High Cost Of Treating Lyme Arthritis In Children With Surgery
A study by Tout and colleagues investigated how operative management impacts the clinical course and health care costs of pediatric patients hospitalized with Lyme arthritis. We hypothesized that surgery does not improve clinical outcomes for children with Lyme arthritis but does increase resource utilization and cost, the authors wrote.
In their article The Impact of Operative Intervention in Pediatric Lyme Arthritis, Tout et al. described 149 children admitted to a tertiary care childrens hospital in Pennsylvania who had been diagnosed with Lyme arthritis between 2008 and 2018.¹
All of the children met the CDC case definition, had Lyme arthritis, and were culture negative. The average age of the children was 6.7 years with a range of 4.5 to 9.7 years.
Out of the 149 patients, 47 underwent orthopedic intervention.
The study found:
- 1 in 3 children underwent surgery
- 2 out of 3 underwent open surgery
- The remaining children underwent arthroscopic surgery. One child underwent arthroscopic surgery followed by open surgery. And, just over 50% of the children underwent a synovectomy.
Two children were re-admitted for surgical complications one for wound dehiscence and the other for persistence of arthritis in the setting of inappropriate initial antibiotic therapy .
This retrospective cohort study demonstrates that operative intervention for Lyme arthritis does not improve outcomes, though it does increase cost and health care utilization.
Treatment For Other Forms Of Lyme Disease
People with other forms of disseminated Lyme disease may require longer courses of antibiotics or intravenous treatment with antibiotics such as ceftriaxone. For more information about treating other forms of Lyme disease, see:
The National Institutes of Health has funded several studies on the treatment of Lyme disease that show most people recover within a few weeks of completing a course of oral antibiotics when treated soon after symptom onset. In a small percentage of cases, symptoms such as fatigue and myalgia can last for more than 6 months. This condition is known as post-treatment Lyme disease syndrome , although it is also sometimes called chronic Lyme disease. For details on research into chronic Lyme disease and long-term treatment trials sponsored by NIH, visit the visit the National Institutes of Health Lyme Disease web siteexternal icon.
Is There A Blood Test For Lyme Disease
If your doctor suspects that you have Lyme disease, they may order two blood tests. These will look for signs that your body is trying to fight it off. The results are most precise a few weeks after youâve been infected.
These tests are:
ELISA test. This test canât check for the bacteria that causes Lyme disease. It can only look for your immune systemâs response to it.
Although itâs the most common way to check for Lyme disease, the ELISA test isnât perfect. It can sometimes give false âpositiveâ results. On the other hand, if you have it done too soon after youâve been infected, your body may not have developed enough antibodies for the test to detect them. This will give you a ânegativeâ result even though you do have Lyme disease.
Western blot test. Whether your ELISA test comes back positive or negative, your doctor will need to do this blood test, too.
A Western blot uses electricity to split certain proteins in your blood into patterns. This is then compared to the pattern of people known to have Lyme disease.
At least five band matches means that you have Lyme disease. Still, not all labs have the same standards. Thereâs a chance that you could get a âpositiveâ result from one and a ânegativeâ result from another.
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Antimicrobials That Kill Growing Phase Cysts
Intracellular and Extracellular
Note: I work with the following agents as anti-cyst agents based on the mechanism by which these antibiotics work and some scientific experiments. For the Rifamycins, there are no laboratory experiments showing these agents work against cysts. Clinically, I see great benefit in using the Rifamycins as my anti-cyst agents so I list them here.
- Rifampin 300 mg 2 pills 1 time a day or 1 pill 2 times a day
- Rifabutin 150 mg 2 pills 1 time a day
- Tinidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days
- Metronidazole 500 mg 1 pill 2 or three times a day usually pulsed for four days on then three days off of each 7 days.
- Grapefruit seed extract 250 mg 1 pill 2 times a day. Note this is an herbal antibiotic that I find as effective as the prescription options in this list.
What Health Professionals Need To Know About Lyme Disease
Lyme disease is a serious illness caused by the bacterium Borrelia burgdorferi. The bacterium is a spirochete transmitted by certain species of Ixodes ticks. It is spread through the bite of infected blacklegged ticks and western blacklegged ticks.
Health professionals are encouraged to further their knowledge of Lyme disease in Canada. This includes the ability to:
- understand and identify the signs and symptoms
- prescribe appropriate treatment for patients diagnosed with the disease
- report human cases through appropriate channels
Symptoms sometimes appear in overlapping stages, as:
- early localized Lyme disease
- early disseminated Lyme disease
- late disseminated Lyme disease
It is important to note that some people with Lyme disease may have no or minimal symptoms. Others may suffer more severe symptoms.
Some people may not develop symptoms until weeks after the initial bite, as described in the early localized disease stage below. In this case, they may not remember the tick bite or associate the illness with the bite. Because the blacklegged tick is so small and usually painless, some people may not even know they were bitten by a tick.
Health professionals should be knowledgeable about the clinical manifestations and epidemiological risk factors of Lyme disease. Consider Lyme disease as part of your differential diagnosis in a patient who presents with compatible symptoms and signs.
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Are There Any Side Effects
Not all people undergoing a treatment for Lyme disease, is said to suffer from side effects of medication. For some people, the side effects may be minor and can be dealt with easily whereas for others who are allergic to a particular medication may suffer from some serious side effects. Some of the side effects for treatment of Lyme disease include troubled breathing, swelling of face, tongue, lips or throat due to allergic reactions, developing hives, severe diarrhoea, bad taste in mouth, nausea, vomiting, vaginal yeast infection and others. Some people may even develop higher fever, redder rashes or increased pain during the initial 24 hours of antibiotic therapy. This is not an allergic reaction, but a symptom that may be indicative of rapid death of the bacteria. People suffering from any of these side effects need to consult their doctor immediately so that alternative medications can be prescribed if necessary.
Notes On Serological Tests
For patients with illness lasting over a month, only IgG testing should be performed . A positive IgM test alone is not sufficient to diagnose current disease in these patients.
Due to antibody persistence, a positive serological test cannot distinguish between active and past infection.
- should not be done as a test of cure
- cannot be used to measure treatment response
The EIA test:
- may yield false-positive results when used as a stand-alone test
- may cross-react with antibodies to commensal or pathogenic spirochetes
- there may be some viral infections for certain autoimmune diseases
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Treatment For Erythema Migrans
People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease.
Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a persons age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions.Treatment regimens for localized Lyme disease.
|100 mg, twice per day orally
|500 mg, three times per day orally
|500 mg, twice per day orally
|4.4 mg/kg per day orally, divided into 2 doses
|100 mg per dose
|50 mg/kg per day orally, divided into 3 doses
|500 mg per dose
|30 mg/kg per day orally, divided into 2 doses
|500 mg per dose
*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize unnecessary antibiotics that might result in adverse effects, including infectious diarrhea and antimicrobial resistance.
NOTE: For people intolerant of amoxicillin, doxycycline, and cefuroxime, the macrolide azithromycin may be used, although it is less effective. People treated with azithromycin should be closely monitored to ensure that symptoms resolve.
What Is Chronic Lyme Disease
Every year, black-legged ticks transmit Lyme disease to over 300,000 people across the US, making it the most common vector-borne illness in the States, according to the CDC. These ticks are about the size of poppy seeds, and mainly inhabit the Northeastern and Northwestern US.
Chronic Lyme disease, also known as post-treatment Lyme disease, is the term used when people infected with the disease continue to experience symptoms even after theyve received treatment.
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Costs Of The Health Policy Program
Due to the increasing number of Lyme disease incidence in Poland over consecutive years, some local government units have introduced health policy programs for LB. They were intended to examine a part of the population living in a specific area in order to diagnose or rule out the occurrence of this disease earlier. By far the highest incidence of Lyme disease has occurred for several years in eastern Polandin the Podlaskie Voivodeship . The highest level was reached in 2016134.9/10,000 inhabitants, which is a value significantly exceeding the average for the whole country, and this area has also been in first place in terms of incidence in relation to the entire country invariably since 2010 .
Table 4. Incidence of Lyme disease per 100,000 inhabitants in the voivodeships of Poland .
How Much Does Lyme Disease Cost To Treat
The price of antibiotics for pets and humans has been increasing in recent years a two-week dose of doxycycline can cost $400 in some areas. Ask your veterinarian if they use a compounding pharmacy, which can help manage cost.
The Healthy Paws plan covers Lyme disease treatment as long as it is not a pre-existing condition and the 15-day waiting period has passed before it is contracted. The insurance does not cover vaccines or preventive treatment.
Blood tests usually run around $80, depending on the methods used. Pet parents also must pay the veterinary exam fee, which is $40 to $100+, depending on your location. However, a pup diagnosed with Lyme is looking at hospitalization and chronic condition treatment. For example, Seans claims for Paisley included emergency treatment, hospitalization, and ongoing medications totaling $6,969, of which hes been reimbursed $6,004 .
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Test For Lyme Disease
Please take the time to read this 15 minute blog. It tells of how someone beat Lyme Disease and Q-fever, both contracted from the same tick bite, but Q-fever being 10 time worse than Lyme Disease. He tells of how doctors were not able to cure him and at his last hope found several natural foods that turned his health around within a week. On deaths door to a full recovery. Check out the simple ways he cured lyme disease with organic foods.
Lyme disease is a bacterial infection caused by a bacterium known as spirochete, which is spread by tick bites. Lyme disease is described in 3 phases: the early localized disease with skin inflammation early disseminated disease with heart and nervous system involvement, including nerve palsies and meningitis and late disease featuring motor and sensory nerve damage, brain inflammation and arthritis.
Since Lyme disease is transmitted by ticks attaching to the body, it is important to use protective clothing and adopt other techniques for the prevention and avoidance of tick bites while staying in, or visiting tick areas. Adequate hygiene should be maintained in order to prevent transmission of this disease.
Stages Of Lyme Disease
There are three stages of Lyme disease. Early localized Lyme disease is defined as being diagnosed soon after a tick has bitten you. You may have seen the tick, removed it, and noticed a rash. You may even be starting to feel like you have the flu or coping with headaches.
This is the best time to treat Lyme disease. This is, for many, the only stage in which oral antibiotics are successful. Once the disease begins to move to other places in the body, as it does in the Early Dissemination stage, oral antibiotics may not be strong enough to fight infection.
In the third stage, Late Lyme, it is unlikely oral antibiotics alone can rid you of the bacterial infection. This is when doctors and patients start to look at alternative methods of treatment.
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Chronic Lyme Dos And Don’ts
Chronic Lyme disease is an ongoing Borrelia burgdorferi infection that can involve any body system or tissue. The infection produces a wide range of symptoms and signs, which can be debilitating for some patients. Common symptoms include severe fatigue, migratory musculoskeletal pain, headaches, and impaired memory. Unfortunately, chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health. Every patient concerned about Lyme disease and tick-borne illness should know the following.
Concern Over Resistance Other Complications
According to the CDC, it is not known how many people seek treatment for chronic Lyme, or how many complications occur during the course of treatment.
In addition to the dangers associated with inappropriate antibiotic use, such as selection of antibiotic-resistant bacteria, these treatments can lead to injuries related to unnecessary procedures, bacteremia and resulting metastatic infection, venous thromboses, and missed opportunities to diagnose and treat the actual underlying cause of the patients symptoms, the authors conclude.
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Why Are Antibiotics The First Line Of Treatment For Lyme Disease
The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.
Who Is Eligible For The Treatment
Any person who has been bitten by blacklegged tick and is suffering from symptoms like fever, headache, weakness, muscle or joint pain, swollen lymph nodes and a typical type of skin rash known as erythema migrans, are said to have Lyme disease and are eligible for such treatment. Pathological tests of blood samples of the patient are also helpful in the diagnosis of Lyme disease, if they are used correctly and performed with validated methods. It is very important to be cautious, so as to avoid misdiagnosis and treatment of Lyme disease, when the actual cause of the ailment is something else.
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Tom Johannes Lyme Disease Fund
Another victim of a tick bite, Tom suffered from Lyme disease unknowingly for many years before he was finally diagnosed with late stage neurological Lyme Disease. Once an outdoor enthusiast, the disease left Tom unable to perform basic tasks or care for his family. Toms brother stepped up and created an online fundraiser that has brought in $26,000 to help Tom and his family find hope and financial peace.
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What Is The Price Of The Treatment In India
The price of treatment of Lyme disease in India may vary depending upon the cost of medicines prescribed by the doctor. On an average, the cost of consulting a doctor regarding the problems of Lyme disease ranges from Rs. 300 to Rs. 1,500 . The cost of medicines in India throughout the course of treatment may range from Rs. 3,500 to Rs. 5,000. Hence, the total cost for treatment of patients suffering from Lyme disease may range from Rs. 4,500 to Rs. 10,000 . This treatment is easily available in almost all cities and towns in India.
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Demographics Of The Samples
The distributions of age, sex and region of the Lyme disease cases in our sample are consistent with what one would expect given national statistics on Lyme disease . Both cases and controls are approximately 51% female. Nearly half of both groups are aged 45â64 years, with 31% between ages 21â44 and the remaining 19% under 20 years of age. The vast majority of those in our studyâapproximately 80%âreside in highly endemic geographic regions, including the Northeast, Mid-Atlantic and Great Lakes regions . The smaller number of cases in other regions may be due to travel exposure or to the possibility of low rates of transmission from ixodes scapularis vectors in southeastern states. This hypothesis is strengthened by the fact that the majority of our ânon-endemicâ cases came from the southeast and Appalachian regions and not from the central, plains or desert regions. The seasonal diagnosis of Lyme disease among our sample peaked in June and July, with a nadir in January and February , consistent with national statistics for Lyme disease.
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