By vgreene, 21 June, 2021 Send tick to lab for species ID per IDSA 4 CDC makes no recommendation re lab ID3 5
By vgreene, 21 June, 2021 Don t use heat match nail polish petrolatum or other chemicals to force tick to detach this may delay removal3 or cause tick to regurgitate and potentially uarr risk of pathogen transmission4
By vgreene, 21 June, 2021 Remove attached ticks ASAP by mechanical means using clean fine tipped tweezer or a comparable device inserted btwn tick body and skin 2 transmission occurs after 36 48h of attachment3 4
By vgreene, 21 June, 2021 Prompt tick removal is important to darr Lyme risk Don t test tick nor asymptomatic pt for B burgdorferi Don t diagnose Lyme dz in asymptomatic pts 1 Abx ppx indicated in certain pts while watch wait is appropriate for others
By vgreene, 21 June, 2021 PTLDS Don t give additional abx to pts w persistent fatigue pain or cognitive impairment but no objective s sx of reinfxn or tx failure eg inflammatory arthritis meningitis neuropathy 5 most will improve w time months yrs 2 3 outcomes for these pts no bet
By vgreene, 21 June, 2021 PTLDS Don t give additional abx to pts w persistent fatigue pain or cognitive impairment but no objective s sx of reinfxn or tx failure eg inflammatory arthritis meningitis neuropathy per IDSA 4 most will improve w time months yrs 2 5 per CDC outcomes for
By vgreene, 21 June, 2021 CDC 2022 & IDSA/AAN/ACR: Recommended parenteral abx dosing/duration for PO abx refractory Lyme arthritis:<sup>1,3</sup>
By vgreene, 21 June, 2021 CDC 2022 IDSA AAN ACR Recommended parenteral abx dosing duration for PO abx refractory Lyme arthritis 1 3
By vgreene, 21 June, 2021 If Lyme arthritis improving but not resolved use 2nd course of PO abx 3 if no minimal response to initial PO abx consider 2 to 4 wk course of IV ceftriaxone over 2nd course of PO abx 3 4 if pt fails PO and IV abx consider DMARDs biologic agents interartic
By vgreene, 21 June, 2021 If pt hx suggests reinfxn offer repeat abx according to specific Lyme indications eg EM carditis etc consider 2nd course of abx w alternate drug if concern for tx failure2
