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.

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 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 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.

scholarly journals Lyme Disease Presenting with Multiple Cranial Nerve Deficits: Report of a Case

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Abhishek Chaturvedi ◽  
Keith Baker ◽  
Donald Jeanmonod ◽  
Rebecca Jeanmonod
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Inflammatory Disease ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
The United States ◽  
Vector Borne Disease ◽  
Vector Borne ◽  
Multiple Cranial Nerve

Lyme disease is a tick-transmitted multisystem inflammatory disease caused by the spirocheteBorrelia burgdorferi. With more than 25,000 CDC reported cases annually, it has become the most common vector-borne disease in the United States. We report a case of 38-year-old man with Lyme disease presenting with simultaneous palsy of 3rd, 5th, 7th, 9th, and 10th cranial nerves.

scholarly journals Misdiagnosis of Lyme Disease With Unnecessary Antimicrobial Treatment Characterizes Patients Referred to an Academic Infectious Diseases Clinic

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Takaaki Kobayashi ◽  
Yvonne Higgins ◽  
Roger Samuels ◽  
Aurasch Moaven ◽  
Abanti Sanyal ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Infectious Diseases ◽  
The United States ◽  
Antimicrobial Treatment ◽  
Community Settings ◽  
Academic Center ◽  
History Of ◽  
Observational Cohort ◽  
Vector Borne ◽  
Retrospective Observational Cohort Study

Abstract Background Although Lyme disease is the most common vector-borne infection in the United States, diagnostic accuracy within community settings is not well characterized. Methods A retrospective observational cohort study of patients referred to an academic center with a presumed diagnosis or concern for Lyme disease between 2000 and 2013 was performed to analyze diagnoses and treatments. Characteristics of those with Lyme disease and those misdiagnosed as having Lyme disease were compared. Results Of 1261 patients, 911 (72.2%) did not have Lyme disease, 184 (14.6%) had active or recent Lyme disease, 150 (11.9%) had a remote history of Lyme disease, and 16 (1.3%) were identified as having possible Lyme disease. Patients without current Lyme disease were more likely to be female (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.08–2.45), to have had symptoms for >3 months (OR, 8.78; 95% CI, 5.87–13.1), to have higher symptom counts (OR per additional symptom, 1.08; 95% CI, 1.02–1.13), to have had more Lyme-related laboratory testing (OR per additional laboratory test, 1.17; 95% CI, 1.03–1.32), and to have been diagnosed with what were regarded as coinfections (OR, 3.13; 95% CI, 1.14–8.57). Of the 911 patients without Lyme disease, 764 (83.9%) had received antimicrobials to treat Lyme disease or their coinfections. The percentage of patients established to have Lyme disease was lower than in earlier studies of referred populations. Conclusions Among patients referred to an academic Infectious Diseases practice for Lyme disease, incorrect diagnoses and unnecessary antibiotic treatment were common, both for Lyme disease and for coinfections.

scholarly journals Advancing the Science of Tick and Tick-Borne Disease Surveillance in the United States

Insects ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 361 ◽  
Author(s):  
Samantha Wisely ◽  
Gregory Glass
Keyword(s):  
Public Health ◽  
United States ◽  
Workforce Development ◽  
Disease Surveillance ◽  
The United States ◽  
Centers Of Excellence ◽  
Public Health Burden ◽  
Vector Borne Disease ◽  
Tick Borne Disease ◽  
Vector Borne

Globally, vector-borne diseases are an increasing public health burden; in the United States, tick-borne diseases have tripled in the last three years. The United States Centers for Disease Control and Prevention (CDC) recognizes the need for resilience to the increasing vector-borne disease burden and has called for increased partnerships and sustained networks to identify and respond to the most pressing challenges that face vector-borne disease management, including increased surveillance. To increase applied research, develop communities of practice, and enhance workforce development, the CDC has created five regional Centers of Excellence in Vector-borne Disease. These Centers are a partnership of public health agencies, vector control groups, academic institutions, and industries. This special issue on tick and tick-borne disease surveillance is a collection of research articles on multiple aspects of surveillance from authors that are affiliated with or funded by the CDC Centers of Excellence. This body of work illustrates a community-based system of research by which participants share common problems and use integrated methodologies to produce outputs and effect outcomes that benefit human, animal and environmental health.

A Lyme Disease Case Study and Individualized Healthcare Plan

2003 ◽  
Vol 19 (2) ◽  
pp. 81-88 ◽  
Author(s):  
Roberta Cavendish
Keyword(s):  
Lyme Disease ◽  
The United States ◽  
School Nurses ◽  
Breeding Cycle ◽  
Peak Time ◽  
Assessment Data ◽  
Healthcare Plan ◽  
Disease Case ◽  
Control And Prevention

The Atlantic and Pacific coasts are the boundaries of Lyme disease with the Northeastern and Midwestern regions of the United States continuing to report the majority of cases. New reported cases of Lyme disease doubled from 1991 to 2001 according to statistics published by the Centers for Disease Control and Prevention ( CDC, 2002 ). Within that population are more children between the ages of 5 and 9. The younger the child, the more difficult it is to diagnose Lyme disease. Children under the age of 19 are at high risk for Lyme disease because of the amount of time spent in outdoor activities during the late spring and summer. These months correlate with the tick breeding cycle and the peak time for outdoor recreational activities. Lyme disease can pose serious health risks in late stage illness. A Lyme disease case study on a school-age child provides comprehensive assessment data, interventions, and educational information for parents. A template of an individualized healthcare plan using standardized language is a guide for school nurses. The value of school nurses as guardians of the public’s health is addressed.

Exploration of School Administrator Attitudes Regarding Do Not Resuscitate Policies in the School Setting

2007 ◽  
Vol 23 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Martha Hone-Warren
Keyword(s):  
Policy Development ◽  
School Administrators ◽  
School Setting ◽  
The United States ◽  
School Nurses ◽  
School Administrator ◽  
Do Not Resuscitate ◽  
Structured Interviews ◽  
Administrator Attitudes ◽  
Dnr Orders

Few school districts in the United States have policies relating to do not resuscitate (DNR) orders in the school setting. School administrators are the gatekeepers of policy development. Little is known about administrator attitudes related to DNR orders in the school setting. School nurses need to understand administrator attitudes in order to facilitate DNR policy development. This study explored the attitudes of 15 administrators about DNR orders in the school setting through structured interviews. Administrators were asked their attitudes about DNR orders in the school setting and about DNR policy implementation. The majority of administrators believed that DNR policies should not be developed for the school setting because of the emotions involved and lack of administrator knowledge related to DNR orders. The majority of administrators did agree that having a DNR policy would clarify how staff should respond to DNR orders at school.

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