Update of the Swiss guidelines on post-treatment Lyme disease syndrome.

Détails

Ressource 1Télécharger: 27922168.pdf (577.15 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_8CFA6AB6E3C7
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Update of the Swiss guidelines on post-treatment Lyme disease syndrome.
Périodique
Swiss medical weekly
Auteur(s)
Nemeth J., Bernasconi E., Heininger U., Abbas M., Nadal D., Strahm C., Erb S., Zimmerli S., Furrer H., Delaloye J., Kuntzer T., Altpeter E., Sturzenegger M., Weber R.
Collaborateur(s)
For The Swiss Society For Infectious Diseases And The Swiss Society For Neurology
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
146
Pages
w14353
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Résumé
Lyme borreliosis is caused by Borrelia burgdorferi sensu lato infection, which responds well to antibiotic therapy in the overwhelming majority of cases. However, despite adequate antibiotic treatment some patients report persisting symptoms which are commonly summarised as post-treatment Lyme disease syndrome (PTLDS). In 2005, the Swiss Society of Infectious Diseases published a case definition for PTLDS. We aimed to review the scientific literature with a special emphasis on the last 10 years, questioning whether the definitions from 2005 are still valid in the light of current knowledge. Furthermore, we describe the clinical history of infection with Borrelia burgdorferi sensu lato, the estimated prevalence of PTLDS, the possible pathogenesis of PTLDS, and treatment options with an emphasis on clinical studies. In summary, we were unable to find a scientific reason for modification of the PTLDS definitions published in 2005. Thus, the diagnostic criteria remain unchanged, namely documented clinical and laboratory evidence of previous infection with B. burgdorferi, a completed course of appropriate antibiotic therapy, symptoms including fatigue, arthralgia, myalgia, cognitive dysfunction or radicular pain persisting for >6 months, a plausible timely association between documented B. burgdorferi infection and onset of symptoms (i.e., persistent or recurrent symptoms that began within 6 months of completion of a recommended antibiotic therapy for early or late Lyme borreliosis), and exclusion of other somatic or psychiatric causes of symptoms. The main therapeutic options remain cognitive behavioural therapy and low-impact aerobic exercise programmes. Growing and unequivocal evidence confirms that prolonged or repeated antibiotic therapy for PTLDS is not beneficial, but potentially harmful and therefore contraindicated. The Guidelines of the Swiss Society of Infectious Diseases offer an evidence based, diagnostic and therapeutic framework for physicians caring for patients suffering from presumptive PTLDS in Switzerland.

Mots-clé
Anti-Bacterial Agents/therapeutic use, Borrelia burgdorferi, Coinfection, Counseling, Exercise, Fatigue/etiology, Humans, Inflammation Mediators/metabolism, Lyme Disease/complications, Lyme Disease/physiopathology, Lyme Disease/psychology, Lyme Disease/therapy, Mental Health, Pain/etiology, Practice Guidelines as Topic, Switzerland
Pubmed
Web of science
Open Access
Oui
Création de la notice
12/12/2016 19:23
Dernière modification de la notice
08/05/2019 21:47
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