Lyme Disease with Erythema Migrans and Seventh Nerve Palsy in an African-American Man

Dennison, Rebekah; Novak, Cheryl B.; Rebman, Alison W.; Venkatesan, Arun; Aucott, John N.

doi:10.7759/cureus.6509

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…In addition, while the findings are representative of Slovenia and likely of Central Europe and probably other parts of Europe, they are not applicable to North America, where Lyme borreliosis is nearly exclusively caused by B. burgdorferi , rather than the Borrelia species usually responsible for LNB in Europe [ 8 , 9 , 10 , 12 , 21 ], and borrelial meningoradiculoneuritis is rare [ 12 ]. Finally, since all of the patients were Caucasian, we did not assess the potential impact of a darker skin color on the timely recognition of an EM skin lesion; a darker skin color may be associated with the development of extracutaneous manifestations (and which is presumably due to failure to recognize an EM skin lesion), based on data from studies conducted in the USA [ 30 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?

Ogrinc,

Bogovič,

Maraspin

et al. 2024

Pathogens

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In prior studies, the skin lesion erythema migrans (EM) was present for a longer time period before diagnosis of concomitant borrelial meningoradiculoneuritis (Bannwarth’s syndrome) compared to EM patients without neurologic symptoms. To determine if this observation pertains to other manifestations of Lyme neuroborreliosis (LNB), we compared EM characteristics in patients with borrelial meningoradiculoneuritis (n = 122) to those with aseptic meningitis without radicular pain (n = 72 patients), and to patients with EM but without neurologic involvement (n = 12,384). We also assessed factors that might impact duration. We found that the duration of EM at diagnosis in patients with borrelial meningoradiculoneuritis was not significantly different compared with those with LNB without radicular pain (34 vs. 26 days; p = 0.227). The duration of EM for each of these clinical presentations of LNB, however, was significantly longer than in patients with EM without LNB (10 days; p < 0.001). Contributing factors to this difference might have been that patients with LNB failed to recognize that they had EM or were unaware of the importance of not delaying antibiotic treatment for EM. In conclusion, the duration of the EM skin lesion in EM patients with LNB is longer than in patients with just EM, irrespective of the type of LNB.

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Section: Discussionmentioning

confidence: 99%

Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?

Ogrinc,

Bogovič,

Maraspin

et al. 2024

Pathogens

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“…While it is sometimes referred to as a "bulls-eye rash, " presentation is known to vary considerably (15,(45)(46)(47). Variation in skin pigmentation, as well as coloring and shape of the rash may also lead to missed or delayed clinical diagnoses (48). The central clearing in the rash is reported to be less common in endemic areas compared to nonendemic areas (15).…”

Section: Em Lesionmentioning

confidence: 99%

Recent Progress in Lyme Disease and Remaining Challenges

Bobe

Jutras

Horn³

et al. 2021

Front. Med.

Self Cite

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Lyme disease (also known as Lyme borreliosis) is the most common vector-borne disease in the United States with an estimated 476,000 cases per year. While historically, the long-term impact of Lyme disease on patients has been controversial, mounting evidence supports the idea that a substantial number of patients experience persistent symptoms following treatment. The research community has largely lacked the necessary funding to properly advance the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment. Given the many outstanding questions raised into the diagnosis, clinical presentation and treatment of Lyme disease, and the underlying molecular mechanisms that trigger persistent disease, there is an urgent need for more support. This review article summarizes progress over the past 5 years in our understanding of Lyme and tick-borne diseases in the United States and highlights remaining challenges.

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“…23 EM may be easily misdiagnosed in patients with darker skin (F). 103 Source: United States Centers for Disease Control and Prevention (public domain).…”

Section: Ticks and Human Illnessmentioning

confidence: 99%

“…23 EM may be easily misdiagnosed in patients with darker skin (F). 103 Source: United States Centers for Disease Control and Prevention (public domain). minutes, the alpha-gal-induced reaction to meat can be delayed by several hours.…”

Section: Alpha-gal Syndromementioning

confidence: 99%

See 1 more Smart Citation

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Management of Tick-Borne Illness in the United States

Ho¹,

Davis

Forrester

et al. 2021

Wilderness & Environmental Medicine

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The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention and management of tick-borne illness. Recommendations are graded based on quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. The guidelines include a brief review of the clinical presentation, epidemiology, prevention, and management of tick-borne illness in the United States, with a primary focus on interventions that are appropriate for resource-limited settings.

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Lyme Disease with Erythema Migrans and Seventh Nerve Palsy in an African-American Man

Cited by 7 publications

References 18 publications

Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?

Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?

Recent Progress in Lyme Disease and Remaining Challenges

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Management of Tick-Borne Illness in the United States

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