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May 6, 2022, 19 tweets

Next speaker:
John Aucott, MD
Associate Professor of Medicine @HopkinsMedicine
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John Aucott, MD
The stages of Lyme disease
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John Aucott, MD
The symptoms of Lyme disease overlap with other diseases and often leads to delayed or misdiagnosis.
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John Aucott, MD
You don't want to do labs in early Lyme disease as they won't show.
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John Aucott, MD
Lyme disease rashes vary. Most are not the bullseye.
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John Aucott, MD
Where Lyme disease lesions are most often located.
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John Aucott, MD
In darked skinned individuals the Lyme disease rash will be harder to see.
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John Aucott, MD
STARI rash. Note STARI is also treated with antibiotics.
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John Aucott, MD
Other diseases with rash.
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John Aucott, MD
Summer flu without a rash suspect Lyme disease and other tick-borne diseases like anaplasmosis.
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John Aucott, MD
Most patients with Lyme disease had flu-like symptoms several days prior to the rash.
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John Aucott, MD
Diagnostic highlights of Anaplasmosis, Ehrlichiosis, Babesiosis.
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John Aucott, MD
Borrelia miyamotoi is carried by the same tick that carries Lyme disease.
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John Aucott, MD
Unfortunately the diagnostic test for Lyme disease relies on antibodies. It was originally designed for surveillance, not diagnostic. The test is often false-negative even 4-5 weeks into the illness.
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John Aucott, MD
Even the new two-tier test for Lyme disease is going to miss early infections. Patients with impaired immune system may not produce anti-bodies (eg in patients co-infected with Babesia &/or Anaplasma)
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John Aucott, MD
It is possible to get Lyme disease multiple times. This makes it difficult to distinguish PTLDS vs reinfection. comparing the western blots may help distinguish if it is a new infection.
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John Aucott, MD
Diagnosis of Early disseminated Lyme disease
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John Aucott, MD
Diagnosis of late stage Lyme disease, neuorborreliosis is more difficult.
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John Aucott, MD
Future directions of Lyme disease testing.
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