Robert T Schoen1. 1. Section of Rheumatology, Allergy and Clinical Immunology, Yale University School of Medicine, 60 Temple Street, Suite 6A, New Haven, CT, 06510, USA. robert.schoen@yale.ed.
Abstract
PURPOSE OF REVIEW: Since recognition in 1975, Lyme disease has become the most common vector-borne illness in North America and Europe. The clinical features are well-characterized and treatment is usually curative, but misperceptions about morbidity persist. The purpose of this review is to examine advances in the diagnosis and treatment of Lyme disease, as well as ongoing management challenges. RECENT FINDINGS: It is useful to recognize that Lyme disease occurs in stages, with early- and late-stage disease. Clinical expression is in part determined by Borrelial variability. For example, some strains of Borrelia burgdorferi, the causative organism in North America, are particularly arthritogenic. Most patients with early Lyme disease can be cured with a single course of oral antibiotic therapy, in contrast to some patients with Lyme arthritis, a late-stage manifestation, who are more antibiotic refractory and require other treatment strategies. Successful treatment of Lyme disease begins with successful diagnosis and with an understanding of the emergence, clinical features, and impact of Lyme disease over the past half century.
PURPOSE OF REVIEW: Since recognition in 1975, Lyme disease has become the most common vector-borne illness in North America and Europe. The clinical features are well-characterized and treatment is usually curative, but misperceptions about morbidity persist. The purpose of this review is to examine advances in the diagnosis and treatment of Lyme disease, as well as ongoing management challenges. RECENT FINDINGS: It is useful to recognize that Lyme disease occurs in stages, with early- and late-stage disease. Clinical expression is in part determined by Borrelial variability. For example, some strains of Borrelia burgdorferi, the causative organism in North America, are particularly arthritogenic. Most patients with early Lyme disease can be cured with a single course of oral antibiotic therapy, in contrast to some patients with Lyme arthritis, a late-stage manifestation, who are more antibiotic refractory and require other treatment strategies. Successful treatment of Lyme disease begins with successful diagnosis and with an understanding of the emergence, clinical features, and impact of Lyme disease over the past half century.
Authors: Robert P Smith; Robert T Schoen; Daniel W Rahn; Vijay K Sikand; John Nowakowski; Dennis L Parenti; Mary S Holman; David H Persing; Allen C Steere Journal: Ann Intern Med Date: 2002-03-19 Impact factor: 25.391
Authors: Gary P Wormser; Donna McKenna; Jennafer Carlin; Robert B Nadelman; L Frank Cavaliere; Diane Holmgren; Daniel W Byrne; John Nowakowski Journal: Ann Intern Med Date: 2005-05-03 Impact factor: 25.391
Authors: Neeta P Connally; Alison F Hinckley; Katherine A Feldman; Melissa Kemperman; David Neitzel; Siok-Bi Wee; Jennifer L White; Paul S Mead; James I Meek Journal: Ticks Tick Borne Dis Date: 2015-10-30 Impact factor: 3.744
Authors: Franc Strle; Daša Stupica; Petra Bogovič; Paul Visintainer; Gary P Wormser Journal: Diagn Microbiol Infect Dis Date: 2018-02-02 Impact factor: 2.803
Authors: Daniel J B Clarke; Alison W Rebman; Allison Bailey; Megan L Wojciechowicz; Sherry L Jenkins; John E Evangelista; Matteo Danieletto; Jinshui Fan; Mark W Eshoo; Michael R Mosel; William Robinson; Nitya Ramadoss; Jason Bobe; Mark J Soloski; John N Aucott; Avi Ma'ayan Journal: Front Immunol Date: 2021-03-08 Impact factor: 7.561