Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies (II). Biological diagnosis, treatment, persistent symptoms after documented or suspected Lyme borreliosis.
Med Mal Infect
; 49(5): 335-346, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-31155367
ABSTRACT
The serodiagnosis of Lyme borreliosis is based on a two-tier strategy a screening test using an immunoenzymatic technique (ELISA), followed if positive by a confirmatory test with a western blot technique for its better specificity. Lyme serology has poor sensitivity (30-40%) for erythema migrans and should not be performed. The seroconversion occurs after approximately 6 weeks, with IgG detection (sensitivity and specificity both>90%). Serological follow-up is not recommended as therapeutic success is defined by clinical criteria only. For neuroborreliosis, it is recommended to simultaneously perform ELISA tests in samples of blood and cerebrospinal fluid to test for intrathecal synthesis of Lyme antibodies. Given the continuum between early localized and disseminated borreliosis, and the efficacy of doxycycline for the treatment of neuroborreliosis, doxycycline is preferred as the first-line regimen of erythema migrans (duration, 14 days; alternative amoxicillin) and neuroborreliosis (duration, 14 days if early, 21 days if late; alternative ceftriaxone). Treatment of articular manifestations of Lyme borreliosis is based on doxycycline, ceftriaxone, or amoxicillin for 28 days. Patients with persistent symptoms after appropriate treatment of Lyme borreliosis should not be prescribed repeated or prolonged antibacterial treatment. Some patients present with persistent and pleomorphic symptoms after documented or suspected Lyme borreliosis. Another condition is eventually diagnosed in 80% of them.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Lyme
/
Doenças Transmitidas por Carrapatos
/
Técnicas de Laboratório Clínico
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Animals
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Med Mal Infect
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França