Varied Signs of Lyme

Varied Signs of Lyme Disease

Our Interest in Lyme Disease

Our practice is located in the heart of Lyme territory. Hundreds of cases of Lyme and associated tick-borne diseases occur annually in our region, including Northampton, Lehigh, Bucks, and Monroe Counties in Pennsylvania.Adjacent Warren and Hunterdon Counties in New Jersey have some of the highest rates of Lyme disease in the United States. Lyme cases surge from Memorial Day thru early August. The peak appearance of Lyme rashes, meningitis, and flu-like illness occurs around July 4th weekend in our area. Later in the year, complications of untreated infections acquired during the summer begin to occur, including arthritis, brain infections and disorders of the heart.

Dr. Kozinn began study of these disorders more than 25 years ago, when the disease was first defined. It is a complex disease! It humbles physicians because of its subtlety, varied signs and symptoms, difficulty in diagnosis and treatment.

It takes an experienced and knowledgeable physician to evaluate and treat patients who presenting with symptoms suggesting Lyme. Blood tests are helpful in diagnosis, but ultimately, management decisions are often made on the basis of clinical diagnosis. In addition, physicians must be able to counsel patients in a clear and understandable fashion.

Our patients can expect that they will be listened to; that they will receive a thorough examination and review of their history and laboratory work. They will be evaluated, as appropriate, for Lyme disease, associated tick borne diseases, as well as conditions which may simulate Lyme. If we do not feel Lyme is the problem we will make a diligent effort to diagnose and treat other conditions. Supportive care may include pain management, nutritional support, cognitive behavior therapy, and the use of selected natural remedies.

In general, we find that oral antibiotics are highly effective for treatment of Lyme disease. Intravenous treatment is reserved for patients with central nervous system infections, poorly responsive Lyme arthritis, heart infection and complicated cases. Treatment duration is usually 1-2 months orally; however we evaluate each case with an open mind.

Patients seeking open ended intravenous antibiotics, “pulse therapy”, “sandwiched” or “sequential” antibiotics and open ended treatment for babesiosis or bartonellosis should consider that such costly treatments often confer far more risk than benefit. As physicians, our first duty to the patient is to “do no harm.” Complications of even brief courses of antibiotics can be quite serious, including antibiotic (Clostridium difficile) diarrhea, PICC line infections, blood clots, rashes, yeast infections, and immune imbalance from killing off normal body bacteria. We urge patients to thoughtfully and keenly evaluate their health care provider. Be wary if it seems to you that the treatment you are receiving might be more for the practitioner’s benefit than for your well being.

We enjoy caring for patients with Lyme disease. Almost all patients with early Lyme disease are curable with safe treatment and supportive care. Yet there are challenges and uncertainties, mostly with respect to persistent symptoms comprising the “chronic Lyme complex”. We will continue our study of Lyme to bring our patients the most up to date information and treatment approaches. In addition we are continuing to educate health professionals in our area about Lyme disease through our pubic lectures, professional seminars, resident teaching, and consultation work.

Prevention remains problematic because persons living in Lyme territory can be repeatedly infected unknowingly. We hope that the development of a new, thoroughly tested vaccine and assuredly safe vaccine may play an important role in the control of Lyme disease in the future.

Wesley P. Kozinn, M.D., F.A.C.P.
President, Valley Infectious Disease Specialists, Ltd.