The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Trevisan, Giusto; Nan, Katiuscia; Meo, Nicola di; Bonin, Serena

doi:10.3390/pathogens11101122

Cited by 5 publications

(5 citation statements)

References 42 publications

(41 reference statements)

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“…Our studies confirm that children have a distinct clinical presentation from adults. This is also a consequence of the different location of the tick bite in children, which as reported also by other authors is often on the head (54,55). We also observed that there is a gender effect on clinical presentation, with females presenting more often with EM or ACA than males, while males present more often with neurological signs or arthritis than females.…”

Section: Discussionsupporting

confidence: 80%

Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France

Perthame,

Chartier,

George

et al. 2024

Front. Med.

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IntroductionLyme borreliosis (LB) is the most common vector disease in temperate countries of the northern hemisphere. It is caused by Borrelia burgdorferi sensu lato complex.MethodsTo study the case presentation of LB in France, we contacted about 700 physicians every year between 2003 and 2011. An anonymous questionnaire was established allowing the collection of 3,509 cases. The information collected was imported or directly entered into databases and allowed identifying variables that were validated in a multiple correspondence analysis (MCA).ResultsSixty percent of the cases were confirmed, 10% were probable, 13.5% doubtful, 10.2% asymptomatic seropositive and 6.3% were negative. The clinical manifestations reported were cutaneous (63%), neurological (26%), articular (7%), ocular (1.9%) and cardiac (1.3%). Almost all patients were treated. When focusing more particularly on confirmed cases, our studies confirm that children have a distinct clinical presentation from adults. There is a gender effect on clinical presentation, with females presenting more often with erythema migrans or acrodermatitis chronica atrophicans than males, while males present more often with neurological signs or arthritis than females.DiscussionThis is the first time that a comprehensive study of suspected Lyme borreliosis cases has been conducted over several years in France. Although we were not able to follow the clinical course of patients after treatment, these results suggest the interest of refining the questionnaire and of following up a cohort of patients over a sufficiently long period to obtain more information on their fate according to different parameters.

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Section: Discussionsupporting

confidence: 80%

Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France

Perthame,

Chartier,

George

et al. 2024

Front. Med.

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“…However, EM is not systematically detected and only non-characteristic symptoms linked to stages 2 and 3 (Lyme neuroborreliosis, carditis, or arthritis) can be expressed [ 1 , 22 ]. It is important to emphasize that the risk of the appearance of other symptoms from LB (especially neurologic and articular manifestations) is significantly reduced after the recognition of EM and the rapid initiation of antibiotic treatment [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Lyme borreliosis diagnosis: state of the art of improvements and innovations

Guérin,

Shawky,

Zedan

et al. 2023

BMC Microbiol

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With almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in the world. Transmitted by ticks of the genus Ixodes and caused by bacteria Borrelia burgdorferi sensu lato, LB occurs with various symptoms, such as erythema migrans, which is characteristic, whereas others involve blurred clinical features such as fatigue, headaches, arthralgia, and myalgia. The diagnosis of Lyme borreliosis, based on a standard two-tiered serology, is the subject of many debates and controversies, since it relies on an indirect approach which suffers from a low sensitivity depending on the stage of the disease. Above all, early detection of the disease raises some issues. Inappropriate diagnosis of Lyme borreliosis leads to therapeutic wandering, inducing potential chronic infection with a strong antibody response that fails to clear the infection. Early and proper detection of Lyme disease is essential to propose an adequate treatment to patients and avoid the persistence of the pathogen. This review presents the available tests, with an emphasis on the improvements of the current diagnosis, the innovative methods and ideas which, ultimately, will allow more precise detection of LB.

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“…Its incidence is increasing in different Western European countries together with a geographical expansion of the disease into previously non-endemic areas (Beltrame et al, 2021). Although we are not describing the incidence of the disease, cases increased in the observation period with a maximum of observations in 2020, possibly due to the COVID pandemic and the use of telemedicine in diagnosing EM (Trevisan et al, 2022). In Italy, during the pandemic, patients could not reach hospitals for dermatological evaluation, and after a telephone interview with the doctors, they sent their pictures of the lesions by e-mail or showed them on a video call.…”

Section: Discussionmentioning

confidence: 86%

“…Patients' data were gathered from 01/01/2010 to 30/08/2022 in the participating centers in Friuli-Venezia Giulia, Liguria, Lombardy, Emilia-Romagna, and Campania, as shown in Figure 1. During the COVID pandemic, telemedicine has also been used (Trevisan et al, 2022) for diagnosis, especially for EM lesions. In each center, the following diagnostic criteria were applied for LB diagnosis:…”

Section: Methodsmentioning

confidence: 99%

The history of Lyme disease in Italy and its spread in the Italian territory

et al. 2023

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Lyme borreliosis (LB) is the most common vector-borne zoonotic inflammatory disease in the Northern Hemisphere. In Italy, the first case was diagnosed in 1985 in a woman in Liguria, while the second, in 1986 in Friuli-Venezia Giulia, documenting the infection in northern Italy. Both diagnoses were confirmed by serological assessment by an indirect immunofluorescence (IFI) technique. Borrelia cultivation from both Ixodes ricinus ticks and human lesions in Trieste (Friuli-Venezia Giulia) identified Borrelia afzelii as the prevalent genospecies; nevertheless, Borrelia garinii, Borrelia burgdorferi (sensu stricto), and Borrelia valaisiana (VS116 Group) were also detected, although less frequently. LB was also documented in other Italian regions: in Tuscany (1991), Trentino–Alto Adige (1995–1996), Emilia-Romagna (1998), Abruzzo (1998), and more recently, Lombardy. Nevertheless, data on LB in other Italian regions, especially in southern Italy and islands, are poor. The aim of this study is to document the spread of LB in Italy through the collection of data from LB patients in eight Italian hospitals located in different Italian regions. Diagnostic criteria for LB diagnosis are as follows: i) the presence of erythema migrans (EM) or ii) a clinical picture suggestive of LB, confirmed by serological tests and/or PCR positivity for Borrelia detection. In addition, data also included the place of residence (town and region) and the place where patients became infected. During the observation period, 1,260 cases were gathered from the participating centers. Although different in extent from northern Italy to central/southern Italy, this study shows that LB is widespread throughout Italy.

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The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Cited by 5 publications

References 42 publications

Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France

Case presentation and management of Lyme disease patients: a 9-year retrospective analysis in France

Lyme borreliosis diagnosis: state of the art of improvements and innovations

The history of Lyme disease in Italy and its spread in the Italian territory

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