{"id":21307,"date":"2022-03-24T05:03:00","date_gmt":"2022-03-23T21:03:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21307"},"modified":"2022-03-24T06:03:12","modified_gmt":"2022-03-23T22:03:12","slug":"jama%e4%b8%b4%e5%ba%8a%e6%8c%87%e5%8d%97%e7%b2%be%e8%a6%81%ef%bc%9a%e8%8e%b1%e5%a7%86%e7%97%85%e7%9a%84%e8%af%8a%e6%96%ad","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21307","title":{"rendered":"[JAMA\u4e34\u5e8a\u6307\u5357\u7cbe\u8981]\uff1a\u83b1\u59c6\u75c5\u7684\u8bca\u65ad"},"content":{"rendered":"\n<p>JAMA Clinical Guidelines Synopsis&nbsp;February&nbsp;15,&nbsp;2022<\/p>\n\n\n\n<h1 class=\"wp-block-heading\" id=\"diagnosis-of-lyme-disease\">Diagnosis of Lyme Disease<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"david-pitrak-cynthia-t-nguyen-adam-s-cifu-et-aljama-2022-327-7-676-677-doi-10-1001-jama-2022-0081\">David\u00a0Pitrak,\u00a0Cynthia T.\u00a0Nguyen,\u00a0Adam S.\u00a0Cifu,\u00a0et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"david-pitrak-cynthia-t-nguyen-adam-s-cifu-et-aljama-2022-327-7-676-677-doi-10-1001-jama-2022-0081\"><em>JAMA.\u00a0<\/em>2022;327(7):676-677. doi:10.1001\/jama.2022.0081<\/h3>\n\n\n\n<p><strong>Guideline title<\/strong>&nbsp;Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease<\/p>\n\n\n\n<p><strong>Developers and funding source<\/strong>&nbsp;IDSA, AAN, and ACR<\/p>\n\n\n\n<p><strong>Release date<\/strong>&nbsp;November 30, 2020<\/p>\n\n\n\n<p><strong>Prior version<\/strong>&nbsp;2010<\/p>\n\n\n\n<p><strong>Target population<\/strong>&nbsp;Adults and children with suspected Lyme disease<\/p>\n\n\n\n<p><strong>Major recommendations<\/strong><\/p>\n\n\n\n<ul><li>Asymptomatic patients should not be tested for\u00a0<em>Borrelia burgdorferi<\/em>\u00a0after a tick bite (strong recommendation; moderate quality of evidence [QOE]).<\/li><li>In patients with early disease with 1 or more skin lesions typical of erythema migrans, no laboratory testing is necessary (strong recommendation; moderate QOE). If the lesion(s) are atypical, careful follow-up with acute serological testing for antibodies at presentation and convalescent testing at least 2 to 3 weeks later is indicated (weak recommendation; low QOE).<\/li><li>When evaluating for possible Lyme neuroborreliosis, serum antibody testing is recommended instead of polymerase chain reaction (PCR) or culture of cerebrospinal fluid (CSF) or serum (strong recommendation; moderate QOE). If CSF testing is done, simultaneous antibody testing of CSF and serum should be done to determine the CSF:serum antibody index (strong recommendation; moderate QOE).<\/li><li>Routine testing for Lyme disease is not recommended for patients with known neurologic conditions, cognitive decline, dementia, or psychiatric, behavioral, or developmental disorders (strong recommendation; low QOE).<\/li><li>At-risk patients with acute myocarditis\/pericarditis of unknown cause should have serum antibody testing (strong recommendation; low QOE).<\/li><li>Serum antibody testing is recommended for possible Lyme arthritis (strong recommendation; moderate QOE).<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.jamanetwork.com\/ama\/content_public\/journal\/jama\/938862\/m_jgs220001t1_1644783403.9791.png?Expires=1647986349&amp;Signature=ZiPdBoTQs5oX~ISVPu5w2HhubXXVVdqm2JBOKCY21ywhrKDFenOpXHEae1Jel9vpxb8bVfHCIjo7ZsF--MwXhdkBWqv6lpifS0AiPKW-HnkEzsE0gO949EHNf6viHgQ2DrIQWwDoxgDrm85vMdp65TAjmQcjrgDfLRvPA-V4YxIGt6XQaLyc6GNhr6wuMrlm7NOQ1-dr1AFO67Sgg6yc8Faop2ygbnAPKEh7-QiI7djxc0XXATrutVs0Hl~KAd8I3FGag67260rUuFNiWf64wPeX6kezM56nGr1gyCKYbwafXH3Sr-u7GDMCd4Dqo962aAc0aJQz7JFWXzP-3n0lag__&amp;Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\" alt=\"\"\/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>JAMA Clinical Guidelines Synopsis&nbsp;February&nbsp;15 [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[25,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21307"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21307"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21307\/revisions"}],"predecessor-version":[{"id":21308,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21307\/revisions\/21308"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21307"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21307"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21307"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}