The clinical spectrum of early lyme borreliosis in patients with culture-confirmed erythema migrans

Nadelman, Robert B.; Nowakowski, John; Forseter, Gilda; Goldberg, Neil S.; Bittker, Susan; Cooper, Denise R.; Agüero-Rosenfeld, Maria E.; Wormser, Gary P.

doi:10.1016/s0002-9343(95)99915-9

Cited by 227 publications

(153 citation statements)

References 22 publications

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“…Such low encounter rates using the drag method with nymphal ticks, the most epidemiologically important tick life stage for pathogen transmission to humans, coupled with low rates of enzootic pathogen transmission and tick infection prevalence (Lane et al, 2013;Padgett et al, 2014) suggests that human risk of tick-borne disease is exceedingly low in central and southern California. If human cases of Lyme disease are acquired in southern California, dates of onset are expected to fall within a brief window between early March to early June, given observed nymphal I. pacificus questing activity in this region, and the average delay in occurrence of 10 days following tick bite of erythema migrans rash, the characteristic skin lesion associated with human Lyme disease (Nadelman et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Truncated seasonal activity patterns of the western blacklegged tick (Ixodes pacificus) in central and southern California

MacDonald

Briggs

2016

Ticks and Tick-borne Diseases

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Section: Discussionmentioning

confidence: 99%

Truncated seasonal activity patterns of the western blacklegged tick (Ixodes pacificus) in central and southern California

MacDonald

Briggs

2016

Ticks and Tick-borne Diseases

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“…A history of a recognized tick bite is obtained in only 14-32% of cases, owing to the tick's small size and painless bite. After recognized tick bite, the incubation period averages 10 days, with a broad range (59). The patient sometimes has other symptoms at the time when erythema migrans is present, including fatigue (54%), myalgia (44%), arthralgia (44%), fever or chills (39%), and stiff neck (35%).…”

Section: Clinical Diagnosismentioning

confidence: 99%

Tick-Transmitted Infectious Diseases in the United States

Walker

1998

Annu. Rev. Public Health

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The epidemiologic concept of tick-transmitted diseases has increased in importance with the recognition of the emerging infectious diseases, Lyme borreliosis, human monocytotropic and granulocytotropic ehrlichioses, and three different babesioses. Effective public health control of these diseases would depend upon critical knowledge of the vector biology of the ticks that transmit them. Rocky Mountain spotted fever and the human ehrlichioses are life-threatening yet treatable diseases. A major problem remains establishment of the diagnosis when treatment decisions are being made. Clinical manifestations, other than erythema migrans for Lyme borreliosis, do not provide strong diagnostic clues. Ehrlichiae or babesiae are often not detected in peripheral blood smears. Frequently there are no antibodies to these diverse agents at the time of presentation, and isolation does not yield sensitive and timely results. Polymerase chain reaction, still a research tool, promises the greatest sensitivity, specificity, and timeliness. Prevention by vaccines is not yet a reality, although OspA-based vaccines offer hope for the prevention of Lyme disease.

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“…The most characteristic clinical marker of the disease, erythema migrans, has an incidence of approximately 40±70 per 100,000 in some parts of Europe [2±5]. Although skin rashes, cardiac conduction defects and neuropathies are commonly reported features, serious respiratory complications of Lyme disease are uncommon [4]. To the authors' knowledge, this is the first description of unilateral diaphragmatic paralysis as a complication of Lyme disease.…”

mentioning

confidence: 99%

Diaphragmatic paralysis due to Lyme disease

Faul

Ruoss²,

Doyle³

et al. 1999

Eur Respir J

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Lyme disease is a tick-borne spirochaete infection which, in a proportion of patients, can lead to neuropathy. This article describes a case of diaphragmatic paralysis due to Lyme disease.A 39-yr-old male presented to the hospital because of an acute left facial palsy. Six weeks prior to admission he had developed a circular rash on his left flank during a camping holiday. He also complained of shortness of breath and arthralgia for 1 week. His chest radiograph demonstrated a raised right hemi-diaphragm. Diaphragmatic paralysis was confirmed by fluoroscopy (a positive sniff test). Serology revealed evidence of recent infection by Borrelia burgdorferi. On the basis of the patient's clinical presentation, a recent history of erythema migrans, and positive Lyme serology, a diagnosis of neuroborreliosis was made. He received oral doxycycline therapy (200 mg . day -1 ) for three weeks. Facial and diaphragmatic palsies resolved within eight weeks.On the basis of this case, a diagnosis of Lyme disease should be considered in patients from endemic regions with otherwise unexplained phrenic nerve palsy. Eur Respir J 1999; 13: 700±702.

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The clinical spectrum of early lyme borreliosis in patients with culture-confirmed erythema migrans

Cited by 227 publications

References 22 publications

Truncated seasonal activity patterns of the western blacklegged tick (Ixodes pacificus) in central and southern California

Truncated seasonal activity patterns of the western blacklegged tick (Ixodes pacificus) in central and southern California

Tick-Transmitted Infectious Diseases in the United States

Diaphragmatic paralysis due to Lyme disease

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