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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Authors: Rauer S, Kastenbauer S, Hofmann H, Fingerle V, Huppertz HI, Hunfeld KP, Krause A, Ruf B, Dersch R, Consensus group Abstract Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3-15% of infections and can manifest as polyradiculitis, meningitis and (rarely) encephalomyelitis. This S3 guideline is directed at physicians in private practices and clinics who treat Lyme neuroborreliosis in children and adults. Twenty AWMF member societies, the Robert Koch Institute, the German Borreliosis Society and three patient organisations participated in its ...
Source: GMS German Medical Science - Category: General Medicine Tags: Ger Med Sci Source Type: research
Publication date: Available online 23 March 2020Source: Ticks and Tick-borne DiseasesAuthor(s): Aris Garro, Miriam Dash, John M. VanBuren, Lise E. Nigrovic, for Pedi Lyme Net
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
CONCLUSIONS: The intrathecal immune reaction in LNB is characterized by B cell associated chemokines. Whether the combination CXCL13/CCL19 further improves discrimination between LNB and NLAM beyond the diagnostic improvements by CXCL13 alone needs to be tested in new studies. PMID: 32199247 [PubMed - as supplied by publisher]
Source: Cytokine - Category: Molecular Biology Authors: Tags: Cytokine Source Type: research
Conclusions: In children, NB more frequently presented as meningitis, and in adults in the form of Bannwarth’s syndrome. CSF pleocytosis in children with NB was higher than in adults, while the protein concentration in children was lower. Outcomes in children and adults were favorable and did not differ after standard NB treatment.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
We report a case of suspected Lyme neuroborreliosis (LNB) where the patient's sole symptom was chronic, intermittent episodes of unilateral ear pain. This case was unusual because this patient did not show any other neurological or extraneurological symptoms of Lyme disease. LNB is a manifestation of infection by Borrelia burgdorferi spirochetes that can manifest in a number of different clinical presentations depending on the nervous system dissemination of the bacteria. Most commonly, these neurological findings present as peripheral nerve radiculopathies, but rarer involvement of the central nervous system (CNS) can...
Source: Journal of Global Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
Lyme disease is caused by a tick-borne bacterium Borrelia sp. This zoonotic infection is common in the Northern Hemisphere, e.g., Europe. Clinical presentation may involve multisystem symptoms and depends on the stage of the disease. The involvement of nervous system in Lyme disease is commonly referred to as neuroborreliosis. Neuroborreliosis may involve meningitis, mononeuritis multiplex, or cranial neuritis including the inflammation of vestibulocochlear nerve. In the late or chronic stage of Lyme disease, vestibular involvement may be the sole presentation, although such cases are rare. Our study was designed to presen...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Semin Neurol 2019; 39: 440-447 DOI: 10.1055/s-0039-1692143Tick-borne infections—including tick-borne encephalitis viruses, represented in the United States by rare infections with Powassan and deer tick viruses, and more often Lyme disease—are of increasing importance to neurologists. Lyme neuroborreliosis (LNB) causes all or part of a triad including meningitis, radiculoneuritis, and cranial neuritis. Rarely, parenchymal brain and spinal cord involvement occur, with focal findings on examination and magnetic resonance imaging (MRI). LNB diagnosis requires plausible exposure, objective evidence of nervous syste...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
(CNN) — Health officials in Maine are warning about the potential for more cases of Powassan virus disease after one person was confirmed to be sick with the rare tick-borne illness, the first reported case in the state since 2017. The Maine Center for Disease Control and Prevention said Wednesday that a person in the southern part of the state had Powassan encephalitis, a severe disease that causes inflammation in the brain. The agency said the patient showed symptoms in late June and was hospitalized. The Maine CDC issued an advisory to physicians that more cases could be possible and suggested that doctors conside...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health CNN Maine news powassan virus ticks Source Type: news
Health officials have confirmed that an individual in Maine is sick with Powassan virus disease, marking the first time since 2017 that a person in the state has come down with the rare and serious tick-borne illness. The Maine Center for Disease Control and Prevention announced Wednesday that a southern Maine resident was hospitalized for Powassan encephalitis—brain inflammation associated with the virus—after showing symptoms in late June. The announcement did not specify the individual’s current condition, but health officils doctors to stay vigilant about the potential spread of Powassan throughout th...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Maine onetime Source Type: news
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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