Casebook of Neuropsychiatry by Trevor A. Hurwitz

Author:Trevor A. Hurwitz
Language: eng
Format: epub
Publisher: American Psychiatric Publishing
Published: 2013-05-09T04:00:00+00:00

Key Clinical Points

Lyme disease, a tick-borne spirochetal infection, is the most common, and still rapidly emerging, vector-borne illness in the United States. Only 10% of cases are reliably detected.

B. burgdorferi enters the CNS early in the infection process; thus, patients with Lyme disease may present first to a psychiatrist.

Early-stage tests for Lyme antibody titers have high false-negative rates. The two-step tests (ELISA or indirect fluorescent antibody assay, followed by immunoblot or Western blot) have increased sensitivity at later stages.

Preventive measures against tick bites remain critical to combat the spread of Lyme disease.

Parenteral antibiotics may be required for severe CNS disease.

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