Would Parents Consent to a Comparative Effectiveness Trial of Oral Doxycycline Versus Intravenous Ceftriaxone for the Treatment of Children with Lyme Meningitis?

Children with Lyme meningitis are often treated with intravenous ceftriaxone, although oral doxycycline may be effective. Parents were surveyed after observing a video describing a hypothetical Lyme meningitis treatment trial. Eighty-four of 102 (82%) would consent to their child participating. Parents would accept 2 additional days of symptoms (noninferiority margin) with doxycycline even if ceftriaxone hastened symptom resolution.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Brief Reports Source Type: research

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Conclusions/SignificanceThese preliminary results suggest the potential utility of CSF metabolomics as a rapid screening test to enhance diagnostic accuracies and improve patient outcomes.
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research
We report on five cases of patients with a diagnosis of neuroborreliosis based on clinical symptoms, serologic tests and MR imaging results. However, neither of them fulfils the diagnostic criteria for definite neuroborreliosis. Are the diagnostic criteria still valid or is there a need to revis e them? Is our diagnosis correct? Are these cases post-Lyme auto-immune neuronal inflammation, and not due to still active spirochetal infection? Do we need to consider immunosuppressive therapy instead of third-generation cephalosporins?
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
Neurologic manifestations of nervous system infection with Borrelia burgdorferi, Borrelia garinii, and Borrelia afzelii are qualitatively similar, and include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and other focal or multifocal mononeuropathies. Parenchymal central nervous system (CNS) infection occurs rarely. Neurobehavioral changes are common, but are rarely evidence of CNS infection. Diagnosis requires likely exposure and a finding with high diagnostic positive predictive value, specifically erythema migrans, or laboratory support, typically positive 2-tiered serologic testing. CNS infection is ofte...
Source: Neurologic Clinics - Category: Neurology Authors: Source Type: research
This article presents an overview of the current diagnosis and management of two spirochetal infections of the nervous system, neuroborreliosis (Lyme disease) and neurosyphilis, focusing on similarities and differences. Although neuroborreliosis was first identified almost a century ago, much confusion remains about how to accurately diagnose this quite treatable nervous system infection. Well-established diagnostic tools and therapeutic regimens exist for neurosyphilis, which has been well-known for centuries. RECENT FINDINGS Serologic testing targeting the C6 antigen may simplify diagnostic testing in neuroborreliosis...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: Review Articles Source Type: research
This article can educate those engaged in imaging of the nervous system and serve as a comprehensive tool in clinical cases.Key Points•Diagnostic criteria for LNB emphasise exclusion of an alternative cause to the clinical symptoms.•MRI makes a crucial contribution in the diagnosis and follow-up of LNB.•MRI may have normal findings, or show neuritis, meningitis, myelitis, encephalitis or vasculitis.•White matter lesions are not a prominent feature of LNB.
Source: Insights into Imaging - Category: Radiology Source Type: research
B. miyamotoi was detected in Ixodes scapularis ticks in Connecticut in 2001 [2], but the first human case in the United States was not reported until 2013 [3]. Unlike with Lyme disease, patients in the United States with B. miyamotoi infections typically do not have skin lesions and instead present with a non-specific febrile illness, potentially associated with leukopenia, thrombocytopenia and elevated liver function tests [4]. Highly immunocompromised patients may develop chronic meningitis [3].
Source: The American Journal of Medicine - Category: General Medicine Authors: Source Type: research
ConclusionDysregulation of prostaglandins and related lipid mediators may play a role in the etiology of LB and persistence of inflammation that may lead to long-term complications. Further investigation into the precise levels of a wide range of PGs and related factors is critical as it may propose novel markers that can be used for early diagnosis.
Source: Inflammation Research - Category: Research Source Type: research
Publication date: July 2018Source: Ticks and Tick-borne Diseases, Volume 9, Issue 5Author(s): Mateusz Markowicz, Anna-Margarita Schötta, Michael Kundi, Petra Bogovič, Katarina Ogrinc, Franc Strle, Gerold StanekAbstractThe aims of the study were to determine and compare the concentration of CXCL13 in cerebrospinal fluid (CSF) of patients with Lyme neuroborreliosis (LNB) and various other neurological disorders applying a Luminex based assay and ELISA, and to find factors associated with CXCL13 concentration. CSF samples obtained from four clinically well-defined groups of patients (proven LNB, suspected LNB, tick-born...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
The aim of this study was to determine the characteristics, treatment, and outcome according to each etiology of pachymeningitis. We conducted a retrospective multicenter French nationwide study between 2000 and 2016 to describe the characteristics, outcome, and treatment of pachymeningitis. We included 60 patients (median age 55.5 years; interquartile range [IQR] 30–80, female/male ratio 0.43). Neurologic signs were present in 59 patients (98%) and consisted of headache in 43 (72%), cranial nerve palsy in 33 (55%), confusion in 10 (17%), seizures in 7 (12%), and focal neurologic signs in 9 (15%). Fever and weight ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
For most of us, springtime marks the return of life to a dreary landscape, bringing birdsong, trees in bud, and daffodils in bloom. But if you work for the Centers for Disease Control and Prevention (CDC), the coming of spring means the return of nasty diseases spread by ticks and mosquitoes. The killjoys at CDC celebrated the end of winter with a bummer of a paper showing that infections spread by ticks doubled in the United States from 2004 to 2016. (Tick populations have exploded in recent decades, perhaps due to climate change and loss of biodiversity.) Lyme disease The most common infection spread by ticks in the US i...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Infectious diseases Source Type: blogs
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