. Dudzinski, D. M.
Chapter: 12 (Page no: 180) The musculoskeletal manifestations of Lyme disease (infection with Borrelia burgdorferi). Author(s): Sigal, L. H.
Chapter: 13 (Page no: 202) Nervous system involvement. Author(s): Halperin, J. J.
Chapter: 14 (Page no: 216) Lyme disease in children. Author(s): Shapiro, E. D.
Chapter: 15 (Page no: 227) The psychology of 'post-Lyme disease syndrome' and 'not Lyme'. Author(s): Hassett, A. L. Sigal, L. H.
Chapter: 17 (Page no: 262) Lyme disease: the great controversy. Author(s): Halperin, J. J. Baker, P. Wormser, G. P.

Chapter details

  • Author Affiliation
  • Clinical Studies Unit, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
  • Year of Publication
  • 2018
  • ISBN
  • 9781786392077
  • Record Number
  • 20183240058