Chronic coinfections in patients diagnosed with chronic lyme disease: a systematic review.

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2014-11

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Abstract

PURPOSE: Often, the controversial diagnosis of chronic Lyme disease is given to patients with prolonged, medically unexplained physical symptoms. Many such patients also are treated for chronic coinfections with Babesia, Anaplasma, or Bartonella in the absence of typical presentations, objective clinical findings, or laboratory confirmation of active infection. We have undertaken a systematic review of the literature to evaluate several aspects of this practice. METHODS: Five systematic literature searches were performed using Boolean operators and the PubMed search engine. RESULTS: The literature searches did not demonstrate convincing evidence of: 1) chronic anaplasmosis infection; 2) treatment-responsive symptomatic chronic babesiosis in immunocompetent persons in the absence of fever, laboratory abnormalities, and detectable parasitemia; 3) either geographically widespread or treatment-responsive symptomatic chronic infection with Babesia duncani in the absence of fever, laboratory abnormalities, and detectable parasitemia; 4) tick-borne transmission of Bartonella species; or 5) simultaneous Lyme disease and Bartonella infection. CONCLUSIONS: The medical literature does not support the diagnosis of chronic, atypical tick-borne coinfections in patients with chronic, nonspecific illnesses.

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10.1016/j.amjmed.2014.05.036

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Lantos, Paul M, and Gary P Wormser (2014). Chronic coinfections in patients diagnosed with chronic lyme disease: a systematic review. Am J Med, 127(11). pp. 1105–1110. 10.1016/j.amjmed.2014.05.036 Retrieved from https://hdl.handle.net/10161/13960.

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Scholars@Duke

Lantos

Paul Michael Lantos

Professor of Medicine

I am interested in the spatial epidemiology of infectious diseases. My research utilizes geographic information systems (GIS) and geostatistical analyses to understand the spatial and spatiotemporal distribution of diseases, and their relationship with environmental and demographic factors. I currently have active studies evaluating the spatial distribution of numerous domestic and international infectious diseases, including SARS-CoV-2 (COVID-19), cytomegalovirus, influenza, and Lyme disease. Additionally I am interested in maternal-child health, and I have a number of ongoing studies of neighborhood health disparities in obstetrical care and birth outcomes. I am interested in GIS education and have conducted workshops on public health GIS in Mongolia and China.


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