does anyone know the definition for acute lyme and chronic lyme? Is there a difference between the two?
Posted by momofthree (Member # 19490) on :
any one an idea?
Posted by canefan17 (Member # 22149) on :
Chronic... spread Central Nervous System/Brain
Acute... local (specific to one part of the body... easier to treat)
That's what I've learned it to mean.
Posted by dmc (Member # 5102) on :
IMO Acute-active high immune response infection
Chronic- long term infection where the high immune response has weakened but infection still doing damage
Posted by momofthree (Member # 19490) on :
thank you!
Posted by TF (Member # 14183) on :
Acute means you just got bitten by the tick. You have no constitutional symptoms except the bulls eye rash.
Burrascano gives these categories from p. 3 of his Guidelines:
acute, early disseminated, and chronic.
Then he says:
"A very important issue is the definition of ``Chronic Lyme Disease''. Based on my clinical data and the latest published information, I offer the following definition. To be said to have chronic LB, these three criteria must be present: 1. Illness present for at least one year (this is approximately when immune breakdown attains clinically significant levels). 2. Have persistent major neurologic involvement (such as encephalitis/encephalopathy, meningitis, etc.) or active arthritic manifestations (active synovitis). 3. Still have active infection with B. burgdorferi (Bb), regardless of prior antibiotic therapy (if any).
Chronic Lyme is an altogether different illness than earlier stages, mainly because of the inhibitory effect on the immune system (Bb has been demonstrated in vitro to both inhibit and kill B- and T-cells, and will decrease the count of the CD-57 subset of the natural killer cells). As a result, not only is the infection with Bb perpetuated and allowed to advance, but the entire issue of co-infections arises. Ticks may contain and transmit to the host a multitude of potential pathogens. The clinical presentation of Lyme therefore reflects which pathogens are present and in what proportion. Apparently, in early infections, before extensive damage to the immune system has occurred, if the germ load of the co-infectors is low, and the Lyme is treated, many of the other ticktransmitted microbes can be contained and eliminated by the immune system. However, in the chronic patient, because of the inhibited defenses, the individual components of the co-infection are now active enough so that they too add to features of the illness and must be treated. In addition, many latent infections which may have pre-dated the tick bite, for example herpes viruses, can reactivate, thus adding to the illness." [end of quote]
Then, from p. 19"
"EARLY LOCALIZED - Single erythema migrans with no constitutional symptoms: 1) Adults: oral therapy- must continue until symptom and sign free for at least one month, with a 6 week minimum. 2) Pregnancy: 1st and 2nd trimesters: I.V. X 30 days then oral X 6 weeks 3rd trimester: Oral therapy X 6+ weeks as above. Any trimester- test for Babesia and Ehrlichia 3) Children: oral therapy for 6+ weeks.
DISSEMINATED DISEASE - Multiple lesions, constitutional symptoms, lymphadenopathy, or any other manifestations of dissemination.
EARLY DISSEMINATED: Milder symptoms present for less than one year and not complicated by immune deficiency or prior steroid treatment: 1) Adults: oral therapy until no active disease for 4 to 8 weeks (4-6 months typical) 2) Pregnancy: As in localized disease, but treat throughout pregnancy. 3) Children: Oral therapy with duration based upon clinical response.
LATE DISSEMINATED: present greater than one year, more severely ill patients, and those with prior significant steroid therapy or any other cause of impaired immunity: 1) Adults and pregnancy: extended I.V. therapy (14 or more weeks), then oral or IM, if effective, to same endpoint. Combination therapy with at least two dissimilar antibiotics almost always needed. 2) Children: IV therapy for 6 or more weeks, then oral or IM follow up as above. Combination therapy usually needed.
CHRONIC LYME DISEASE (PERSISTENT/RECURRENT INFECTION) By definition, this category consists of patients with active infection, of a more prolonged duration, who are more likely have higher spirochete loads, weaker defense mechanisms, possibly more virulent or resistant strains, and probably are significantly co-infected." [end of quote--p.19]