illness. The benefi t of cerebrospinal fl uid testing is helpful in only 10% of patients. Specifi c testing for Lyme or any of the co-infections has to been done by someone trained in this arena.
Consideration of
Additional Testing Additional lab test would include CBC, CD57 and C4A. Other appropriate testing includes viruses such as mycoplasma pneumonia, chlamydia pneumonia and all the co-infections.
What to do if you see a bull’s eye rash after
a tick bite exposure? It is important that you seek treatment immediately with 3-6 weeks of antibiotics treatment. You need to be closely monitored since the initial flu-like symptoms, as related to the tick bite, will necessitate at least 6 weeks or longer of antibiotics.
What do I do if I have a
tick bite without a rash? The ILADS organization and the Boston meeting of November 2012
recommends treatment with antibiotics for 3 weeks. The CDC does not conform to the same guidelines and recommends a shorter duration of antibiotics.
Appropriate treatment for Chronic Lyme
Symptoms This is a complex area and there are many organizations that work hard to show that long-term antibiotics can be of benefi t. IDSA (Infectious Disease of America) recommends only 4 weeks of antibiotics. ILADS recommend longer treatment of antibiotics. From personal experience in dealing with Lyme for over 6 years in my offi ce, there is a role for antibiotics and supportive medications. There needs to be a cycling for intravenous antibiotics and antibiotics for a given period of time. Additional support needs to be given for detoxifi cation and intravenous support for overall improvement.
Why is Lyme
Controversial? In the arena of Lyme, many doctors in Florida are not familiar with the
symptoms. There is a misconception that Lyme is not present in Florida. Locations such as Pennsylvania, New England and Virginia have had a marked increase in reported Lyme cases. Any patients presenting with Chronic Fatigue and Fibromyalgia would need to consider Lyme as a possibility since these symptoms do overlap quite signifi cantly.
Symptoms Related to Ehrlichia, Bartonella
and Babesia There are some specifi c symptoms related to each of these illnesses and that can be determined through appropriate questionnaires created by Lyme-trained physicians. Some of them are very specifi c symptoms such as Bartonella which will have on-going fatigue, headaches, swollen glands, arthritis and vision symptoms. Babesia symptoms can be diffi cult to differentiate from Lyme. Ehrlichia can cause some muscle aches and fever but can easily be eradicated with 2 months of Doxycycline.
Duration of Antibiotics The duration is determined by
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