Author: Dr. Daniel Cameron
-
Can Lyme disease trigger a cascade of costly, unnecessary tests?
Dr. Meredith Niess discussed the case in more detail in an NPR story.[1] A man was scheduled for hernia surgery. A preoperative X-ray was ordered despite the paucity of evidence of whether the X-ray was needed. The X-ray suggested a mass. The patient was worried about cancer. Cancer was ruled out. “In fact, a follow-up…
-
Anesthetic concerns for Lyme disease patients
In her article “Lyme Disease and Anesthesia Considerations,” Smit discusses three approaches: Disease awareness Some patients may have Lyme disease that has not been diagnosed. “Infected patients in whom the diagnosis has not yet been made or has been missed may present for invasive investigations such as biopsies or arthroscopies or for larger surgical interventions…
-
Lyme disease and herxheimer reaction in newborn
In 2020, investigators published a case involving a 13-year-old boy with Lyme arthritis, a common manifestation of Lyme disease, who developed a Herxheimer reaction when treated with doxycycline. On the 7th day of treatment, the boy developed a low-grade fever and severe arthralgias with intense hip, ankle and cervical spine pain and myalgias. You can…
-
Successful removal of pacemakers in patients with Lyme carditis
In their study “Pacemaker Explantation in Patients With Lyme Carditis,” Wamboldt and colleagues¹ describe two cases involving the removal of pacemakers in patients with Lyme carditis, which highlights the importance of including Lyme carditis in the differential diagnosis for high-degree AV block. Furthermore, these cases demonstrate the “benefits of early device interrogation in patients who…
-
‘Near-universal’ negative experiences with healthcare providers reported by Lyme disease patients
“Healthcare providers frequently struggle to provide effective care to patients with chronic Lyme-associated symptoms…potentially causing these patients to feel misunderstood or neglected by the healthcare system,” the authors wrote. They listed 6 themes that emerged from the participants experiences: Late diagnosis, abandonment, loss, unpredictability, lack of understanding, and a need for a holistic experience. The…
-
Lyme meningitis leading to hyponatremia
There are many causes of hyponatremia. Any disorder of the central nervous system, including infections, can trigger it. However, only a few case reports of Lyme meningitis or Lyme neuroborreliosis have been published with a focus on hyponatremia, according to the authors. Hyponatremia is a condition that occurs when the level of sodium in the…
-
Lyme arthritis with rheumatoid arthritis leads to poor quality of life
In the study “Assessment of quality of life in patients with Lyme arthritis and rheumatoid arthritis,” Yuskevych and colleagues surveyed 90 patients with Rheumatoid Arthritis who were treated at their rheumatology clinic.¹ Nearly 50% of the patients with Rheumatoid Arthritis also tested positive for Lyme disease. Survey results indicated, “The presence of Borrelia burgdorferi [the…
-
Erythema migrans rash doesn’t always have bull’s eye appearance
Several reports have found urticarial, linear, granulomatous, and bullous erythema migrans presentations associated with Lyme disease, as well. And as this case series highlights, “several erythema migrans variants have been reported, which may result in misidentification as well as delayed diagnosis and treatment.”¹ In their article, “Vesiculobullous Lyme disease: A case series,” the authors describe…
-
Single dose doxycycline for treatment of tick bite only prevents Lyme disease rash
In the article, the authors reference the 2006 Infectious Diseases Society of America (IDSA) guidelines when making their recommendation that “individuals be treated with a single dose of doxycycline (4 mg/kg in children ≥8 years of age to a maximum 200 mg and 200 mg in adults)”. [1] Their recommendation applies only to patients meeting…
-
When babesiosis turns deadly
The man presented to the emergency department with fatigue, generalized weakness and intermittent subjective fevers. The symptoms had worsened over a 2-week period. The patient also complained of headaches, vision changes, nausea, vomiting and diarrhea. And had a medical history of type 2 diabetes and intermittent asthma. “He denied any known recent tick or animal…