Borrelia: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 12: Line 12:
''Borrelia afzelii''<br />
''Borrelia afzelii''<br />
''Borrelia anserina''<br />
''Borrelia anserina''<br />
''Borrelia burgdorferi''<br />
[[''Borrelia burgdorferi'']]<br />
''Borrelia garinii''<br />
''Borrelia garinii''<br />
''Borrelia hermsii''<br />
''Borrelia hermsii''<br />

Revision as of 18:01, 7 August 2015

Borrelia
Scientific classification
Kingdom: Bacteria
Phylum: Spirochaetes
Class: Spirochaetes
Order: Spirochaetales
Family: Spirochaetaceae
Genus: Borrelia
Species

Borrelia afzelii
Borrelia anserina
''Borrelia burgdorferi''
Borrelia garinii
Borrelia hermsii
Borrelia recurrentis
Borrelia valaisiana
etc.

Template:Seealso Template:Seealso

WikiDoc Resources for Borrelia

Articles

Most recent articles on Borrelia

Most cited articles on Borrelia

Review articles on Borrelia

Articles on Borrelia in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Borrelia

Images of Borrelia

Photos of Borrelia

Podcasts & MP3s on Borrelia

Videos on Borrelia

Evidence Based Medicine

Cochrane Collaboration on Borrelia

Bandolier on Borrelia

TRIP on Borrelia

Clinical Trials

Ongoing Trials on Borrelia at Clinical Trials.gov

Trial results on Borrelia

Clinical Trials on Borrelia at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Borrelia

NICE Guidance on Borrelia

NHS PRODIGY Guidance

FDA on Borrelia

CDC on Borrelia

Books

Books on Borrelia

News

Borrelia in the news

Be alerted to news on Borrelia

News trends on Borrelia

Commentary

Blogs on Borrelia

Definitions

Definitions of Borrelia

Patient Resources / Community

Patient resources on Borrelia

Discussion groups on Borrelia

Patient Handouts on Borrelia

Directions to Hospitals Treating Borrelia

Risk calculators and risk factors for Borrelia

Healthcare Provider Resources

Symptoms of Borrelia

Causes & Risk Factors for Borrelia

Diagnostic studies for Borrelia

Treatment of Borrelia

Continuing Medical Education (CME)

CME Programs on Borrelia

International

Borrelia en Espanol

Borrelia en Francais

Business

Borrelia in the Marketplace

Patents on Borrelia

Experimental / Informatics

List of terms related to Borrelia

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Borrelia is a genus of bacteria of the spirochete class. It is a zoonotic, vector-borne disease transmitted primarily by ticks and some by lice, depending on the species. There are 37 known species of Borrelia.

Borreliosis (Lyme disease)

Of the 37 known species of Borrelia, 12 of these species are known to cause Lyme disease or borreliosis and are transmitted by ticks. The major Borrelia species causing Lyme disease are Borrelia burgdorferi, Borrelia afzelii, Borrelia garinii and Borrelia valaisiana.

Relapsing fever

Other Borrelia species cause relapsing fever such as Borrelia recurrentis, caused by the human body louse. No animal reservoir of B. recurrentis exists. Lice that feed on infected humans acquire the Borrelia organisms that then multiply in the gut of the louse. When an infected louse feeds on an uninfected human, the organism gains access when the victim crushes the louse or scratches the area where the louse is feeding. B. recurrentis infects the person via mucous membranes and then invades the bloodstream.

Other tick-borne relapsing infections are acquired from other species, such as Borrelia hermsii or Borrelia Parkeri, which can be spread from rodents, and serve as a reservoir for the infection, via a tick vector. Borelia hermsii and Borrelia recurrentis cause very similar diseases although the disease associated with Borrelia hermsii has more relapses and is responsible for more fatalities, while the disease caused by B. recurrentis has longer febrile and afebrile intervals and a longer incubation period.

Gallery

Treatment

Antimicrobial Regimen

  • 1. Tick-Borne Relapsing Fever [2]
  • Preferred regimen: Doxycycline 100 mg PO bid for 5-10 days
  • Alternative regimen: Erythromycin 500 mg PO qid for 5-10 days
  • Note: If meningitis/encephalitis present, use Ceftriaxone 2 g IV q12h for 14 days
  • 2. Louse-Borne Relapsing Fever
  • Lyme disease [3]
  • 1. Early Lyme Disease
  • 1.1 Erythema migrans
  • 1.1.1 Adult
  • Preferred regimen (1): Doxycycline 100 mg PO bid for 10-21 days
  • Preferred regimen (2): Amoxicillin 500 mg PO tid for 14-21 days
  • Preferred regimen (3): Cefuroxime axetil 500 mg bid for 14-21 days
  • Alternatie regimen (1): Azithromycin 500 mg PO qd for 7–10 days
  • Alternatie regimen (2): Clarithromycin 500 mg PO bid for 14–21 days (if the patient is not pregnant)
  • Alternatie regimen (3): Erythromycin 500 mg PO qid for 14–21 days
  • 1.1.2 Pediatric
  • 1.1.2.1 children <8 years of age
  • Preferred regimen (1): Amoxicillin 50 mg/kg PO per day in 3 divided doses (maximum of 500 mg per dose)
  • Preferred regimen (2): Cefuroxime axetil 30 mg/kg PO per day in 2 divided doses(maximum, 500 mg per dose)
  • 1.1.2.2 children ≥8 years of age
  • Preferred regimen (1): Doxycycline 4 mg/kg PO per day in 2 divided doses(maximum, 100 mg per dose)
  • Preferred regimen (2): Azithromycin 10 mg/kg PO qd (maximum, 500 mg qd)
  • Preferred regimen (3): Clarithromycin 7.5 mg/kg PO bid (maximum, 500 mg per dose)
  • Preferred regimen (4): Erythromycin 12.5 mg/kg PO qid (maximum, 500 mg per dose)
  • 1.2 When erythema migrans cannot be reliably distinguished from community-acquired bacterial cellulitis
  • 1.3 Lyme meningitis and other manifestations of early neurologic Lyme disease
  • 1.3.1 Adult
  • Preferred regimen: Ceftriaxone 2 g IV q24h for 10–28 days
  • Alternative regimen (1): Cefotaxime 2 g IV q8h
  • Alternative regimen (2): Penicillin G 18–24 MU q4h (for patients with normal renal function)
  • Alternative regimen (3): Doxycycline 200–400 mg PO per day in 2 divided doses for 10–28 days
  • 1.3.2 Pediatric
  • Preferred regimen (1): Ceftriaxone 50–75 mg/kg IV single dose (maximum, 2 g)
  • Preferred regimen (2): Cefotaxime 150–200 mg/kg IV per day divided into 3 or 4 doses (maximum, 6 g per day)
  • Alternative regimen (1): Penicillin G 200,000–400,000 units/kg IV qd divided into doses given q4h (for normal renal function) (maximum, 18–24 MU qd)
  • Alternative regimen (2): Doxycycline 4–8 mg/kg PO qd in 2 divided doses (maximum, 100–200 mg per dose) (≥8 years old)
  • 1.4 Lyme carditis
  • Preferred regimen: Ceftriaxone 2 g IV q24h for 10–28 days
  • Note: patients with advanced heart block, a temporary pacemaker may be required; expert consultation with a cardiologist is recommended; Use of the pacemaker may be discontinued when the advanced heart block has resolved; An oral antibiotic treatment regimen should be used for completion of therapy and for outpatients, as is used for patients with erythema migrans without carditis (see above)
  • 1.5 Borrelial lymphocytoma
  • Preferred regimen: The same regimens used to treat patients with erythema migrans (see above)
  • 2. Late Lyme Disease
  • 2.1 Lyme arthritis
  • Preferred regimen (2): Amoxicillin 500 mg PO tid
  • Alternative regimen: Cefuroxime axetil 500 mg PO bid for 28 days
  • Pediatric regimen: Amoxicillin 50 mg/kg per day in 3 divided doses (maximum, 500 mg per dose); Cefuroxime axetil 30 mg/kg per day in 2 divided doses (maximum,500 mg per dose); (≥8 years of age) Doxycycline 4 mg/ kg per day in 2 divided doses (maximum, 100 mg per dose)
  • Note: For patients who have persistent or recurrent joint swelling after a recommended course of oral antibiotic therapy, we recommend re-treatment with another 4-week course of oral antibiotics or with a 2–4 weeks course of Ceftriaxone IV
  • 2.2 patients with arthritis and objective evidence of neurologic disease
  • 2.3 Late neurologic Lyme disease
  • 2.4 Acrodermatitis chronica atrophicans
  • 3. Post–Lyme Disease Syndromes
  • Preferred regimen: Further antibiotic therapy for Lyme disease should not be given unless there are objective findings of active disease (including physical findings, abnormalities on cerebrospinal or synovial fluid analysis, or changes on formal neuropsychologic testing)

External links

Template:WH Template:WS

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 "Public Health Image Library (PHIL)".
  2. Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
  3. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, Krause PJ, Bakken JS, Strle F, Stanek G, Bockenstedt L, Fish D, Dumler JS, Nadelman RB (2006). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America". Clin. Infect. Dis. 43 (9): 1089–134. doi:10.1086/508667. PMID 17029130.