Re: Scared of actually finding Lyme patients?

[Guest guest]

What are the " endemic areas " and who has decided these?

> Scared of actually finding Lyme patients?????

>

> Nelly

>

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=16050454 & query_hl=2

>

> Am Fam Physician. 2005 Jul 15;72(2):297-304. Links

>

>

> Diagnosis of lyme disease.

>

> DePietropaolo DL, Powers JH, Gill JM, Foy AJ.

>

> Christiana Care Health Services, Wilmington, Delaware, USA.

drdan1954@a...

>

> The use of serologic testing and its value in the diagnosis of Lyme

disease remain confusing and controversial for physicians, especially

concerning persons who are at low risk for the disease. The approach

to diagnosing Lyme disease varies depending on the probability of

disease (based on endemicity and clinical findings) and the stage at

which the disease may be. In patients from endemic areas, Lyme

disease may be diagnosed on clinical grounds alone in the presence of

erythema migrans. These patients do not require serologic testing,

although it may be considered according to patient preference. When

the pretest probability is moderate (e.g., in a patient from a highly

or moderately endemic area who has advanced manifestations of Lyme

disease), serologic testing should be performed with the complete two-

step approach in which a positive or equivocal serology is followed

by a more specific Western blot test. Samples drawn from patients

within four weeks of disease onset are tested by Western blot

technique for both immunoglobulin M and immunoglobulin G antibodies;

samples drawn more than four weeks after disease onset are tested for

immunoglobulin G only. Patients who show no objective signs of Lyme

disease have a low probability of the disease, and serologic testing

in this group should be kept to a minimum because of the high risk of

false-positive results. When unexplained non-specific systemic

symptoms such as myalgia, fatigue, and paresthesias have persisted

for a long time in a person from an endemic area, serologic testing

should be performed with the complete two-step approach described

above.

>

> PMID: 16050454 [PubMed - in process]