Wednesday, September 21, 2022

Infectious Disease Doctor Lyme Disease

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Survey Data Collection And Analysis

Infectious Disease Physician Costi Sifri, MD

The project team was unsuccessful in efforts to engage frontline clinicians via focus groups during the project period. After discussing barriers with clinic practice managers, our team determined that we would be unable to engage frontline clinicians in focus groups due to variable schedules and constraints among that population. The project team pursued an alternate approach to engage this group through an online survey questionnaire. Two project team members developed a survey questionnaire using validated questions from the published literature and focus group data to measure both baseline provider knowledge and the perceptions and experiences of frontline clinicians practicing in the studys geographic area. Project team physicians reviewed and beta tested the questionnaire prior to finalization. The questionnaire was open for responses from March to May 2019. Participants were invited via email invitation and informational flyers delivered to hospital and urgent care clinics in the small-town community. Despite several recruitment efforts, and a participation incentive in the form of gift cards to local restaurants, the number of responses to the survey in the targeted small-town community fell well short of the projects goal.

Protocols and procedures for this study involving human subjects were deemed exempt for review under criterion three by the Institutional Review Board of Cornell University, Protocol Numbers: 1806008097 and 1903008648.

Diagnosis Testing And Treatment

You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.

Several weeks after infection, FDA cleared tests have very good sensitivity.

It is possible for someone who was infected with Lyme disease to test negative because:

  • Some people who receive antibiotics early in disease may not have a fully developed antibody response or may only develop an antibody response at levels too low to be detected by the test.
  • Antibodies against Lyme disease bacteria usually take a few weeks to develop, so tests performed before this time may be negative even if the person is infected. In this case, if the person is retested a few weeks later, they should have a positive test if they have Lyme disease. It is not until 4 to 6 weeks have passed that the test is likely to be positive. This does not mean that the test is bad, only that it needs to be used correctly.
  • If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.

  • Telford SR, Wormser GP. Bartonella transmission by ticks not established.Emerg Infect Dis. 2010 Mar 16 379-84.
    • Report being bitten by a tick, or
    • Live in, or have recently visited, a tick-infested area.

    Confronting The Misnomer Of Chronic Lyme Disease

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    Studies suggest that around 300,000 people are diagnosed with Lyme disease each year in the United States, according to the CDC, with 14 states in the Northeast and upper Midwest accounting for 96% of reported cases. As the most commonly reported tickborne illness in the country, Lyme disease has grown in incidence and expanded beyond its historically endemic range in the last 2 decades.

    The CDC estimates that 70% to 80% of patients with Lyme disease develop the telltale erythema migrans rash, but some patients may exhibit only symptoms of fever, fatigue or muscle/joint pain, which leaves physicians to piece together the diagnosis after confirming whether the patient was in a Lyme-endemic area. If symptoms are vague, physicians may order a blood test. If a diagnosis of Lyme disease is confirmed, patients should be prescribed a 2- to 4-week course of antibiotics, according to current Infectious Diseases Society of America guidelines.

    H. Cody Meissner, MD,

    The rise of chronic Lyme

    First diagnosed in Connecticut in 1975, Lyme disease remained an etiologic mystery until the discovery of the spirochete, a corkscrew-shaped bacterium named Borrelia burgdorferi, which is primarily transmitted through the bite of the blacklegged tick, or deer tick .

    Dangers of alternative therapies

    Off the map

    Consider all possibilities

    • References:

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    Whats So Hard About Finding A Lyme Doctor Anyhow

    If youve landed on this post, you probably already know the answer. But for those who are at the beginning stages of investigating Lyme disease, let me fill you in.

    You see, most doctors simply dont understand Lyme disease and some are certainly not humble enough to admit they dont really understand this disease. Many doctors dont even believe chronic Lyme exists.

    To make matters worse,testing is unreliable and notoriously inaccurate, particularly the standard tests most doctors will run. If you happen to test positive for Lyme on one of those standard tests, the doctors will most likely throw a couple weeks of antibiotics at you and call it good.

    Yeahthats not so good. And likely it wont help much at all.

    When it comes right down to it, theres been precious little research done on this complex disease. Doctors at large have not been educated about what the good research out there actually says about Lyme. All they know is the outdated and ineffective guidelines passed down from the CDC.

    The doctors that are really making an impact are those that have gone out of their way to dig into the research. Theyve spent time educating themselves and working intimately with their patients .

    Infectious Disease Physician & Travel Clinic Services Located In Lansdowne Va

    Pathology of Acrodermatitis Chronica Atrophicans ...

    Early signs of Lyme disease include fever, chills, fatigue and muscle aches. If youre experiencing any of these symptoms and youve been in an area known to have deer ticks, you should call the Infectious Diseases Tropical Medicine and Travel Clinic in Lansdowne, Virginia, for an appointment with specialist Sarfraz Choudhary, MD, FACS, right away. Its important to treat Lyme disease early because later symptoms can be more severe. Dr. Choudhary has extensive experience diagnosing and treating Lyme disease, which is often difficult to diagnose. Call or make an appointment online.

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    What To Bring With You

    You will need to bring the following items:

    • Your insurance card
    • A photo ID
    • Previous medical records, if any.
    • List of all your medications, including the dose and the times you take them. Alternatively, you may want to just bring them with you.
    • A list of all your concerns so that you may discuss them with the scheduled physician.

    What Are The Symptoms Of Lyme Disease

    Symptoms are wide-ranging and can occur from three to 30 days after a bite. Not all ticks are infected with Lyme disease, so getting a tick bite is not a guarantee that you will develop it. If you did get bitten or spent time outside and you have any of following early Lyme disease symptoms, you should call the Infectious Diseases Tropical Medicine and Travel Clinic for an appointment:

    • Rash
    • Inflammation of the brain or spinal cord

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    Focus Group Data Collection And Analysis

    The initial target study population included primary care and emergency and urgent healthcare providers practicing in a small-town community endemic to Lyme disease with emerging incidence of additional TBDs. Invitation emails for focus group participation were sent to practice managers and medical directors for medical practices employing members of the study target population. Researchers coordinated with these key contacts within the practices to schedule in-person focus groups at a date and time convenient to the participating providers. Focus groups were scheduled in late fall 2018 and early spring 2019. Participants included both prescribing and non-prescribing providers.

    Academic project team members developed guided focus group questions covering current knowledge, perceived challenges, and needed resources on tick-borne illness, which were reviewed by physician and health department team members prior to finalization . Focus groups were hosted at each participating practices office location and time-appropriate meals were offered to participants. After receiving verbal informed consent from participants, a project team member trained in qualitative interviewing techniques led a group discussion based on the guided questions. All focus groups were audio-recorded and transcribed verbatim for analysis. No names or other personally identifiable information were recorded in the transcripts, including the business names of the participating clinics.

    The Different Types Of Doctors Who Can Test For Lyme Disease

    Differential Diagnosis of Lyme Disease

    Home » Tick Talk » The Different Types of Doctors Who Can Test for Lyme Disease

    Lyme disease is a tick-borne infectious disease caused by a group of spiral-shaped bacteria we now refer to as Lyme borreliae. This includes, but is not limited to, Borrelia burgdorferi. It is treatable with antibiotics, but in order to have the best chance at full recovery, its crucial to get your disease diagnosed and treated as soon as possible. That means finding the right doctor.

    But what kind of doctor tests for Lyme disease? You may be wondering if you need to see a specific kind of physician to get the right test and treatment. The answer can depend on your particular situation.

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    Contact Us For An Appointment If You Need Support

    The other more modern name for Lyme disease is M-SIDS. This stands for Multiple System Infectious Diseases Syndrome. We only have to look at the Covid pandemic to see what damage an infection can do to our body systems. We have all been listening and reading over the past year and have become more educated on the concept of infection causing potential long term health challenges. So here we have a root cause which is important to explore and treat.

    Our medical approach allows us to use antibiotics, or antiviral / antifungal medications to target key infections. Our Doctor will discuss with you in detail the best approach for you. Our holistic functional medical approach also allows us to deal with optimising gut health within the body including attention to SIBO the presence of active infections of Helicobacter pylori and gut permeability. Mitochondrial function is critical as this is where we produce our energy or ATP.

    We use both natural and allopathic methods to calm the inflammatory process in the body. We optimise the gut allowing modulation of the immune system with the use of diet and supplements that are well researched and evidence-based. Examples of natural support and medications include transfer factors and low dose naltrexone. We know how to support detoxification in the body to allow bio toxins to be properly excreted.

    Examples of complex disease with possible underlying immune dysregulation associated

    We can also address the following situations:

    Lyme Disease Frequently Asked Questions

    If you have not done so already, remove the tick with fine-tipped tweezers.

    The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, and how long it was attached to you. Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in the highly endemic areas of the northeastern and north central U.S. are commonly infected. Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why its so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.

    If you develop illness within a few weeks of a tick bite, see your health care provider right away. Common symptoms of Lyme disease include a rash, fever, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so its important to be alert for any illness that follows a tick bite.

    References:

    Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.external iconAm J Trop Med Hyg 44: 135-9.

    There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic thats safe for use when breastfeeding.

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    Do Your Research And Get Referrals

    You can learn a lot just by researching doctors and reading patient reviews online. You can also connect with other patients through local and online support groups for various tick-borne diseases. Asking other patients to recommend or share their own experiences with different doctors can be particularly helpful when youre trying to locate and learn about physicians who specialize in various tick-borne illnesses.

    The following sites can connect you to online support-group forums or help you identify different tick-borne support groups in the United States:

    What Kind Of Doctor Tests For Lyme Disease

    Lyme Disease: Symptoms and Prevention

    In fact, any kind of doctor can test you for Lyme disease. However, that doesnt mean its a good idea to have your dermatologist or podiatrist order the diagnostic tests. Many people simply see their family physician or primary care doctor to get diagnosed and treated for Lyme.

    There are also doctors who specialize in Lyme disease and other tick-borne illnesses, called Lyme-literate doctors, who you may want to consult instead more on that a little later in this article.

    Finally, there are other types of specialists you may or may not need to consult with depending on the duration and severity of your symptoms.

    For example, many patients wonder if they need to see an infectious disease specialist.

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    Hand Mouth And Foot Disease

    Hand foot and mouth disease is an infection caused by the Coxsackie virus. Though it mostly affects young children, it can happen at any age. Outbreaks are most common in the summer and fall. It is usually not a severe illness, and there is no treatment for the infection.

    For more information on hand mouth and foot disease, please visit the Caring for Kids website.

    Are Llmds Infectious Disease Specialists

    No. While it is possible for a LLMD to be an infectious disease specialist, LLMDs can come from any field or background. Many LLMDs are general practitioners or family doctors, while others may specialize in a specific type of medicine, such as naturopathic medicine.

    For more information on finding a LLMD, read IGeneXs blog How to Find Doctors Who Can Help with Your Tick-Borne Disease.

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    A Goc A Niedzwiecki M Rath

    Abstract: Background: Borrelia sp., is a causative pathogen of Lyme disease which has become a worldwide health concern. Non-toxic approaches especially directed toward latent persistent forms of this pathogen are desired. Lipids in the form of volatile and non-volatile oils, and fatty acids with proven anti-borreliae efficacy could become an additional support or an alternative for consideration in treatment approaches.

    Why You Might Need To See A Llmd:

    Vaccine and infectious disease updates: Mayo Clinic Radio

    Even patients who dont fall into the above categories may simply feel safer in the hands of a LLMD who is familiar with the various ways Lyme and other tick-borne diseases present themselves.

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    Has Niaid Looked At The Potential Benefits Of Long

    Yes. NIAID has funded three placebo-controlled clinical trials on the efficacy of prolonged antibiotic therapy for treating PTLDS. The published results were subjected to rigorous statistical, editorial, and scientific peer review.

    These trials were designed to ensure that several key parameters were addressed:

    • The susceptibility of B.burgdorferi to the antibiotics used
    • The ability of the antibiotics to both cross the blood-brain barrier and access the central nervous system and to persist at effective levels throughout the course of therapy
    • The ability of the antibiotics to kill bacteria living both outside and inside mammalian cells
    • The safety and welfare of patients enrolled in the trials

    The first clinical trial, which included two multicenter studies, provided no evidence that extended antibiotic treatment is beneficial. In those studies, physicians examined long-term antibiotic therapy in patients with a well-documented history of previous Lyme disease but who reported persistent pain, fatigue, impaired cognitive function, or unexplained numbness. Those symptoms are common among people reporting PTLDS. Patients were treated with 30 days of an intravenous antibiotic followed by 60 days of an oral antibiotic.

    In 2016, a clinical trial conducted in the Netherlands also concluded that in patients with persistent symptoms attributed to Lyme disease, longer term treatment with antibiotics did not provide additional benefits compared with shorter term regimens.

    When Should Someone Seek Medical Care For Lyme Disease

    Seek immediate medical attention if you live in or have visited an area where Lyme disease is common and you experience a flu-like illness or develop a red or target-like rash anytime from late spring to early fall. Prompt treatment at this early stage reduces the risk of further symptoms of Lyme disease.

    • Remove any attached ticks by pulling them off your body. The CDC recommends the following tick-removal process:
    • Grasp the tick with fine-tipped tweezers as close to the skin’s surface as possible.
    • Pull upward with steady, even pressure. Don’t twist or jerk the tick or mouth-parts may break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are cannot remove the mouth easily with tweezers, leave it alone and let the skin heal.
    • After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
    • If the tick is still alive, dispose of it by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.
  • However, removing ticks promptly is more important than how you remove them. If you cannot remove an attached tick, see a doctor, who will remove it.
  • Following tick removal, see a doctor if any flu-like symptoms or rash develop within the next three weeks. If a rash develops, draw a line around it with ink that does not wash off each day to see if it is growing.
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