Spontaneous Knee Effusion in an Adolescent Soccer Player

2021 ◽  
pp. 1-4
Author(s):  
Bernadette D. Buckley ◽  
Christopher J. Joyce
Keyword(s):  
Lyme Disease ◽  
Soccer Player ◽  
Complete Blood Count ◽  
Early Recognition ◽  
The United States ◽  
Disease Diagnosis ◽  
Left Knee ◽  
Lyme Arthritis ◽  
Radiographic Imaging ◽  
Knee Effusion

A 13-year-old female recreational soccer player presented with spontaneous left knee effusion approximately 2 weeks after the start of soccer season. Radiographic imaging was negative, and a complete blood count identified an increase in inflammatory markers. Additional two-tier testing confirmed a Lyme disease diagnosis, which was unusual for an athlete residing in the southeast region of the United States. The presentation of knee effusion, and subsequently Lyme arthritis, is a common clinical manifestation of late-stage Lyme disease. Early recognition of this infection and prompt treatment by a variety of specialists reduce the severity or chronicity of symptoms.

scholarly journals Postoperative Lyme Arthritis in the Orthopaedic Patient

2019 ◽  
Vol 11 (4) ◽  
pp. 350-354
Author(s):  
Matthew C. Hess ◽  
Zachary Devilbiss ◽  
Garry Wai Keung Ho ◽  
Raymond Thal
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Postoperative Complication ◽  
Joint Pain ◽  
English Language ◽  
The United States ◽  
Lyme Arthritis ◽  
Level Of Evidence ◽  
Pubmed Database ◽  
Level 3

Context:Lyme disease is the most common tick-borne illness in North America and Europe, and Lyme arthritis is a frequent late-stage manifestation in the United States. However, Lyme arthritis has rarely been reported as a postoperative complication.Evidence Acquisition:The PubMed database was queried through June 2018, and restricted to the English language, in search of relevant articles.Study Design:Clinical review.Level of Evidence:Level 3.Results:A total of 5 cases of Lyme arthritis as a postoperative complication have been reported in the literature.Conclusion:These cases highlight the importance for providers practicing in Lyme-endemic regions to keep such an infection in mind when evaluating postoperative joint pain and swelling. We propose herein an algorithm for the workup of potential postoperative Lyme arthritis.Strength of Recommendation Taxonomy (SORT):C

scholarly journals Bull’s-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
John N. Aucott ◽  
Lauren A. Crowder ◽  
Victoria Yedlin ◽  
Kathleen B. Kortte
Keyword(s):  
Infectious Disease ◽  
Lyme Disease ◽  
Early Recognition ◽  
Erythema Migrans ◽  
Skin Lesions ◽  
Disease Diagnosis ◽  
Internet Survey ◽  
Appropriate Use ◽  
Bull's Eye ◽  
Use Of Medical Services

Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull’s-eye lesion and nontarget appearing lesions.Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease.Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans.Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient’s appropriate use of medical services for early Lyme disease diagnosis.

scholarly journals Seasonality of Acute Lyme Disease in Children

2021 ◽  
Vol 6 (4) ◽  
pp. 196
Author(s):  
Kathryn M. Sundheim ◽  
Michael N. Levas ◽  
Fran Balamuth ◽  
Amy D. Thompson ◽  
Desiree N. Neville ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Regression Models ◽  
Disease Incidence ◽  
Erythema Migrans ◽  
The United States ◽  
Lyme Arthritis ◽  
Cranial Neuropathy ◽  
Acute Arthritis ◽  
Presenting Symptoms ◽  
Fourier Regression

Due to the life cycle of its vector, Lyme disease has known seasonal variation. However, investigations focused on children have been limited. Our objective was to evaluate the seasonality of pediatric Lyme disease in three endemic regions in the United States. We enrolled children presenting to one of eight Pedi Lyme Net participating emergency departments. Cases were classified based on presenting symptoms: early (single erythema migrans (EM) lesion), early-disseminated (multiple EM lesions, headache, cranial neuropathy, or carditis), or late (arthritis). We defined a case of Lyme disease by the presence of an EM lesion or a positive two-tier Lyme disease serology. To measure seasonal variability, we estimated Fourier regression models to capture cyclical patterns in Lyme disease incidence. While most children with early or early-disseminated Lyme disease presented during the summer months, children with Lyme arthritis presented throughout the year. Clinicians should consider Lyme disease when evaluating children with acute arthritis throughout the year.

The Limping Child: Could It Be Lyme Arthritis? Information and Planning for School Nurses

2019 ◽  
Vol 34 (5) ◽  
pp. 262-265
Author(s):  
Tanya Laudenslager ◽  
Sheila Q. Hartung
Keyword(s):  
Lyme Disease ◽  
Joint Pain ◽  
School Setting ◽  
The United States ◽  
School Nurses ◽  
Lyme Arthritis ◽  
Acute Injury ◽  
Vector Borne Disease ◽  
History Of ◽  
Vector Borne

Lyme disease is the most common vector-borne disease in the United States with Lyme arthritis becoming one of the most common symptoms of Lyme disease. It is imperative that school nurses become familiar with vector-borne disease and promptly consider Lyme arthritis to be contemplated as a differential diagnosis of a child presenting to the office with a limp and joint pain and swelling with no history of acute injury. The following article will discuss the overview, implications and management of Lyme arthritis in the school setting and includes a relevant IHP for school nurses to utilize in practice.

Quantitative multiplexed strategies for human Lyme disease serological testing

2021 ◽  
pp. 153537022110034
Author(s):  
Eunice Chou ◽  
Armond Minor ◽  
Nathaniel C Cady
Keyword(s):  
Lyme Disease ◽  
The United States ◽  
Disease Diagnosis ◽  
Response To Treatment ◽  
Serological Response ◽  
Serological Testing ◽  
Current State ◽  
Primary Means ◽  
Human Immune Response ◽  
Diagnostic Approaches

Lyme disease, which is primarily caused by infection with the bacterium Borrelia burgdorferi in the United States or other Borrelia species internationally, presents an ongoing challenge for diagnostics. Serological testing is the primary means of diagnosis but testing approaches differ widely, with varying degrees of sensitivity and specificity. Moreover, there is currently no reliable test to determine disease resolution following treatment. A distinct challenge in Lyme disease diagnostics is the variable patterns of human immune response to a plurality of antigens presented by Borrelia spp. during the infection. Thus, multiplexed testing approaches that capture these patterns and detect serological response against multiple antigens may be the key to prompt, accurate Lyme disease diagnosis. In this review, current state-of-the-art multiplexed diagnostic approaches are presented and compared with respect to their diagnostic accuracy and their potential for monitoring response to treatment.

scholarly journals Immune Mediators of Murine Lyme Arthritis

2014 ◽  
Author(s):  
◽  
Anna Maria Cunningham
Keyword(s):  
Lyme Disease ◽  
Subsequent Development ◽  
The United States ◽  
Lyme Arthritis ◽  
Immune Mediators ◽  
Eicosanoid Production ◽  
Immunological Mechanisms ◽  
Serum Transfer ◽  
Dietary Fish ◽  
Vector Borne

Lyme disease is the most common vector-borne disease in both the United States and Europe; however, its pathogenesis is incompletely understood. The studies described in this thesis aid in the elucidation of mechanisms regulating murine Lyme arthritis and may suggest mechanisms by which human Lyme disease is mediated. (1) We found that the chemokine KC is responsible for neutrophil recruitment and subsequent development of Lyme arthritis and carditis. This was the first study to describe an immunological regulatory mechanism mediating disease susceptibility to murine Lyme disease, as resistant mice (B6) produce less KC than susceptible (C3H/HeJ) mice and do not develop disease. (2) We found that metabolites produced via the COX-2 pathway are important for functional resolution and that resolution is likely mediated via the PGE2/EP2 axis. (3) We found that although dietary fish oil substitution leads to a global shift in eicosanoid production (from AA/LA-derived eicosanoids to EPA/DHA-derived eicosanoids) and promotes antiinflammatory prostaglandin production, disease severity is not altered. (4) We found that eicosanoid production throughout the course of autoantibody-drive K/BxN serum-transfer arthritis differs significantly from that seen during Lyme arthritis and that patterns of eicosanoid expression reflect the severity and kinetics of each type of arthritis. These studies aid in understanding the immunological mechanisms regulating the occurrence and severity of murine Lyme arthritis.

Lyme Disease

1994 ◽  
Vol 15 (5) ◽  
pp. 167-173
Author(s):  
Robert S. Baltimore ◽  
Eugene D. Shapiro
Keyword(s):  
Lyme Disease ◽  
Lyme Borreliosis ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
The United States ◽  
Lyme Arthritis ◽  
Medical Attention ◽  
The Us ◽  
Ixodes Ticks ◽  
The Common

Introduction and Definitions Lyme borreliosis (Lyme disease) is a systemic infection caused by a spirochete, Borrelia burgdoferi. It is the most common vector-borne disease in the United States. Lyme disease was first described in Lyme, Connecticut (hence its name), where a cluster of children who had unexplained arthritis first were brought to medical attention by one of their parents. Investigation of this "epidemic" of arthritis led to the description of Lyme arthritis and ultimately to the discovery of its bacterial etiology. The clinical manifestations of Lyme borreliosis are protean; this, coupled with the practical difficulties of confirming the diagnosis in many patients, has led to many misconceptions about Lyme disease. Indeed, there is much we do not know about the disease, which was only recognized in the US as a distinct entity slightly more than 15 years ago, and the cause of which was first identified only about 10 years ago. Epidemiology ECOLOGY AND TRANSMISSION Borrelia burgdorferi is transmitted by ticks of the Ixodid species. In the US, the common vectors are Ixodes dammini (the deer tick), reported to be the same species as I scapularis, in the Northeast and the Midwest and I pacificus (the western black-legged tick) on the Pacific Coast. Ixodes ticks are much smaller than the common wood tick; the nymphal Ixodes tick is about the size of a pencil point (1 to 2 mm).

scholarly journals Pediatric unilateral knee swelling: a case report of a complicated differential diagnosis and often overlooked cause

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
Katherine E. Guardado ◽  
Shane Sergent
Keyword(s):  
Differential Diagnosis ◽  
Lyme Disease ◽  
The United States ◽  
Lyme Arthritis ◽  
Tick Bite ◽  
Joint Effusion ◽  
Test Results ◽  
History Of ◽  
Vector Borne

Abstract Lyme disease is the most common vector-borne illness in the United States. However, Lyme arthritis is a diagnosis that is often missed, even in children, who are the population with the highest incidence of Lyme disease. Lyme arthritis, which presents in the later stage of Borrelia burgdorferi infection, needs to be recognized and managed promptly, especially in endemic areas or when exposure to ticks is known. We present a case of a 3-year-old female presenting to the emergency department with a history of limping for 2 weeks. The mother of the child recognized a tick bite. However, the child was not taken to seek care expeditiously, because she had not developed any rashes. Test results demonstrated that the patient was IgG positive and IgM negative for Lyme disease, with Western blot confirming the diagnosis of Lyme arthritis. Most patients presenting with Lyme arthritis do not recall having a tick bite, making it difficult to differentiate it from other pediatric conditions. When this diagnosis is missed, it can result in long-term morbidity, which is generally refractory to intravenous antibiotic therapy, oftentimes requiring synovectomy. Hence, this underscores the importance of the consideration of Lyme arthritis as a differential diagnosis in patients presenting with joint effusion.

scholarly journals qS-Ne2Mo Score – A New Risk Stratification Tool For Early Detection of Septic Shock in The Field of Emergency Medicine

2021 ◽  
Author(s):  
Peter Erdelyi ◽  
Laszlo Papp ◽  
Imre Foldesi ◽  
Katalin Farkas ◽  
Zsolt Molnar ◽  
...  
Keyword(s):  
Septic Shock ◽  
Risk Stratification ◽  
Cell Population ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Population Data ◽  
The United States ◽  
Receiver Operating Curve ◽  
Suspected Infection ◽  
Risk Stratification Tool

Abstract Background Sepsis is one of the most significant healthcare concerns of the 21st century. In the United States sepsis affect 1.7 million adults, with 270,000 fatal cases, according to the estimation of Centers for Disease Control and Prevention. The management of sepsis relies on early recognition, therefore the emergency departments have distinctive role in sepsis care, hence the need for early reliable risk stratification tools.Methods A retrospective, quantitative study was performed in Department of Emergency, University of Szeged. Hungary. Patients with suspected infection were enrolled to four subgroups based on the results of patient examination and laboratory results. In all cases (N=276), cell population data markers were analyzed along with ordinary infection biomarkers, such as CRP, PCT and WBC. Performance of cell population data parameters were investigated with ROC (Receiver Operating Curve) analysis.Results Almost all cell population biomarkers showed significant differences in the subgroup analysis. Remarkable performance was found in three markers (NE-SFL/M, MO-X/M and NE-WY/M) in patients having septic shock. Combining quick SOFA with these biomarkers (qS-Ne2Mo score) resulted in excellent diagnostic ability for septic shock (AUC 0.914, p<0.001), with good sensitivity (73.9%) and excellent specificity (89 %).Conclusions Since determination of cell population data requires complete blood count analysis, turn-around time of this novel indicator is significantly lower than other methods. qS-Ne2Mo score might be used as an initial screening tool to select only those patients that need more extensive laboratory investigations for their proper treatment and spare inadequate, time and money consuming laboratory requests.Trial Registration: University of Szeged, Ethical Committee ref. nr. 25/2016-SZTE

Mosquito and Tick-borne Illnesses in the United States. Guidelines for the Recognition and Empiric Treatment of Zoonotic Diseases in the Wilderness.

2019 ◽  
Vol 19 (3) ◽  
pp. 238-257
Author(s):  
Suresh Antony
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Spotted Fever ◽  
Disease Process ◽  
Rocky Mountain ◽  
The United States ◽  
Health Care Facilities ◽  
Diagnostic Tools ◽  
Rocky Mountain Spotted Fever ◽  
Number Of Patients

Background:In the United States, tick-borne illnesses account for a significant number of patients that have been seen and treated by health care facilities. This in turn, has resulted in a significant morbidity and mortality and economic costs to the country.Methods:The distribution of these illnesses is geographically variable and is related to the climate as well. Many of these illnesses can be diagnosed and treated successfully, if recognized and started on appropriate antimicrobial therapy early in the disease process. Patient with illnesses such as Lyme disease, Wet Nile illness can result in chronic debilitating diseases if not recognized early and treated.Conclusion:This paper covers illnesses such as Lyme disease, West Nile illness, Rocky Mountain Spotted fever, Ehrlichia, Tularemia, typhus, mosquito borne illnesses such as enteroviruses, arboviruses as well as arthropod and rodent borne virus infections as well. It covers the epidemiology, clinical features and diagnostic tools needed to make the diagnosis and treat these patients as well.

Sign in / Sign up

Export Citation Format

Share Document