The Infectious Disease Clinic At Ahn: Why Choose Us
Our team includes physicians who completed extra training in diagnosing and treating infectious diseases. This training, combined with our years of experience, helps you receive the best care right from the start.
When needed, we also provide more care options, such as clinical trials for new medications. Other highlights of our program include:
- Safety: We follow national care guidelines. These guidelines make sure you receive antibiotics with a proven track record for safety and effectiveness. Our high standards mean our infectious disease doctors successfully treat a broad range of conditions with fewer side effects, including Lyme disease. For Lyme disease, we strictly adhere to the Centers for Disease Control and Prevention treatment guidelines.
- Accurate diagnosis: We use molecular testing techniques that offer a high degree of accuracy and rapid results in certain conditions.
- Team approach: Our physicians work alongside pharmacists specializing in infectious disease. Together, theyâll help you receive the medications that are most appropriate for your diagnosis â even if youâre allergic to certain antibiotics. If you are on antibiotics for a long time, we monitor your care to lower the risk of complications.
Related Services And Treatments
- COVID-19, influenza and other respiratory virus infections
- Diseases caused by ticks or mosquitoes
- Infections after bone marrow transplant/stem cell transplant
- Infections after solid organ transplant
- Infections due to highly resistant organisms or highly infectious organisms
- Infections in immunocompromised persons
- Skin and soft tissue infections
- Travel-related infections
- Wound and surgical site infections
Healing Care Medicine: Marina Makous Md
Expertise in Lyme and Tick-Borne Diseases Traditional and Integrative Mental HealthPhone 484-876-1362 or email drmakous@healingcaremedicine.com Office address: 430 Exton Commons, Exton, PA 19341Publications and Teaching Experience/Conference Presentations/Patient Advocacy::
- “Conquering Lyme Disease: Science Bridge the Great Divide”, by Brian Fallon, MD and Jennifer Sotsky, Carl Brenner, and Marina Makous, MD, Columbia University Press
- Somatic Symptom Disorders and Illness Anxiety in Integrated Care Settings, Landa, A., Makous, M., Fallon, B.A. . In Feinstein, R., et al, Psychiatry, Primary Care, and Medical Specialties: Pathways for Integrated Care. Oxford University Press, released April, 2017.
Lectures to the Family Medicine Residents, Columbia University Family and Community MedicinepresentationsColumbia University and Lyme Disease Association Conference, Providence, RI:International Lyme and Associated Diseases Association Annual Conference, DC:Presentation to the Massachusetts General Hospital Lyme Support groupCambridge, MA: “International Lyme and Associated Diseases Conference, Drexel School of Medicine:PanelistPanel Discussion about the state of Lyme disease in PA, Topic LeaderILADS Conference, Philadelphia: Presenter Chester County Medicine Magazine: Diagnostic Challenges in Lyme Disease Chester County Medicine Magazine: Lyme Disease: What Patients and Clinicians Need to KnowEditorNBC Interview/News Article: Print media and TV interviews
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Blacklegged Tick Life Cycle
Knowing about the tick’s life cycle is important for understanding the risk of acquiring Lyme disease and finding ways to prevent it. Adult female ticks lay eggs in the spring. The eggs hatch into larvae during the summer. Ticks are free of pathogens when they hatch. Larvae feed on mice, other small mammals, and birds in the summer and early fall if they feed on an infected host, they may become infected. They then are inactive until the following spring, when they molt into nymphs.
Nymphs feed on small rodents, small mammals, and birds in late spring and summer. They seek small to medium-sized hosts, including domestic animals and people. If these nymphs fed on infected animals as larvae, they may then transmit pathogens to their second host. Nymphs are most likely to be found during the early summer months . Nymphs molt into adults in the fall and actively seek larger mammals. Adults may be found nearly year-round, particularly in the fall and early spring. Black-legged ticks are commonly called “deer ticks” because they are often found in high densities on white-tailed deer even though they feed on many large animals.
Lyme Disease And Tick
Lyme disease patients have difficulty finding doctors with experience treating Lyme disease. For the past 25 years, LymeDisease.org has been connecting patients with Lyme-literate practitioners who specialize in caring for patients with Lyme disease.
We are happy to connect you with your nearest Lyme literate practitioners contact information. Please note, however, we are not privy to the status on each individual offices payment/insurance practices or if they are accepting new patients, with that said, we do encourage you to use the information available to contact the offices directly.
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Reported Cases Of Lyme Disease United States 2016
Each dot represents one case of Lyme disease and is placed randomly in the patient’s county of residence. The presence of a dot in a state does not necessarily mean that Lyme disease was acquired in that state. People travel between states, and the place of residence is sometimes different from the place where the patient became infected.
Image courtesy of the Centers for Disease Control and Prevention
When To See An Infectious Disease Doctor
Infectious diseases come from germs, including bacteria, viruses, and parasites. You may face a higher risk of infectious disease if you have other medical conditions that weaken your bodyâs natural ability to fight disease. HIV is one example of this kind of condition.
Infectious diseases can also happen when you travel to other countries where conditions, such as malaria, are more common.
You may need to see an infectious disease doctor if you have:
- Signs of an uncommon infection, such as yellow fever or polio
- A high fever and standard treatments arenât working
- Recently been hospitalized for an infectious disease and need follow-up care
- A complex infection, including a bone, joint, or brain infection
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The Medical Minute: What You Need To Know About Lyme Disease
HERSHEY, Pa. Summer means ample healthy outdoor activities, but the tiny deer tick may have other plans for us. This particular arachnid carries a bacterium that causes Lyme disease which, if left untreated, can lead to severe health problems. As Pennsylvania leads the nation in Lyme disease infections, it is critical that all in the commonwealth know how to minimize the risk of contracting the disease and recognize the symptoms of an infection.
Prevention in the backyard and beyond
Ticks can dwell anywhere, but they thrive in the woods and areas that are damp, dark or overgrown, according to Tara Simmons, a community health nurse at Penn State Health Milton S. Hershey Medical Center. That includes lawns that are overgrown or near wooded areas.
Mow your lawn, Simmons said. And if your kids have a playset in the backyard that borders trees, create a barrier of wood chips. Ticks will have difficulty crossing a dry, sunny area.
The risks of being exposed to deer ticks increase significantly in meadows and the woods.
When I hike in the woods, I always stay in the center of the path and avoid the brush the tick habitat, Simmons said. She also advised wearing light-colored clothing on which its easier to see ticks and treating the clothing and hiking gear with the insecticide permethrin. It lasts through several washings. But dont spray it on your skin.”
After a hike, Simmons advises doing a tick check.
Removing a tick safely
Early symptoms
Benefits Of Telemedicine For Lyme Disease
The study, entitled The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era, compares clinical data of 439 patients with an erythema migrans rash before and after the onset of the COVID-19 pandemic.¹ Participants in the study were being treated at an Italian Dermatology Clinic. Most individuals with an EM rash were diagnosed using an in-person
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Protecting Yourself From Tick Bites
The chances of being bitten by a deer tick can be reduced with a few precautions:
- Avoid tick-infested areas, especially in May, June, and July.
- Wear light-colored clothing so that ticks can be spotted more easily.
- Wear long-sleeved shirt and pants.
- Spray insect repellent containing DEET, picaridin, or IR3535 on clothes and exposed skin .
- After being outdoors, remove clothing and wash and dry it at a high temperature.
- Inspect yourself carefully and, if possible, shower within an hour of coming inside.
Can Lyme Disease Be Mistaken For Herpes
In their article Disseminated Lyme disease with a herpetiform center, Zhang et al.¹ described a patient who presented with a Lyme disease rash that could have been mistaken for herpes. The woman in her 30s developed a herpetiform rash, which resembles herpes lesions. Initially, the patient developed a small red bump and surrounding swelling on her back, along with a rash in her left armpit and left ipsilateral swollen lymph
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Illinois Clinicians Demonstrate Gaps In Understanding Of Tick
Carson and colleagues surveyed clinicians between August 2020 and February 2022 and reported their findings in the article Knowledge, attitudes, and practices of Illinois medical professionals related to ticks and tick-borne disease. ¹ The respondents included RNs , physicians , and APNs/PAs . The authors found that clinicians were best at identifying Lyme disease. Out of 346 respondents, 80% correctly identified Lyme disease as endemic to Illinois, while 95% were
Powassan Virus Encephalitis Contracted During Winter Months
In their article Powassan Encephalitis: A Case Report from New York, USA, Bazer and colleagues describe a male patient who was admitted to the hospital in December due to altered mental status, dysarthria, and a left facial droop.¹ The man also had a history of multiple medical problems including of a right putamen infarct, hepatitis C, hypertension, and substance abuse. Clinicians considered a tick-borne disease since the patient had reported
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Penncare Medical Associates Of Bucks County
777 Township Line Rd Ste 200, YardleyPA19067
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Lyme Disease Has Stubborn Hold In Pennsylvania Northeast Us
Pennsylvania remains ground zero for the debilitating illness, the CDC says.
In most states that have traditionally been hot spots for Lyme disease, the number of confirmed cases of the illness has stabilized or even decreased in recent years, according to a new U.S. government analysis.
Reach for your long pants and bug spray, Pennsylvanians. Our local ticks apparently did not get the memo.
In 2016, the state Department of Health reported 8,988 confirmed cases of Lyme to the U.S. Centers for Disease Control and Prevention, top in the nation and the state’s highest toll in recent memory.
Just a few years ago, Pennsylvania’s annual totals of Lyme disease which is transmitted by tick bites and can cause a rash, fever, and debilitating joint pain were routinely under 5,000. But in 2016, the 8,988 confirmed cases in the state was more than the next four states on the list combined. New Jersey was number two, at 3,332 cases.
A true increase, or just better reporting?
Hard to say, but one thing is clear, said Anne Norris, an infectious diseases specialist at the University of Pennsylvania’s Perelman School of Medicine: “We are high achievers with respect to Lyme disease in Pennsylvania,” she said.
And there is no official word yet on what happened in 2017, which some experts had warned could be a big year. Norris, who practices at Penn Presbyterian Medical Center, said she saw more cases than usual.
The CDC defines a confirmed case as meeting one of two conditions:
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If You’re Bitten By A Tick
Physicians must determine if the advantages of using antibiotics outweigh the disadvantages in any instance. Antibiotic treatment to prevent Lyme disease after a known tick bite may not be warranted. If antibiotics are not used, physicians should alert patients to the symptoms of early Lyme disease and advise them to return for reevaluation if symptoms occur.
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Prepare For Your Visit
Outpatient clinics: Patients can also receive outpatient care from our clinic team. We currently see patients at the Wood Building on the Philadelphia Campus and at CHOPs Specialty Care & Surgery Center on the King of Prussia Campus. In most cases, your pediatrician will let you know if they recommend setting up an appointment.
Specialty clinics: We are dedicated to providing comprehensive care to children with infectious diseases. For some of our more complex patients, our outpatient team collaborates with other specialties to coordinate visits and create personalized robust care plans and monitor patient progress together. We currently have specialty clinics for oncology, cystic fibrosis, solid organ transplant, and neurology patients. Your care team will let you know if this is right for your child.
Global Health: The CHOP Global Health Center leads CHOPs work in low- and middle- income countries. It utilizes CHOPs academic pediatric model of excellence in clinical care, teaching, research and advocacy to improve health and achieve equity in health for all children worldwide.
Advanced Expertise For Infectious Diseases
These are a few reasons why patients choose us:
- Our General Infectious Diseases inpatient service is one of the busiest specialty services at Penn State Health Milton S. Hershey Medical Center, seeing 45-50 new hospitalized patients each week this high level of consultation helps to keep our knowledge in our field up-to-date.
- For outpatients, appointments can be scheduled at a variety of times and days and we see patients in Hershey, Lebanon, Harrisburg, and via telehealth.
- Were known for our comprehensive services for persons living with HIV with a multidisciplinary team that brings together physicians, nurses, case managers, dieticians, and pharmacists to ensure complete care and support.
- In 2018, our HIV/AIDS program was awarded additional funding for medical case management. Medical case management provides support outside of the clinic to help meet clients basic needs such as food and housing so our patients can better focus on their health. The case manager can also assist with medical expenses, not covered by insurance or in connecting clients to community resources. These support services are provided to eligible individuals in the following counties: Adams, Bedford, Blair, Cumberland, Dauphin, Franklin, Fulton, Huntington, Juniata, Lancaster, Lebanon, Mifflin, Perry and York.
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How To Safely Remove Attached Ticks
Use a pair of fine-tipped forceps or tweezers and grasp the tick as close to the skin surface as possible. Pull straight back with slow and steady force. Avoid crushing the tick’s body. Save the tick in a plastic bag or container in the freezer. If suspicious symptoms develop, the tick can be tested for pathogens.
Researchers On The Front Line In A Gangbusters Year For Lyme Disease
Before winter had even ended, the warnings came in: 2017 was going to be a bad one for Lyme disease. Anecdotally, the experience of Anne Norris, an infectious disease physician and associate professor of clinical medicine at Penns Perelman School of Medicine, backs this up.
This has been a tremendous year for Lyme disease, and tick-borne disease in general, she says. Its just gangbusters.
Whether or not this year winds up an outlier, its clear that cases are on the rise as the disease marches steadily across the Northeast and Midwest. According to the U.S. Centers for Disease Control and Prevention, there were nearly 30,000 confirmed cases in the nation in 2015though actual cases may have been closer to 300,000up from fewer than 12,000 two decades earlier.
In the lab and in the clinic, faculty at Penn are paying attention to Lyme disease. Their research, observations, and science-driven care are augmenting our understanding of the infection, clearing up confusion that surrounds it, and getting patientshuman and animalthe treatments they need.
Lyme disease is caused by Borrelia burgdorferi, a bacterium carried by ticks in the genus Ixodes. Ticks arent born infected they must feed from an infected mammal, such as a mouse, chipmunk, shrew, or deer, to be capable of transmitting the disease.
Brisson notes that such information could help predict future tick migrations and Lyme disease cases as the disease expands in range.
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Symptoms And Signs Of Lyme Disease
The early stage of Lyme disease is usually marked by flu-like symptoms . A bull’s-eye rash, called erythema migrans, is the most characteristic symptom of Lyme disease. It begins as a red circular patch, generally at the site of the tick bite, that appears three days to one month after the bite. The patch then expands to a diameter of 2 to 12 inches or more. Common areas for the rash to appear are the thigh, groin, trunk, and armpits. The center of the rash may clear as it enlarges, resulting in a ring-like appearance. It is usually not painful. It is important to note that 30 to 50 percent of patients may not display the rash.
In late stage Lyme disease, symptoms may occur weeks, months, or even years later. These symptoms include arthritis, migratory pain and swelling in the large joints , and nervous system abnormalities, including numbness, pain, Bell’s palsy , and meningitis. Occasionally, irregularities in heart rhythm may occur.
Bite site of Borrelia burgdorfericarrying tick. Photo courtesy of Penn State Extension