Lyme borreliosis (early infection)
Last Updated: 2021-10-15
ICD11: -
Last Updated: 2021-10-15
Author(s): Anzengruber F., Navarini A.
ICD11: -
Lyme disease, tick borreliosis borreliosis, erythema migrans disease, Lyme borreliosis, Lyme disease, Borrelia burgdorferi infection, European tick borreliosis.
Early phase of Lyme borreliosis.
3 stadiums
Acrodermatitis chronica atrophicans.
Acrodermatitis acuta.
Malignant B-cell lymphoma.
Peripheral neuropathy.
Subacute encephalopathy.
Chronic encephalomyelitis.
Recurrent chronic arthritis (arthritides are typical in patients from the USA).
Fibromyalgia.
Chronic pain syndrome.
Neurological symptoms are mainly observed in Europe.
Acrodermatitis chronica atrophicans (leading symptom).
Nodular panniculitis (rare).
Early summer meningoencephalitis in the context of a double infection (very rare).
Progressive encephalomyelitis.
CAVE: Stages can be skipped.
Postinfectious Lyme disease syndrome (post Lyme disease):
Continued feeling of illness with myalgia and arthralgia after
symptoms subside and adequate antibiotic therapy.
Perivascular infiltrates rich in plasma cells are typical.
Therapy after Lebwohl |
Early stage |
Level of evidence |
|
Doxycycline p.o. 100 mg 2x daily for 14 days |
A |
Amoxicillin p.o. 500 mg 3x daily for 14 days |
A |
Cefuroxime p.o. 500 mg 2x daily for 14 days |
A |
For neurological symptoms |
|
Cefuroxim intravenously 2g daily for 14 days |
B |
Penicillin G intravenously 18-24 Mio. IU daily (in 4 ED) for 14 days |
B |
For cardiological symptoms |
|
Both oral and intravenous therapy (see above possible) |
C |
Lyme arthritis without neurological involvement |
|
Doxycylcline p.o. 100 mg 2x daily for 14 days |
|
Amoxicillin 500 mg 3x daily for 14 days |
|
Lyme arthritis with neurological symptoms |
|
Ceftriaxone 2 g intravenously daily for 2-3 weeks |
B |
Penicillin G 18-24 Mio. IU intravenously (in 4 ED) for 2-3 weeks |
|
Chronic recurrent arthritides |
|
Renewed antibiotic therapy for 28 days |
D |
Late manifestation of neurological symptoms |
|
Ceftriaxon 2 g intravenously daily for 2-3 weeks |
B |
Penicillin G 18-24 Mio. IU intravenously (in 4 ED) for 2-3 weeks |
B |
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