Leading Lyme Physicians in Lyme Disease Conversations – Dr. Daniel Cameron speaking with Dr. Joseph Burrascano. Dr. Burrascano- Treatment Recommendations Dr. Joseph Burrascano, Jr. DIAGNOSTIC HINTS AND TREATMENT GUIDELINES FOR LYME AND OTHER . These guidelines for diagnosis and management of borreliosis (Lyme in turn to our mentors and teachers, principally ILADS and the Burrascano guidelines.

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In the co-infected Lyme patient, eradication may be difficult. Burrascano is retired from clinical practice.


Joint pain or swelling: The LDA does not make specific recommendations for treatment. Thus, careful evaluation often includes neuropsychiatric testing, SPECT and MRI brain scans, CSF analysis when appropriate, regular input from Lyme-aware neurologists and psychiatrists, pain clinics, and occasionally specialists in psychopharmacology.

Refer to the diet outlined below. Below, is the current case definition used for surveillance. It has also been reported that Babesial infections can range in severity from mild, subclinical infection, to fulminant, potentially life-threatening ubrrascano.

Useful in EM rashes co-infected with common skin pathogens.

Again, consider this diagnosis in a Lyme Borreliosis LB patient not responding well to therapy. As in Lyme Disease and Babesiosis, Bartonella may be transmitted to the fetus in the infected pregnant patient.

Because it takes 48 to 72 hours of therapy to initiate bacterial killing, the Herxheimer reaction is therefore delayed. They are available as a liquid concentrate and as granules. Repeated treatment failures should alert the clinician to the possibility of an otherwise inapparent immune brurascano, and a workup for this may be advised.


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Cefuroxime axetil mg q12h for 6 weeks. This allows for several advantages: Fuidelines may have to be resumed if oral or IM therapy fails. It is related to vitamin B12 and has several documented benefits: Use repellents cautiously on small children, as they are more susceptible to their toxic effects.

If levels are too low at tolerated doses, give parenterally or change to another drug.


Retreatment is always possible. Rarely, gurrascano forms have been seen in peripheral blood. The evaluation of a Lyme patient must begin with testing for all currently known tick borne pathogens. It is important to note that the CDC’s published reporting criteria are for surveillance only, not for diagnosis. Amoxicillin mg q6h for 6 weeks. It may also help in energy level and cognition.

Published reports and clinical experience have shown this regimen to be unacceptable, as nearly half of patients so treated have had to abandon treatment due to serious side effects, many of which were disabling. Yeast problems usually begin in the mouth, for when thrush is present, organisms may repeatedly pass down into the GI tract where they cause the most problems. View All Lyme Disease Conversations. Therefore, it is necessary to prescribe physical therapy, the extent of which depends on an individual patients’ condition, followed by a graded exercise program.

Chloramphenicol Not recommended as not proven and potentially toxic. These compounds reportedly can cause many of the symptoms of encephalopathy, cause an ongoing inflammatory reaction manifested as some of the virus-like symptoms common in late Lyme, and also potentially interfere with hormone action by blocking hormone receptors.


Advise them to take a break when or ideally before the inevitable mid afternoon fatigue sets in. Remember — there currently is no test for cure, so this clinical follow-up assumes a major role in Lyme Disease care. Follow with oral therapy or IM benzathine penicillin until no active disease for 6—8 weeks.

Because Bb serologies often give inconsistent results, test at more than one laboratory using, if possible, different methods. Such individuals may have to be maintained on open-ended, ongoing antibiotic therapy, for they repeatedly relapse after antibiotics are stopped.

These include duration and severity of illness, presence of co-infections, immune deficiencies, prior significant immunosuppressant use while infected, age, weight, gastrointestinal function, blood levels achieved, and patient tolerance. PCR This is more sensitive than smears for B.

Increase burraacano while protecting damaged and weakened joints, tendons, and ligaments, to increase range of motion and relieve stiffness. Methyl B12 must burrascao into the muscle as it will not be absorbed if swallowed or used sublingually. Therefore, just as in routine blood culturing, multiple specimens must be collected to increase yield; a negative result does not rule out infection, but a positive one is significant.

The best kinds are frozen or refrigerated to ensure potency.

Because of this, the doses listed below may have to be raised.