By vgreene, 18 June, 2021 Don t screen w EKG perform EKG only in pts w s sx consistent w carditis eg dyspnea palpitations edema chest pain dizziness syncope 4
By vgreene, 18 June, 2021 Assess for anaplasmosis and or babesiosis in pts w high fever or characteristic lab abnormalities in areas where these infxns are endemic5
By vgreene, 18 June, 2021 In seropositive pts w Lyme arthritis needing more definitive info for tx decisions use PCR of synovial fluid or tissue over cx 4
By vgreene, 18 June, 2021 If CSF testing is done perform simultaneous serum sample for determination of CSF serum Ab index don t perform CSF serology alone or perform CSF PCR or cx4
By vgreene, 18 June, 2021 Perform 2 tier testing over PCR or cx of blood CSF or synovial fluid initial ELISA1 2 or IFA 1 then Western immunoblot or FDA approved 2nd EIA3 if 1st test is or equivocal 1 don t r o dx if tests are but there s high clinical suspicion of Lyme dz2
By hgreaney@athen…, 17 June, 2021 Pt w typical Lyme sx erythema migrans carditis arthritis neuro sx lymphocytoma acrodermatitis chronica atrophicans
By vgreene, 17 June, 2021 Bamlanivimab and etesevimab distribution currently halted due to high frequency of non susceptible variants
