Lyme disease - Revision history

Danbot: Add Cefuroxime AntibioticDose entries (Adult + Pediatric) from original Cefuroxime page

2026-03-20T12:37:11Z

Add Cefuroxime AntibioticDose entries (Adult + Pediatric) from original Cefuroxime page

← Older revision		Revision as of 12:37, 20 March 2026
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	*{{AntibioticDose\|drug=Doxycycline\|dose=>8 years old; 100mg PO q12h x14-21 days; Treat for 28 days if Lyme arthritis\|context=Lyme Disease\|disease=Lyme disease\|population=Pediatric}}		*{{AntibioticDose\|drug=Doxycycline\|dose=>8 years old; 100mg PO q12h x14-21 days; Treat for 28 days if Lyme arthritis\|context=Lyme Disease\|disease=Lyme disease\|population=Pediatric}}
	*{{AntibioticDose\|drug=Amoxicillin\|dose=50mg/kg/day PO divided q8h x 14-21 days; First Dose: 16.6mg/kg PO x1; Max: 500mg/dose\|context=Early Lyme Disease\|disease=Lyme disease\|population=Pediatric}}		*{{AntibioticDose\|drug=Amoxicillin\|dose=50mg/kg/day PO divided q8h x 14-21 days; First Dose: 16.6mg/kg PO x1; Max: 500mg/dose\|context=Early Lyme Disease\|disease=Lyme disease\|population=Pediatric}}
			*{{AntibioticDose\|drug=Cefuroxime\|dose=500mg PO BID x 20 days\|context=Early Lyme disease, alternative\|disease=Lyme disease\|population=Adult}}
			*{{AntibioticDose\|drug=Cefuroxime\|dose=30mg/kg/day PO divided BID x 20 days (max 500mg/dose)\|context=Early Lyme disease, alternative, >13yo\|disease=Lyme disease\|population=Pediatric}}

	==Disposition==		==Disposition==

Danbot: Add Doxycycline and Amoxicillin AntibioticDose entries

2026-03-20T10:59:06Z

Add Doxycycline and Amoxicillin AntibioticDose entries

← Older revision		Revision as of 10:59, 20 March 2026
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	*[[Doxycycline]], [[Amoxicillin]] PO, as effective as parenteral		*[[Doxycycline]], [[Amoxicillin]] PO, as effective as parenteral
	*[[Ceftriaxone]]/[[Pen G]] IV		*[[Ceftriaxone]]/[[Pen G]] IV


			===Antibiotic Dosing===
			====Adult====
			*{{AntibioticDose\|drug=Amoxicillin\|dose=500mg PO q8h x 14-21 days\|context=Lyme Disease\|disease=Lyme disease\|population=Adult}}
			====Pediatric====
			*{{AntibioticDose\|drug=Doxycycline\|dose=>8 years old; 100mg PO q12h x14-21 days; Treat for 28 days if Lyme arthritis\|context=Lyme Disease\|disease=Lyme disease\|population=Pediatric}}
			*{{AntibioticDose\|drug=Amoxicillin\|dose=50mg/kg/day PO divided q8h x 14-21 days; First Dose: 16.6mg/kg PO x1; Max: 500mg/dose\|context=Early Lyme Disease\|disease=Lyme disease\|population=Pediatric}}

	==Disposition==		==Disposition==

Masoodrm: /* Early Disseminated Infection (Days to Weeks) */

2022-05-06T17:04:25Z

Early Disseminated Infection (Days to Weeks)

← Older revision		Revision as of 17:04, 6 May 2022
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	*Fatigue, low grade [[fever]], migrating [[arthralgia]], lymphadenopathy, [[headache]], nausea/[[vomiting]], [[abdominal pain]]		*Fatigue, low grade [[fever]], migrating [[arthralgia]], lymphadenopathy, [[headache]], nausea/[[vomiting]], [[abdominal pain]]

	===Early Disseminated Infection (Days to ~~weeks~~)===		===Early Disseminated Infection (Days to Weeks)===
	*Skin-~~mult~~ annular lesions ~~sparing~~ palm/soles		*Skin- Multiple annular lesions that spare the palm and soles
	*Nervous System-fluctuating [[meningoencephalitis]], [[headache]], [[nausea/vomiting]], [[cranial nerve palsies]] (ie 7th-can be bilateral) peripheral neuropathy, radiculopathy		*Nervous System-fluctuating [[meningoencephalitis]], [[headache]], [[nausea/vomiting]], [[cranial nerve palsies]] (ie 7th-can be bilateral) peripheral neuropathy, radiculopathy
	*Cardiovascular: [[AV blocks]], [[RBBB]], [[dysrhythmias]], LV dysfunction		*Cardiovascular: [[AV blocks]], [[RBBB]], [[dysrhythmias]], LV dysfunction

Masoodrm: /* Early Localized Infection (7-14 Days) */

2022-05-06T17:03:50Z

Early Localized Infection (7-14 Days)

← Older revision		Revision as of 17:03, 6 May 2022
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	''3 Distinct Stages - Not all patients suffer all stages, and stages may overlap with remissions between stages''		''3 Distinct Stages - Not all patients suffer all stages, and stages may overlap with remissions between stages''

	===Early Localized Infection (7-~~14d~~)===		===Early Localized Infection (7-14 Days)===
	*Erythema Chronicum Migrans: Occurs at site of tick bite, beginning with red macule that expands outward. Starts 3-30 days after bite and occurs in 70-80% of cases		*Erythema Chronicum Migrans: Occurs at site of tick bite, beginning with red macule that expands outward. Starts 3-30 days after bite and occurs in 70-80% of cases
	*Erythema migrans rash more often without central clearing		*Erythema migrans rash more often without central clearing

Masoodrm: /* Background */

2022-05-06T17:03:03Z

Background

← Older revision		Revision as of 17:03, 6 May 2022
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	[[File:Lyme Disease Risk Map.gif\|thumb\|National Lyme disease risk map with 4 categories of risk.]]		[[File:Lyme Disease Risk Map.gif\|thumb\|National Lyme disease risk map with 4 categories of risk.]]
	[[File:Ixodes scapularis.jpg\|thumb\|Ixodes tick]]		[[File:Ixodes scapularis.jpg\|thumb\|Ixodes tick]]
	*Tick Borne - ''Ixodes'' black-legged ticks		*Caused by spirochete ''Borrelia burgdorferi''
	*Endemic Areas: NE, E US Coasts		** Typically carried on Ixodes scapularis aka Deer tick
	*Caused by spirochete ''Borrelia burgdorferi''		**The spirochete ''Borrelia mayonii'' has been a new strain implicated in cases in the midwest<ref>Pritt BS, Mead PS, Johnson DKH, et al.Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infectious Disease. Published Online: 05 February 2016. </ref>
	*The spirochete ''Borrelia mayonii'' has been a new strain implicated in cases in the midwest<ref>Pritt BS, Mead PS, Johnson DKH, et al.Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infectious Disease. Published Online: 05 February 2016. </ref>		*Endemic to the northeastern US
	*Peak in May to ~~Aug~~		*Peak time of infection is May to August
	*Stages: Early localized infection, early disseminated, and late disseminated		*Stages: Early localized infection, early disseminated, and late disseminated

Rossdonaldson1: /* External Links */

2022-05-03T18:13:03Z

External Links

← Older revision		Revision as of 18:13, 3 May 2022
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	==External Links==		==External Links==
	[https://www.cdc.gov/lyme/index.html CDC: Lyme Disease]		*[https://www.cdc.gov/lyme/index.html CDC: Lyme Disease]

	==References==		==References==

Spenceemmett: /* Early Localized Infection */

2022-04-26T00:01:55Z

Early Localized Infection

← Older revision		Revision as of 00:01, 26 April 2022
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	*Treat before serologic testing if endemic area if + erythema migrans rash		*Treat before serologic testing if endemic area if + erythema migrans rash
	**'''[[Doxycycline]]''' ~~100mg~~ PO BID x ~~14-21~~ days<ref>~~Shapiro~~, ~~E. (2014) ‘Lyme disease’~~, ~~New England Journal~~ of ~~Medicine~~, ~~371~~(7)~~, pp~~. ~~683–684~~.</ref>		**'''[[Doxycycline]]''' 100 mg PO BID x 10 days <ref name="IDSA guidelines">Clinical Practice Guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology
			2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease. Lantos et al. Neurology Feb 2021, 96 (6) 262-273; DOI: 10.1212/WNL.0000000000011151</ref>
	***Acceptable for all pediatric patients when used for 21 days or less		***Acceptable for all pediatric patients when used for 21 days or less
	***Also treats human granulocytic [[ehrlichiosis]]		***Also treats human granulocytic [[ehrlichiosis]]
	**'''[[Amoxicillin]]''' ~~500mg~~ PO TID x 14~~-21~~ days		**'''[[Amoxicillin]]''' 500 mg PO TID x 14 days <ref name="IDSA guidelines"/>
	***Preferred in pregnant, lactating		***Preferred in pregnant, lactating
	**[[Cefuroxime]] axetil ~~500mg~~ PO BID x 14~~-21~~ days		**[[Cefuroxime]] axetil 500 mg PO BID x 14 days <ref name="IDSA guidelines"/>
	**[[Macrolides]]-not first line		**[[Macrolides]]- not first line
	*[[Jarisch-Herxheimer reaction\|Jarisch-Herxheimer]] like reaction can occur in first 24 hrs of treatment (fevers, chills, myalgia, tachycardia)		*[[Jarisch-Herxheimer reaction\|Jarisch-Herxheimer]] like reaction can occur in first 24 hrs of treatment (fevers, chills, myalgia, tachycardia)

Elcatracho: /* See Also */

2021-03-17T04:31:41Z

Elcatracho: /* See Also */

2021-01-24T02:32:13Z

Elcatracho: /* See Also */

2021-01-24T02:31:56Z

← Older revision		Revision as of 04:31, 17 March 2021
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	*[[Bell's palsy]]		*[[Bell's palsy]]
	*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]		*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]
			*[[In-training exam review]]

	==External Links==		==External Links==

← Older revision		Revision as of 02:32, 24 January 2021
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	*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]		*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]

	[[External Links]]		==External Links==
	[https://www.cdc.gov/lyme/index.html CDC: Lyme Disease]		[https://www.cdc.gov/lyme/index.html CDC: Lyme Disease]

← Older revision		Revision as of 02:31, 24 January 2021
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	*[[Bell's palsy]]		*[[Bell's palsy]]
	*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]		*[https://www.nejm.org/doi/10.1056/NEJM200107123450207?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Allen C. Steere, "Lyme disease" N Engl J Med 2001; 345:115-125. Accessed 13 Jan 2021.]

			[[External Links]]
			[https://www.cdc.gov/lyme/index.html CDC: Lyme Disease]

	==References==		==References==