Research Assistant, Department of Infectious Diseases, The Miriam Hospital; Medical Student, Warren Alpert Medical School of Brown University.
Assistant Professor, Section of Infectious Diseases,West Virginia University.
R I Med J (2013). 2020 Dec 1;103(10):51-55.
Although the prevalence of Lyme and tick-borne diseases (TBDs) continues to rise, there is conflicting information regarding the best approach to management. The Lifespan Lyme Disease Clinic (LDC) is an academic out- patient clinic for Lyme and other TBDs. A chart review of 218 new patients between March and November 2018 was conducted. Symptoms most commonly reported included fatigue (66.5%), joint pain (58.2%), cognitive difficulty (32.1%), and headaches (27.9%). Most (87.1%) patients had received TBD-directed antibiotic treatment prior to their first appointment. Of the 136 patients who had experienced more than 6 months of symptoms attributed to Lyme, 55.1% had positive two-tiered serologies. Many patients characterized themselves as having "chronic Lyme" or had a diagnosis of "post-treatment Lyme disease syndrome," a condition for which there is no clear consensus on pathophysiology or treatment. Outlined here are some lessons learned and practical approaches used by LDC physicians in caring for this patient population.
尽管莱姆病和蜱传疾病（TBD）的患病率持续上升，但对于最佳管理方法仍存在相互矛盾的信息。莱姆病终生诊所（LDC）是一家针对莱姆病和其他 TBD 的学术门诊诊所。对 2018 年 3 月至 11 月期间的 218 名新患者进行了图表审查。报告的最常见症状包括疲劳（66.5%）、关节疼痛（58.2%）、认知困难（32.1%）和头痛（27.9%）。大多数（87.1%）患者在首次就诊前已接受 TBD 定向抗生素治疗。在 136 名经历了超过 6 个月归因于莱姆病的症状的患者中，55.1% 的患者二级血清学检测呈阳性。许多患者认为自己患有“慢性莱姆病”或被诊断为“莱姆病后治疗综合征”，对于这种病症，其病理生理学或治疗方法尚无明确共识。这里列出了 LDC 医生在照顾这一患者群体时所获得的一些经验教训和实用方法。
