tetracycline and Lyme-Disease

To determine if antibiotic prophylaxis following a dear tick bite is effective in reducing the risk of developing Lyme disease.. Meta-analysis of published trials.. Clinical trials were identified by a computerised literature search of MEDLINE and by an assessment of the bibliographies of published studies.. Trials were included in the analysis if their patients were randomly allocated to a treatment or control group, enrolled within 72 hours following an Ixodes tick bite, and had no clinical evidence of Lyme disease at enrollment. Three trials were selected for review after inclusion criteria were applied.. Data were extracted for details of study design, patient characteristics, interventions, duration of therapy, and number of adverse events in each arm of therapy.. Among the 600 patients with Ixodes tick bites, the rate of infection in the placebo group was 1.4%. In contrast, patients who received antibiotic prophylaxis had a 0% infection rate. The pooled odds ratio, comparing prophylaxis to placebo, was 0.0 (95% confidence interval 0.0, 1.5) (p = .12).. The available evidence to date suggests that the routine use of antibiotic prophylaxis for the prevention of Lyme disease remains uncertain. Meta-analysis of the controlled trials failed to establish definitive treatment efficacy owing to the small sample size of the combined trials and the low rates of infection following a deer tick bite. A larger randomized trial is needed to demonstrate definitively that prophylaxis is more effective than placebo in reducing the risk of early Lyme disease in endemic areas.

Topics: Amoxicillin; Animals; Antibiotic Prophylaxis; Bites and Stings; Humans; Ixodes; Lyme Disease; Penicillins; Risk Factors; Tetracycline

Topics: Adult; Antibodies, Bacterial; Borrelia burgdorferi Group; Cefotaxime; Diagnosis, Differential; Female; Humans; Lyme Disease; Male; Middle Aged; Nervous System Diseases; Neurologic Examination; Tetracycline

In the light of a survey of the world literature Lyme borreliosis, an epidemic disease caused by gram-negative organisms Borrelia burgdorferi is described. The disease has three phases with involvement of the skin, the nervous system, the cardiovascular system and joints. Treatment with antibiotics is effective. The disease lies in the fields of interest of various specialties including paediatrics.

Topics: Animals; Arachnid Vectors; Arthritis, Infectious; Borrelia burgdorferi Group; Child; Diagnosis, Differential; Humans; Lyme Disease; Meningoencephalitis; Penicillin G; Tetracycline; Ticks

Topics: Arthritis, Infectious; Ceftriaxone; Drug Administration Schedule; Erythema; Humans; Lyme Disease; Nervous System Diseases; Penicillins; Skin Diseases; Tetracycline

Lyme disease is caused by the spirochete B. burgdorferi. Like its counterpart syphilis, it causes multisystem disease particularly affecting the skin, nervous system, heart and musculoskeletal system. It is endemic in several areas of the United States as well as in Europe. The prompt recognition of this disease and its diverse manifestations should lead to early treatment and resolution. Prevention is aimed at avoidance of the tick vector.

Topics: Animals; Arachnid Vectors; Arthritis; Borrelia; Diagnosis, Differential; Erythema; Humans; Lyme Disease; Neuritis; Penicillins; Rheumatic Fever; Tetracycline; Ticks

Topics: Erythromycin; Heart Rate; Humans; Joints; Lyme Disease; Penicillin V; Skin; Tetracycline

Lyme disease has protean manifestations. The causative agent is Borrelia burgdorferi, a recently discovered spirochete. The disease has been found on three continents. The initial major clinical feature is a characteristic skin eruption known as erythema chronicum migrans. Subsequent main clinical manifestations are meningopolyneuritis and arthritis. However, clinical expressions of the disease vary widely. Some patients have very mild disease and others develop severe and prolonged illness. Specific laboratory tests for the detection of antibody to the organism are now available. The sensitivity of these tests approaches 100% when the sera are collected from patients having the later clinical manifestations. Penicillin and tetracycline are the therapeutic drugs of choice.

Topics: Adolescent; Adult; Aged; Arachnid Vectors; Arthritis; Aspartate Aminotransferases; Australia; Blood Sedimentation; Borrelia; Borrelia Infections; Child; Child, Preschool; Culture Media; Diagnosis, Differential; Disease Reservoirs; Erythema; Europe; Female; Humans; Immunoglobulin M; Lyme Disease; Lymphopenia; Male; Middle Aged; Nervous System Diseases; Penicillins; Tetracycline; Ticks; United States

Two hundred seventy-seven patients with chronic Lyme disease were treated with tetracycline for 1 to 11 months (mean, 4 months); the outcomes for these patients were generally good. Overall, 20% of the patients were cured; 70% of the patients' conditions improved, and treatment failed for 10% of the patients. Improvement frequently did not take place for several weeks; after 2 months of treatment, 33% of the patients' conditions were significantly improved (degree of improvement, 75%-100%), and after 3 months of treatment, 61% of the patients' conditions were significantly improved. Treatment outcomes for seronegative patients (20% of all patients) were similar to those for seropositive patients. Western immunoblotting showed reactions to one or more Borrelia burgdorferi-specific proteins for 65% of the patients for whom enzyme-linked immunosorbent assays were negative. Whereas age, sex, and prior erythema migrans were not correlated with better or worse treatment outcomes, a history of longer duration of symptoms or antibiotic treatment was associated with longer treatment times to achieve improvement and cure. These results support the use of longer courses of treatment in the management of patients with chronic Lyme disease. Controlled trials need to be conducted to validate these observations.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibodies, Bacterial; Chronic Disease; Female; Humans; Lyme Disease; Male; Middle Aged; Tetracycline; Treatment Outcome

To determine if the early antibiotic treatment of deer tick bites prevented Lyme disease.. Prospective, double-blind, placebo-controlled, antibiotic treatment.. Private practice in an area endemic for Lyme disease.. Patients between 3 and 19 years of age who received antibiotic treatment within 3 days following a deer tick bite.. Patients received an antibiotic or placebo and were followed up for stage I and II disease. All patients had blood drawn at the time of presentation and 6 weeks later for immunofluorescent antibodies (IFA).. One patient in the placebo group developed clinical Lyme disease associated with an IFA titer of 1:32, considered weakly positive. Three other patients in the placebo group developed an IFA titer of 1:32; one had an influenzalike illness and two had no symptoms. None of the study patients developed any neurologic, cardiac, or arthritic symptoms in the 1- to 3-year follow-up.. Based on the low frequency of illness, the absence of stage II disease, and the inability to establish the efficacy of early antibiotic treatment, we suggest that physicians not routinely use prophylactic antibiotics for deer tick bites.

Topics: Adolescent; Adult; Animals; Antibodies, Bacterial; Bites and Stings; Borrelia burgdorferi Group; Child; Child, Preschool; Deer; Double-Blind Method; Female; Humans; Lyme Disease; Male; Penicillins; Prospective Studies; Tetracycline; Ticks; Time Factors; Treatment Outcome

We compared phenoxymethyl penicillin, erythromycin, and tetracycline, in each instance 250 mg four times a day for 10 days, for the treatment of early Lyme disease (stage 1). None of 39 patients given tetracycline developed major late complications compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (p = 0.07). However, with all three antibiotic agents, nearly half of patients had minor late symptoms. For neurologic abnormalities (stage 2), 12 patients were treated with high-dose intravenous penicillin, 20 million U a day for 10 days. Pain usually subsided during therapy, but a mean of 7 to 8 weeks was required for complete recovery of motor deficits. For the treatment of established arthritis (stage 3), 20 patients were assigned treatment with intramuscular benzathine penicillin (7.2 million U) and 20 patients received saline. Seven of the 20 penicillin-treated patients (35%) were apparently cured, but all 20 patients given placebo continued to have attacks of arthritis (P less than 0.02). Of 20 arthritis patients treated with intravenous penicillin G, 20 million U a day for 10 days, 11 (55%) were apparently cured. Thus, all 3 stages of Lyme disease can be treated with antibiotic therapy, but some patients with late disease may not respond.

Topics: Adult; Arthritis, Infectious; Child; Erythromycin; Humans; Lyme Disease; Nervous System Diseases; Penicillin V; Random Allocation; Tetracycline

Topics: Administration, Intravaginal; Adult; Aged; Anti-Bacterial Agents; Body Piercing; Campylobacter Infections; Campylobacter jejuni; Cellulitis; Ciprofloxacin; Communicable Diseases; Cyanosis; Diarrhea; Dietary Fiber; Drug Therapy, Combination; Estrogens; Female; Helicobacter Infections; Humans; Lyme Disease; Male; Metronidazole; Middle Aged; Otitis; Penicillin V; Phenazopyridine; Proton Pump Inhibitors; Tetracycline; Tick Bites; Travel-Related Illness; Urinary Tract Infections; Young Adult

Lyme disease, caused by Borrelia burgdorferi sensu lato, is a multisystem disease that may occur with rheumatic, dermatological, neurological symptoms and heart diseases. Its most typical lesion is erythema migrans, although not always present. The clinical diagnosis is supported by serology, and treatment is almost always tetracycline in young people and adults. Amoxicillin is most often used in children and pregnant women, and cephalosporins in the presence of neurological signs. The prognosis, with the appropriate treatment, is good. But if not treated promptly, there may be chronic signs, particularly, neurological, which may be disabling. In Spain, where the incidence is low, antimicrobial prophylaxis is indicated the after a tick bite.

Topics: Aged; Amoxicillin; Anti-Bacterial Agents; Borrelia burgdorferi; Cephalosporins; Female; Humans; Lyme Disease; Prognosis; Spain; Tetracycline

A prior study in mice has shown that the timely application of topical antibiotics to the skin at the tick bite site could eradicate Borrelia burgdorferi infection. That study, however, did not evaluate antibiotic preparations that are considered suitable for use in humans. In this murine study, topical application of 2% erythromycin and 3% tetracycline preparations that are acceptable for use in humans was found to be ineffective in eliminating B. burgdorferi from the tick bite site or in preventing dissemination to other tissues. Reasons for the discrepant findings are discussed.

Topics: Administration, Cutaneous; Animals; Anti-Bacterial Agents; Borrelia burgdorferi; Erythromycin; Insect Bites and Stings; Lyme Disease; Male; Mice; Mice, Inbred C3H; Tetracycline

The objective of this study is to determine whether doxycycline, ceftiofur or tetracycline could be effectively used to treat equine Lyme disease. Ponies experimentally infected with Borrelia burgdorferi by tick exposure were treated with doxycycline, ceftiofur or tetracycline for 4 weeks (28 days). Doxycyline and ceftiofur treatment were inconsistent in eliminating persistent infection in this experimental model. However, tetracycline treatment seems to eliminate persistent infection. Although serum antibody levels to B. burgdorferi in all ponies declined gradually after antibiotic treatment, three out of four ponies treated with doxycline and two out of four ponies treated with ceftiofur, serum KELA titers were raised again 3 month after treatment was discontinued. Five months after antibiotic treatment, tissues aseptically collected at necropsy from ponies with increased antibody levels after antibiotic treatment also showed culture positive to B. burgdorferi in various post-mortem tissues. However, all four-tetracycline treatment ponies showed a negative antibody level and culture negative from post-mortem tissues. Untreated infected ponies maintained high KELA titers throughout the study and were tissue culture positive.

Topics: Animals; Anti-Bacterial Agents; Antibodies, Bacterial; Biopsy; Blotting, Western; Borrelia burgdorferi; Cephalosporins; DNA, Bacterial; Doxycycline; Enzyme-Linked Immunosorbent Assay; Female; Histocytochemistry; Horse Diseases; Horses; Ixodes; Lyme Disease; Male; Polymerase Chain Reaction; Tetracycline

Topics: Anti-Bacterial Agents; Borrelia burgdorferi; Ceftriaxone; Chronic Disease; Doxycycline; Humans; Lyme Disease; Tetracycline

To report a case of Lyme disease that presented with a single nummular unilateral interstitial keratitis.. Case report and review of the literature.. A 57-year-old black man who had contact with freshly killed deer had a chief complaint of foreign-body sensation in his right eye (OD) that had been diagnosed and treated for herpes simplex stromal keratitis. The patient underwent a systemic workup for interstitial keratitis. All results including RPR and MHA-TP were negative except for Lyme antibody titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, <159 U/ml).. Interstitial keratitis from Lyme disease has been regarded as a bilateral disease in the literature. We present this infrequent ocular manifestation of Lyme disease as a rare single nummular unilateral presentation.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi Group; Corneal Stroma; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Eye Infections, Bacterial; Follow-Up Studies; Humans; Keratitis; Lyme Disease; Male; Middle Aged; Tetracycline

Topics: Anti-Bacterial Agents; Doxycycline; Drug Administration Schedule; Humans; Lyme Disease; Tetracycline; Time Factors; Treatment Outcome

Doxycycline is widely used to treat Lyme disease associated with erythema migrans. Whether it is comparable to tetracycline is unknown.. We conducted a two-part retrospective analysis of (1) the safety and efficacy of doxycycline compared with tetracycline and (2) the safety and efficacy of a 14-day versus a 20-day course of doxycycline.. Twenty-seven patients given tetracycline (500 mg four times a day for 14 days [group 1]) were compared retrospectively with 21 patients who received doxycycline (100 mg two or three times a day for 14 days [group 2]). The results for group 2 were also compared with that of 38 patients who received doxycycline for 20 days (100 mg three times daily) in a prospective treatment trial (group 3).. There was no significant difference in the incidence of adverse drug effects or in efficacy at 1 month, but at 1 year there was a trend toward a better outcome in the group treated with tetracycline (p = 0.08). A 14-day course of doxycycline was comparable to a 20-day course in the incidence of adverse drug effects and in clinical outcome.. The principal advantage of doxycycline over tetracycline for the treatment of Lyme disease associated with erythema migrans is the convenience of less frequent dosing, not enhanced efficacy or safety. There appears to be no advantage in extending treatment with doxycycline from 14 to 20 days.

Topics: Administration, Oral; Adult; Age Factors; Doxycycline; Drug Administration Schedule; Erythema Chronicum Migrans; Female; Follow-Up Studies; Humans; Lyme Disease; Male; Middle Aged; Nausea; Photosensitivity Disorders; Prospective Studies; Retrospective Studies; Safety; Tetracycline; Treatment Outcome

To determine whether early dissemination of Borrelia burgdorferi to the central nervous system occurs in stage I of Lyme borreliosis, neurological and cerebrospinal fluid examination was performed in 48 consecutive patients in whom the only sign of infection was a solitary erythema migrans lesion. Long-term follow-up after treatment with tetracycline was carried out by telephone interview. At presentation, neurological findings were normal in all 48 patients. Cerebrospinal fluid samples were obtained from 29 (60%) patients. Mild pleocytosis and mild impairment of the blood-brain barrier were present in four and one of these patients, respectively. No significant amount of tumor necrosis factor or interleukin 6 was found in the cerebrospinal fluid samples. Culture results of 13 cerebrospinal fluid samples were negative. Borrelia burgdorferi DNA was only detected by the polymerase chain reaction in one of two aliquots of the cerebrospinal fluid sample of one patient. None of 46 patients who were interviewed 12 to 51 (median 25) months after antibiotic treatment developed manifestations consistent with disseminated or chronic Lyme borreliosis. Thus, no compelling evidence was found for the presence of asymptomatic central nervous system involvement in patients with clinically localized Lyme borreliosis.

Topics: Adult; Aged; Borrelia burgdorferi Group; Central Nervous System Diseases; Erythema Chronicum Migrans; Female; Follow-Up Studies; Humans; Interleukin-6; Lyme Disease; Male; Middle Aged; Polymerase Chain Reaction; Prospective Studies; Serologic Tests; Tetracycline; Tumor Necrosis Factor-alpha

To determine whether infection with the Lyme disease spirochete (Borrelia burgdorferi) can be aborted by topical application of antibiotic to the site of tick attachment, individual infected nymphal deer ticks (Ixodes dammini) were permitted to feed on the ears of mice, and various antibiotics were applied to the feeding site at intervals after the replete infecting tick had detached. Infection in each mouse was determined by serology and by xenodiagnosis at 4 weeks after the bite of the infected tick. None of these mice became infected when antibiotic was topically applied to the site of tick attachment within 2 days after the spirochete-infected ticks had detached. In contrast, all nontreated and virtually all solvent-treated mice became persistently infected. Thus, persistent infection by the agent of Lyme disease can be aborted by appropriate topical application of antibiotic.

Topics: Administration, Topical; Animals; Bites and Stings; Borrelia burgdorferi Group; Deer; Lyme Disease; Mice; Mice, Inbred Strains; Tetracycline; Ticks; Time Factors

Erythema migrans recurred in a patient 6 months after a course of treatment with minocycline for Lyme disease. Polymerase chain reaction on heparinized peripheral blood at that time demonstrated the presence of Borrelia burgdorferi-specific DNA. The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure. Reinfection was not believed to have occurred. Further treatment with minocycline led to resolution of the erythema migrans.

Topics: Aged; Erythema Chronicum Migrans; Female; Humans; Lyme Disease; Minocycline; Recurrence; Tetracycline

Topics: Animals; Antibodies, Bacterial; Borrelia burgdorferi Group; Dog Diseases; Dogs; Enzyme-Linked Immunosorbent Assay; Lyme Disease; Spain; Tetracycline; Tick Infestations

Three patients with retinal vasculitis are reported who were found to be seroreactive for Lyme borreliosis. Careful investigation revealed no other apparent etiology for the angiitis, and improvement of the retinal vasculitis on tetracycline therapy was documented by fluorescein angiography in one of them. Two cases of retinal vasculitis were presented at the International Conference on Lyme Borreliosis in Stockholm 18-21 June 1990, and two cases of cerebral vasculitis due to Borrelia burgdorferi have been published. To our knowledge, this is the first published report of retinal vasculitis occurring in patients seroreactive for Lyme borreliosis. Although further investigation will be necessary to prove a cause-and-effect relationship, ophthalmologists encountering patients with otherwise unexplained cases of retinal vasculitis, or Eales disease, are encouraged to study these patients carefully for the possibility of Borrelia burgdorferi infection.

Topics: Adult; Fluorescein Angiography; Fundus Oculi; Humans; Lyme Disease; Male; Middle Aged; Retinal Vessels; Tetracycline; Vasculitis

Topics: Adult; Humans; Lyme Disease; Male; Military Personnel; Rickettsia Infections; Tetracycline

The in-vitro and in-vivo susceptibility of Borrelia burgdorferito tetracycline, erythromycin and azithromycin was investigated. A macrodilution broth technique was used to determine MBCs. B. burgdorferi was most susceptible to azithromycin (MBC 0.04 mg/l) followed by erythromycin (MBC 0.16 mg/l) and tetracycline (MBC 1.6 mg/l). Syrian hamsters were used to determine ED50S for the three antimicrobials. Azithromycin was most effective in the elimination of spirochaetes from experimentally infected hamsters with an ED50 of 3.71 (+/- 1.9) mg/kg followed by tetracycline (ED50 15.6 (+/- 4.58) mg/kg). Erythromycin possessed low activity, having an ED50 of 122.2 (+/- 51.9) mg/kg. Tissue concentrations of azithromycin exceeding the MBC were present 24 h after the final treatment.

Topics: Animals; Azithromycin; Borrelia burgdorferi Group; Cricetinae; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Erythromycin; Lyme Disease; Mesocricetus; Tetracycline; Tissue Distribution

Topics: Adult; Humans; Lyme Disease; Male; Penicillins; Quebec; Tetracycline

Topics: Adult; Humans; Lyme Disease; Male; Tanzania; Tetracycline; Travel

Topics: Child; Child, Preschool; Humans; Lyme Disease; Myositis; Oculomotor Muscles; Tetracycline

A 66 year old woman with a history suggesting a tick bite on the right arm developed a slowly expanding erythematosus lesion. Similar lesions appeared on the trunk and extremities in the following months. A skin biopsy showing spiral shaped agents and the clinical findings were compatible with erythema chronicum migrans. A course of penicillin resulted in complete resolution of the lesions. After a 2 year follow up period she remains free of rheumatic, neurologic or cardiac lesions of Lyme's disease.

Topics: Aged; Erythema Chronicum Migrans; Female; Humans; Lyme Disease; Penicillin G; Penicillin G Benzathine; Tetracycline

Four patients from Caribbean and Central American countries with ocular disease and serologic evidence of Lyme borreliosis are discussed. To our knowledge this is the first report of Lyme disease from this geographic area. Two patients exhibited ocular inflammatory disease, and two patients developed optic neuropathy. A brief discussion of Lyme borreliosis, its serologic diagnosis, and its treatment is presented.

Topics: Adult; Aged; Borrelia Infections; Ceftriaxone; Child; Endophthalmitis; Eye Diseases; Humans; Intraocular Pressure; Lyme Disease; Male; Middle Aged; Optic Nerve Diseases; Penicillins; Tetracycline; Visual Acuity; West Indies

Neurologic manifestations of Lyme disease are common, often debilitating, and potentially treatable. We document a case of Borrelia infection of the nervous system manifesting as a reversible Horner's syndrome. The search for Lyme disease should be part of the evaluation of an isolated central or preganglionic Horner's syndrome or any unexplained pupillary abnormality.

Topics: Adult; Ceftriaxone; Horner Syndrome; Humans; Lyme Disease; Male; Tetracycline

Meningopolyradiculitis (Garin-Bujadoux syndrome, Bannwarth syndrome) is the second stage of Lyme disease, a tick-borne Borrelia infection. Almost 60% of these patients develop an acute peripheral facial paresis. The disease can be differentiated from Bell's palsy only by finding the specific Borrelia antibodies in serum and CSF. Other cranial nerve lesions can be found besides facial paresis. The follow-up of seven Borrelia-infected patients is described: one showed bilateral, the others unilateral, facial paresis. High dosage of penicillin or tetracycline for 10-14 days is the appropriate therapy. The prognosis of facial paresis in tick-borne Borrelia infection is considered to be good. All our patients showed complete recovery of motor nerve function.

Topics: Adolescent; Adult; Antibodies, Bacterial; Borrelia; Child; Facial Paralysis; Female; Follow-Up Studies; Humans; Lyme Disease; Male; Meningitis; Middle Aged; Polyradiculoneuropathy; Syndrome; Tetracycline

The incidence of Lyme disease has been increasing at alarming rates in recent years. Being the most commonly reported tickborne bacterial disease in the United States, it now outnumbers Rocky Mountain spotted fever by a ratio of almost 2:1. It is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. The ocular complications of Lyme disease can present as one of the more ominous signs during the course of the illness. The detection of the disease and proper referral by the optometrist may permit more appropriate treatment, and thus, a better prognosis of the illness.

Topics: Bites and Stings; Borrelia Infections; Conjunctivitis; Eye Diseases; Humans; Keratitis; Lyme Disease; Optic Nerve Diseases; Papilledema; Penicillins; Tetracycline; Uveitis

Topics: Erythema; Humans; Lyme Disease; Tetracycline

Topics: Adult; Heart Block; Humans; Lyme Disease; Male; Penicillins; Tetracycline

Lyme spirochaetal disease (LSD) is a complex multisystem disorder which has been recognized as a separate entity due to its close geographic clustering of affected patients. The study aimed at evaluating the clinical and immunological features of LSD with chronic symptoms of meningoradiculitis, carditis and pauciarticular arthritis. Six patients with LSD and erosive arthritis who developed an increase of serum IgM rheumatoid factor (RF) which correlated with the inflammatory activity of the disease are described in detail. Besides raised IgG antibody titers to Borrelia burgdorferi (B. burgd.) antigen measured by ELISA technique, circulating immune complexes, antinuclear antibodies (ANA) and RF measured by laser nephelometric immunoassay were detected. Increased ANA and RF antibody rates suggest that LSD may closely be linked with transient autoimmune phenomena. Thus, in some cases, B. burgd. antigens might be able to produce a strong polyclonal B-cell stimulation, hence leading to an unspecific autoimmune reaction. But the question remains if transient unspecific autoimmune reactions actually take part in the pathogenesis of LSD.

Topics: Adult; Arthrography; Autoimmune Diseases; Drug Therapy, Combination; Female; Humans; Lyme Disease; Male; Middle Aged; Penicillins; Rheumatoid Factor; Tetracycline; Time Factors

A dry cough, fever, generalized maculopapular rash, and myositis developed in a 67-year-old woman; she also had markedly abnormal liver function test results. Serologic tests proved that she had an infection of recent onset with Borrelia burgdorferi, the agent that causes Lyme disease. During a two-month course of illness, her condition remained refractory to treatment with antibiotics, salicylates, and steroids. Ultimately, fatal adult respiratory distress syndrome developed; this was believed to be secondary to Lyme disease.

Topics: Aged; Antibodies, Bacterial; Borrelia; Female; Humans; Immunoglobulin G; Immunoglobulin M; Lyme Disease; Penicillin G; Respiratory Distress Syndrome; Tetracycline

Topics: Adult; Arrhythmias, Cardiac; Arthritis, Infectious; Ceftriaxone; Child; Doxycycline; Female; Humans; Lyme Disease; Male; Microbial Sensitivity Tests; Nervous System Diseases; Penicillins; Pregnancy; Tetracycline

Topics: Borrelia; Cell Movement; Humans; Lyme Disease; Lymphocytes; Macrophages; Male; Middle Aged; Muscles; Myositis; Plasma Cells; Tetracycline

The antimicrobial susceptibility of Borrelia burgdorferi isolated from human spinal fluid was determined in vitro and in vivo. A broth dilution technique was used to determine the MBCs of four antimicrobial agents. The Lyme disease spirochete was most susceptible to ceftriaxone (MBC, 0.04 microgram/ml) and erythromycin (MBC, 0.05 microgram/ml), then tetracycline (MBC, 0.8 microgram/ml), and finally penicillin G (MBC, 6.4 micrograms/ml). Syrian hamsters were used to determine the 50% curative doses (CD50s) of the four antimicrobial agents. Ceftriaxone and tetracycline had the highest activities, with CD50s of 24.0 and 28.7 mg/kg [corrected], respectively. Both erythromycin and penicillin G possessed low activities. The CD50 of erythromycin was 235.3 mg/kg [corrected], and the CD50 of penicillin G was greater than 197.5 mg/kg [corrected].

Topics: Animals; Borrelia; Borrelia burgdorferi; Ceftriaxone; Cricetinae; Erythromycin; Humans; Lyme Disease; Mesocricetus; Microbial Sensitivity Tests; Penicillin G; Tetracycline

We describe the clinical courses of 5 patients with Lyme disease who developed significant late complications, despite receiving tetracycline early in the course of their illness. All 5 patients had been treated for erythema chronicum migrans with a course of tetracycline that met or exceeded current recommendations. The late manifestations of Lyme disease included arthritis, cranial nerve palsy, peripheral neuropathy, chronic fatigue, and changes in mental function. Our findings suggest that the use of tetracycline at a dosage of 250 mg, 4 times a day for 10 days, as a treatment for early Lyme disease should be reconsidered. To determine optimal therapy for early Lyme disease, a study that compares an increased dosage of tetracycline with alternative treatments is indicated.

Topics: Adolescent; Adult; Arthritis, Infectious; Female; Humans; Lyme Disease; Male; Middle Aged; Nervous System Diseases; Recurrence; Tetracycline; Time Factors

The Jarisch-Herxheimer reaction includes the accentuation of symptoms during antibiotic therapy. More commonly associated with the treatment of syphilis, it can also occur in patients treated for Lyme disease caused by the spirochete Borrelia burgdorferi.

Topics: Adult; Erythema; Humans; Lyme Disease; Male; Tetracycline

Topics: Arachnid Vectors; Borrelia burgdorferi; Humans; Lyme Disease; Penicillins; Tetracycline; Ticks

Topics: Adult; Humans; Lyme Disease; Male; Meningitis; Tetracycline

Eight cases of meningoradiculitis (Garin-Bujadoux-Bannwarth's syndrome) are presented; the first case followed an "unidentified insect" bite and erythema chronicum migrans, whereas the second and third cases were not preceded by any documented insect bite or erythema; they occurred during summer in 1984 and 1985 and were characterized by cranial or radicular neuritis, lymphocytic meningitis, positive serology by immunofluorescence against Borrelia Burgdorferi and a good response to Penicillin (20 000 000 U during 14 days I.V.). Five other cases were observed in the same area as the first and second cases (Walloon Brabant) during the preceding summers; in two, serological proof of Borrelia Burgdorferi infection was obtained retrospectively. Lyme disease and Garin-Bujadoux-Bannwarth syndrome are both tick-born spirochetosis, due to two slightly different subtypes of Borrelia Burgdorferi. Their early neurological manifestations differ mainly by focalised pain on the bitten region in Garin-Bujadoux-Bannwarth's syndromes. This could be due to direct aggression of the peripheral nerve in Garin-Bujadoux-Bannwarth syndrome.

Topics: Antibodies, Bacterial; Arthropods; Bites and Stings; Borrelia; Borrelia Infections; Diagnosis, Differential; Female; Humans; Lyme Disease; Meningitis; Meningitis, Aseptic; Middle Aged; Penicillin G; Peripheral Nervous System Diseases; Radiculopathy; Tetracycline; Ticks