Lyme Disease

Caused by B burgdorferi is a spirochete. It is transmitted from host to host by the Ixodes, or deer tick. 

Treatment:

Tick bite: Single dose of 200 mg of doxycycline within 72 hours of removing a tick can prevent the development of Lyme disease. This still should be limited to patients who have had possible tick exposure in endemic areas.

Skin manifestations: Institute an oral regimen for 30 days.

Arthritis: Institute an oral regimen for 30 days. * Re-treat for 30 days with oral regimen or intravenous ceftriaxone for 14-30 days if the first oral course is unsuccessful.

Neuroborreliosis

• Facial palsies: Institute an oral regimen for 30 days. Although facial palsies may resolve without treatment, antibiotic therapy may prevent further sequelae.
• Paresthesias/radiculopathy: Institute intravenous therapy for 14 days. Oral doxycycline for 30 days may be as good as intravenous ceftriaxone for neuroborreliosis.
• Encephalitis/encephalopathy: Institute intravenous therapy for 28 days.