Borrelia species

Borrelia species

Background:
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Spirochetes
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>Leptospira species (includes pathogenic and saprophytic species)
>Borrelia species (36 known strains).  Led Most common strains associated with Lyme disease:
     1] Borrelia burgdorferi – Lyme Disease
     2] Borrelia afzelii – Tick-borne relapsing fever
     3] Borrelia garinii – Tick-borne relapsing fever
>Treponema pallidum
 

Borelia species

 

  • Spirochaete bacterium. 
  • 36 known species of Borrelia (12 of these species are known to cause Lyme disease or borreliosis and are transmitted by ticks). 
  • Other tick-borne relapsing infections are acquired from other species, such as Borrelia hermsii or Borrelia parkeri or Borrelia miyamotoi,  which can be spread from rodents, and serve as a reservoir for the infection, via a tick vector.

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Therapy:
Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.   Listed dosages may need to be adjusted for renal dysfunction.  

  1. Erythema migrans – Early disease:   (Usual length of therapy: 2-3 weeks)
  2. Neurologic complications:   (Usual length of therapy: 2-4 weeks)
    • Doxycycline 100mg orally twice daily
    • Ceftriaxone 2 grams IV q24h  (range: 1-2 grams q12-24h) or
      Cefotaxime 2 grams IV q8h.
  3. Cardiac involvement / carditis:  (Usual length of therapy: 2-3 weeks)
  4. Other:   Generally, the oral regimens listed above will cover the most common areas of involvement such as the joints.  Reserve IV therapy for severe cases or extensive disease. Length of therapy should be guided by close observation and overall clinical improvement of the patient.   For patients unable to tolerate preferred regimens (allergies, pregnancy, etc.), consider Azithromycin 500mg orally  once daily for adult patients.
Borrelia species