Clinical practice guidelines are increasing in number. Unfortunately, when scientific evidence is uncertain, limited, or evolving, as is often the case, conflict often arises between guideline committees and practicing physicians, who bear the direct responsibility for the care of individual patients.
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According to federal government researchers, by the year 2020 80% of Canadians will live in Lyme endemic areas.
The Lyme disease spirochete, Borrelia burgdorferi, is an extracellular microbe that causes persistent infection despite the development of strong immune responses against the bacterium.
The recent article in the NEJM, “Two Controlled Trials of Antibiotic Treatment in Patients with Persistent Symptoms and a History of Lyme Disease,” by Klempner, et. al., provides some interesting data, but the proper interpretation of this data is of little relevance to both clinical practice and guidelines related to chronic Lyme disease.
Alan Stone of Chelmsford, who suffers from Lyme disease along with his daughter Angela, 14, says insurance companies are afraid of the high expenses that can come from long-term treatments.
Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement.
Carios kelleyi (Colley & Kohls 1941), a tick associated with bats and bat habitats, has been reported to feed on humans, but there is little published data regarding the presence of vector-borne pathogens in these ticks.