Sandbox ID Central Nervous System: Difference between revisions
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:* Bacteria | :* Bacteria | ||
::* Anaplasma phagocytophilum (human granulocytotrophic ehrlichiosis) | ::* [[Anaplasma phagocytophilum]] ([[human granulocytotrophic ehrlichiosis]]) | ||
:::* Preferred regimen: [[Doxycycline]] | :::* Preferred regimen: [[Doxycycline]] | ||
::* Bartonella bacilliformis (Oroya fever) | ::* [[Bartonella bacilliformis]] ([[Oroya fever]]) | ||
:::* Preferred regimen: [[Chloramphenicol]] {{or}} [[Ciprofloxacin]]] {{or}} [[Doxycycline]] {{or}} [[Ampicillin]] {{or}} [[trimethoprim-sulfamethoxazole]] | :::* Preferred regimen: [[Chloramphenicol]] {{or}} [[Ciprofloxacin]]] {{or}} [[Doxycycline]] {{or}} [[Ampicillin]] {{or}} [[trimethoprim-sulfamethoxazole]] | ||
::* Bartonella henselae (Cat scratch disease) | ::* [[Bartonella henselae]] ([[Cat scratch disease]]) | ||
:::* Preferred regimen: [[Doxycycline]] {{or}} [[Azithromycin]] {{withorwithout}} [[Rifampin]] | :::* Preferred regimen: [[Doxycycline]] {{or}} [[Azithromycin]] {{withorwithout}} [[Rifampin]] | ||
::* Borrelia burgdorferi (Lyme disease) | ::* [[Borrelia burgdorferi]] ([[Lyme disease]]) | ||
:::* preferred regimen: [[Ceftriaxone]] {{or}} [[Cefotaxime]] {{or}} [[Penicillin G]] | :::* preferred regimen: [[Ceftriaxone]] {{or}} [[Cefotaxime]] {{or}} [[Penicillin G]] | ||
::* Coxiella burnetii (Q fever) | ::* [[Coxiella burnetii]] ([[Q fever]]) | ||
:::* Preferred regimen: [[Doxycycline]] {{and}} [[Fluoroquinolone]] {{and}} [[Rifampin]] | :::* Preferred regimen: [[Doxycycline]] {{and}} [[Fluoroquinolone]] {{and}} [[Rifampin]] | ||
::* Ehrlichia chaffeensis (human monocytotrophic ehrlichiosis) | ::* [[Ehrlichia chaffeensis]] ([[human monocytotrophic ehrlichiosis]]) | ||
:::* Preferred regimen: [[Doxycycline]] | :::* Preferred regimen: [[Doxycycline]] | ||
::* Listeria monocytogenes | ::* [[Listeria monocytogenes]] | ||
:::* Preferred regimen: [[Ampicillin]] {{or}} [[Trimethoprim-sulfamethoxazole]] {{and}} [[Gentamicin]] | :::* Preferred regimen: [[Ampicillin]] {{or}} [[Trimethoprim-sulfamethoxazole]] {{and}} [[Gentamicin]] | ||
::* Mycobacterium tuberculosis | ::* [[Mycobacterium tuberculosis]] | ||
:::'''with meningitis''' | :::'''with meningitis''' | ||
:::* Preferred regimen: [[Dexamethasone]] | :::* Preferred regimen: [[Dexamethasone]] | ||
:::'''without meningitis''' | :::'''without meningitis''' | ||
:::* Preferred regimen: [[Isoniazid]] {{or}} [[Rifampin]] {{or}} [[Pyrazinamide]] {{or}} [[Ethambutol]] | :::* Preferred regimen: [[Isoniazid]] {{or}} [[Rifampin]] {{or}} [[Pyrazinamide]] {{or}} [[Ethambutol]] | ||
::* Mycoplasma pneumoniae | ::* [[Mycoplasma pneumoniae]] | ||
:::* Preferred regimen: [[Azithromycin]] {{or}} [[Doxycycline]] {{or}} [[Fluoroquinolone]] | :::* Preferred regimen: [[Azithromycin]] {{or}} [[Doxycycline]] {{or}} [[Fluoroquinolone]] | ||
::* Rickettsia rickettsii (Rocky Mountain spotted fever) | ::* [[Rickettsia rickettsii]] ([[Rocky Mountain spotted fever]]) | ||
:::* Preferred regimen: [[Doxycycline]] | :::* Preferred regimen: [[Doxycycline]] | ||
:::* Alternative regimen: [[Chloramphenicol]] | :::* Alternative regimen: [[Chloramphenicol]] | ||
::* Treponema pallidum (syphilis) | ::* [[Treponema pallidum]] ([[syphilis]]) | ||
:::* preferred regimen: [[Ceftriaxone]] {{or}} [[Penicillin G]] | :::* preferred regimen: [[Ceftriaxone]] {{or}} [[Penicillin G]] | ||
::* Tropheryma whipplei (Whipple's disease) | ::* [[Tropheryma whipplei]] ([[Whipple's disease]]) | ||
:::* Preferred regimen: [[Ceftriaxone]] for 2–4 weeks, followed by [[Trimethoprim-sulfamethoxazole]] {{or}} [[Cefixime]] for 1–2 years | :::* Preferred regimen: [[Ceftriaxone]] for 2–4 weeks, followed by [[Trimethoprim-sulfamethoxazole]] {{or}} [[Cefixime]] for 1–2 years | ||
:* Fungi | :* Fungi | ||
::* Coccidioides | ::* [[Coccidioides]] | ||
:::* Preferred regimen: [[Fluconazole]] | :::* Preferred regimen: [[Fluconazole]] | ||
:::* Alternative regimen: [[Itraconazole]] {{or}} [[Voriconazole]] {{or}} [[Amphotericin B]] (intravenous and intrathecal) | :::* Alternative regimen: [[Itraconazole]] {{or}} [[Voriconazole]] {{or}} [[Amphotericin B]] (intravenous and intrathecal) | ||
::* Cryptococcus neoformans | ::* [[Cryptococcus neoformans]] | ||
:::* Preferred regimen: [[Amphotericin B]] [[deoxycholate]] {{and}} [[flucytosine]] for 2 weeks, followed by [[fluconazole]] for 8 weeks {{or}}v Lipid formulation of amphotericin B {{and}} flucytosine for 2 weeks, followed by fluconazole for 8 weeks {{or}} Amphotericin B {{and}} flucytosine for 6–10 weeks | :::* Preferred regimen: [[Amphotericin B]] [[deoxycholate]] {{and}} [[flucytosine]] for 2 weeks, followed by [[fluconazole]] for 8 weeks {{or}}v Lipid formulation of amphotericin B {{and}} flucytosine for 2 weeks, followed by fluconazole for 8 weeks {{or}} Amphotericin B {{and}} flucytosine for 6–10 weeks | ||
::* Histoplasma capsulatum | ::* [[Histoplasma capsulatum]] | ||
:::* Preferred regimen: Liposomal amphotericin B for 4–6 weeks, followed by itraconazole for at least 1 year and until resolution of CSF abnormalities | :::* Preferred regimen: Liposomal amphotericin B for 4–6 weeks, followed by itraconazole for at least 1 year and until resolution of CSF abnormalities | ||
:* Protozoa | :* Protozoa | ||
::* Acanthamoeba | ::* [[Acanthamoeba]] | ||
:::* Preferred regimen: Trimethoprim-sulfamethoxazole {{and}} [[rifampin]] {{and}} [[ketoconazole]] {{or}} [[Fluconazole]] {{and}} [[sulfadiazine]] {{and}} [[pyrimethamine]] | :::* Preferred regimen: Trimethoprim-sulfamethoxazole {{and}} [[rifampin]] {{and}} [[ketoconazole]] {{or}} [[Fluconazole]] {{and}} [[sulfadiazine]] {{and}} [[pyrimethamine]] | ||
::* Balamuthia mandrillaris | ::* [[Balamuthia mandrillaris]] | ||
:::* Preferred regimen: [[Azithromycin]] {{or}} [[Clarithromycin]] {{and}} [[pentamidine]] {{and}} [[flucytosine]] {{and}} [[fluconazole]] {{and}} [[sulfadiazine]] {{and}} [[thioridazine]] {{or}} [[trifluoperazine]] | :::* Preferred regimen: [[Azithromycin]] {{or}} [[Clarithromycin]] {{and}} [[pentamidine]] {{and}} [[flucytosine]] {{and}} [[fluconazole]] {{and}} [[sulfadiazine]] {{and}} [[thioridazine]] {{or}} [[trifluoperazine]] | ||
::* Naegleria fowleri | ::* [[Naegleria fowleri]] | ||
:::* Preferred regimen: Amphotericin B (intravenous and intrathecal) {{and}} rifampin {{and}} [[azithromycin]] {{or}} [[sulfisoxazole]] {{or}} [[miconazole]] | :::* Preferred regimen: Amphotericin B (intravenous and intrathecal) {{and}} rifampin {{and}} [[azithromycin]] {{or}} [[sulfisoxazole]] {{or}} [[miconazole]] | ||
::* Plasmodium falciparum | ::* [[Plasmodium falciparum]] | ||
:::* Preferred regimen: [[Quinine]] {{or}} [[quinidine]] {{or}} [[artesunate]] {{or}} [[artemether]] | :::* Preferred regimen: [[Quinine]] {{or}} [[quinidine]] {{or}} [[artesunate]] {{or}} [[artemether]] | ||
:::* Alternative regimen: Atovaquone {{or}} proguanil {{or}} Exchange transfusion (less than 10% parasitemia or cere- bral malaria) | :::* Alternative regimen: Atovaquone {{or}} proguanil {{or}} Exchange transfusion (less than 10% parasitemia or cere- bral malaria) | ||
::* Toxoplasma gondii | ::* [[Toxoplasma gondii]] | ||
:::* Preferred regimen: [[Pyrimethamine]] {{and}} [[Sulfadiazine]] {{or}} [[Clindamycin]] [[and}} [[Pyrimethamine]] | :::* Preferred regimen: [[Pyrimethamine]] {{and}} [[Sulfadiazine]] {{or}} [[Clindamycin]] [[and}} [[Pyrimethamine]] | ||
:::* Alternative regimen (1): [[Trimethoprim-sulfamethoxazole]] | :::* Alternative regimen (1): [[Trimethoprim-sulfamethoxazole]] | ||
:::* Alternative regimen (2): [[Pyrimethamine]] {{and}} [[atovaqone]] {{or}} [[Pyrimethamine]] {{and}} [[clarithromycin]] {{or}} Pyrimethamine {{and}} [[azithromycin]] {{or}} Pyrimethamine {{and}} [[dapsone]] | :::* Alternative regimen (2): [[Pyrimethamine]] {{and}} [[atovaqone]] {{or}} [[Pyrimethamine]] {{and}} [[clarithromycin]] {{or}} Pyrimethamine {{and}} [[azithromycin]] {{or}} Pyrimethamine {{and}} [[dapsone]] | ||
::* Trypanosoma brucei gambiense (West African trypanosomiasis) | ::* [[Trypanosoma brucei gambiense]] ([[West African trypanosomiasis]]) | ||
:::* Preferred regimen: [[Eflornithine]] {{or}} [[Melarsoprol]] | :::* Preferred regimen: [[Eflornithine]] {{or}} [[Melarsoprol]] | ||
::* Trypanosoma brucei rhodesiense (East African trypanosomiasis) | ::* [[Trypanosoma brucei rhodesiense]] ([[East African trypanosomiasis]]) | ||
:::* Preferred regimen: [[Melarsoprol]] | :::* Preferred regimen: [[Melarsoprol]] | ||
:* Helminths | :* Helminths | ||
::* Baylisascaris procyonis | ::* [[Baylisascaris procyonis]] | ||
:::* Preferred regimen: [[Corticosteroids]] | :::* Preferred regimen: [[Corticosteroids]] | ||
:::* Alternative regimen: [[Albendazole]] {{and}} [[diethylcarbamazine]] | :::* Alternative regimen: [[Albendazole]] {{and}} [[diethylcarbamazine]] | ||
::* Gnathostoma | ::* [[Gnathostoma]] | ||
:::* Preferred regimen: [[Albendazole]] {{or}} [[Ivermectin]] | :::* Preferred regimen: [[Albendazole]] {{or}} [[Ivermectin]] | ||
::* Taenia solium (cysticercosis) | ::* [[Taenia solium]] ([[cysticercosis]]) | ||
:::* Preferred regimen: [[Albendazole]] {{or}} [[Corticosteroids]] | :::* Preferred regimen: [[Albendazole]] {{or}} [[Corticosteroids]] | ||
:::* Alternative regimen: [[Praziquantel]] | :::* Alternative regimen: [[Praziquantel]] | ||
:* Prion | :* Prion | ||
::* Human transmissible spongiform encephalopathy | ::* [[Human transmissible spongiform encephalopathy]] | ||
:::* Preferred regimen: supportive | :::* Preferred regimen: supportive | ||
Revision as of 14:32, 28 May 2015
Lyme neuroborreliosis
- Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines[1]
- Early neurologic disease
- Cranial nerve palsy (adult)
- Preferred regimen: Amoxicillin 500 mg PO tid for 14 (14–21) days OR Doxycycline 100 mg PO bid for 14 (14–21) days OR Cefuroxime 500 mg PO bid for 14 (14–21) days.
- Alternative regimen: Azithromycin 500 mg PO qd for 7–10 days OR Clarithromycin 500 mg PO bid for 14–21 days(not for pregnant) OR Erythromycin 500 mg PO qid for 14–21 days.
- Cranial nerve palsy (pediatric)
- Preferred regimen: Amoxicillin 50 mg/kg/day PO in 3 divided doses (maximum, 500 mg per dose) for 14 (14–21) days OR Doxycycline (for children aged ≥ 8 years) 4 mg/kg/day PO in 2 divided doses (maximum, 100 mg per dose) for 14 (14–21) days OR Cefuroxime 30 mg/kg/day PO in 2 divided doses (maximum, 500 mg per dose) for 14 (14–21) days.
- Alternative regimen: Azithromycin 10 mg/kg/day PO (maximum of 500 mg per day) for 7–10 days OR Clarithromycin 7.5 mg/kg PO bid (maximum of 500 mg per dose) for 14–21 days OR Erythromycin 12.5 mg/kg PO qid (maximum of 500 mg per dose) for 14–21 days.
- Meningitis or radiculopathy (adult)
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 (10–28) days.
- Alternative regimen: Cefotaxime 2 g IV q8h for 14 (10–28) days OR Penicillin G 18–24 million U/day IV divided every 4 h for 14 (10–28) days.
- Note: For nonpregnant adult patients intolerant of β-lactam agents, Doxycycline 200–400 mg/day PO/IV in 2 divided doses may be considered.
- Meningitis or radiculopathy (pediatric)
- Preferred regimen: Ceftriaxone 50–75 mg/kg IV q24h (maximum, 2 g) for 14 (10–28) days.
- Alternative regimen: Cefotaxime 150–200 mg/kg/day IV in 3–4 divided doses (maximum, 6 g per day) for 14 (10–28) days OR Penicillin G 200,000–400,000 U/kg/day IV divided every 4 h (not to exceed 18–24 million U per day) for 14 (10–28) days.
- Note: For children ≥ 8 years of age intolerant of β-lactam agents, Doxycycline 4–8 mg/kg per day PO/IV in 2 divided doses (maximum daily dosage of 200–400 mg) may be considered.
- Late neurologic disease
- Central or peripheral nervous system disease (adult)
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 (10–28) days.
- Alternative regimen: Cefotaxime 2 g IV q8h for 14 (10–28) days OR Penicillin G 18–24 million U/day IV divided every 4 h for 14 (10–28) days.
- Central or peripheral nervous system disease (pediatric)
- Preferred regimen: Ceftriaxone 50–75 mg/kg IV q24h (maximum, 2 g) for 14 (10–28) days.
- Alternative regimen: Cefotaxime 150–200 mg/kg/day IV in 3–4 divided doses (maximum, 6 g per day) for 14 (10–28) days OR Penicillin G 200,000–400,000 U/kg/day IV divided every 4 h (not to exceed 18–24 million U per day) for 14 (10–28) days.
- American Academy of Neurology (AAN) Practice Parameter[2]
- Meningitis
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 days OR Cefotaxime 2 g IV q8h for 14 days OR Penicillin G 18–24 MU/day q4h for 14 days
- Alternative regimen: Doxycycline 100–200 mg BID for 14 days
- Pediatric dose: Ceftriaxone 50–75 mg/kg/day in 1 dose, max 2 g; Cefotaxime 150–200 mg/kg/day in 3–4 divided doses, max 6 g/day; Penicillin G 200,000–400,000 U/kg/day divided q4h, max 18–24 MU/day; Doxycycline (≥ 8 y/o) 4–8 mg/kg/day in 2 divided doses, max 200 mg/dayose
- Any neurologic syndrome with CSF pleocytosis
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 days OR Cefotaxime 2 g IV q8h for 14 days OR Penicillin G 18–24 MU/day q4h for 14 days
- Alternative regimen: Doxycycline 100–200 mg BID for 14 days
- Pediatric dose: Ceftriaxone 50–75 mg/kg/day in 1 dose, max 2 g; Cefotaxime 150–200 mg/kg/day in 3–4 divided doses, max 6 g/day; Penicillin G 200,000–400,000 U/kg/day divided q4h, max 18–24 MU/day; Doxycycline (≥ 8 y/o) 4–8 mg/kg/day in 2 divided doses, max 200 mg/dayose
- Peripheral nervous system disease (radiculopathy, diffuse neuropathy, mononeuropathy multiplex, cranial neuropathy; normal CSF)
- Preferred regimen: Doxycycline 100–200 mg BID for 14 days
- Alternative regimen: Ceftriaxone 2 g IV q24h for 14 days OR Cefotaxime 2 g IV q8h for 14 days OR Penicillin G 18–24 MU/day q4h for 14 days
- Pediatric dose: Doxycycline (≥ 8 y/o) 4–8 mg/kg/day in 2 divided doses, max 200 mg/dayose; Ceftriaxone 50–75 mg/kg/day in 1 dose, max 2 g; Cefotaxime 150–200 mg/kg/day in 3–4 divided doses, max 6 g/day; Penicillin G 200,000–400,000 U/kg/day divided q4h, max 18–24 MU/day; Doxycycline (≥ 8 y/o) 4–8 mg/kg/day in 2 divided doses, max 200 mg/dayose
- Encephalomyelitis
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 days OR Cefotaxime 2 g IV q8h for 14 days OR Penicillin G 18–24 MU/day q4h for 14 days
- Pediatric dose: Ceftriaxone 50–75 mg/kg/day in 1 dose, max 2 g; Cefotaxime 150–200 mg/kg/day in 3–4 divided doses, max 6 g/day; Penicillin G 200,000–400,000 U/kg/day divided q4h, max 18–24 MU/day
- Encephalopathy
- Preferred regimen: Ceftriaxone 2 g IV q24h for 14 days OR Cefotaxime 2 g IV q8h for 14 days OR Penicillin G 18–24 MU/day q4h for 14 days
- Pediatric dose: Ceftriaxone 50–75 mg/kg/day in 1 dose, max 2 g; Cefotaxime 150–200 mg/kg/day in 3–4 divided doses, max 6 g/day; Penicillin G 200,000–400,000 U/kg/day divided q4h, max 18–24 MU/day
- Post-treatment Lyme syndrome
- Preferred regimen: No antibiotics indicated; symptomatic management only
Encephalitis
- Viruses
-
- Preferred regimen: supportive
- prophylactic antiviral therapy after bite or scratch
- Preferred regimen: Valacyclovir
- established disease
- Preferred regimen: Valacyclovir OR Acyclovir OR Ganciclovir
- Preferred regimen: Ganciclovir AND foscarnet
- Preferred regimen: supportive
- Preferred regimen: supportive AND Corticosteroids
- Preferred regimen: supportive
- Preferred regimen: Ganciclovir OR Foscarnet
- Preferred regimen: HAART
- HSV-1 and -2
- Preferred regimen: Acyclovir
- Preferred regimen: Oseltamivir
- Preferred regimen: supportive
- Preferred regimen: supportive
- Preferred regimen: supportive
- Preferred regimen: supportive
- Preferred regimen: supportive AND Ribavirin
- Preferred regimen: supportive AND Intraventricular γ-globulin (for chronic and/or severe disease)
- Preferred regimen: supportive
- Preferred regimen: supportive
- postxposure prophylaxis
- Preferred regimen: rabies immunoglobulin AND vaccine
- after onset of disease
- Preferred regimen: supportive
- Preferred regimen: supportive
- Preferred regimen: supportive
- Alternative regimen: IFN-a-2b
- Preferred regimen: supportive
- Preferred regimen: supportive ± Corticosteroids
- Preferred regimen: supportive
- Preferred regimen: Acyclovir ± Corticosteroids
- Preferred regimen: Ganciclovir ± Corticosteroids
- Preferred regimen: supportive
- Preferred regimen: supportive
- Bacteria
-
- Preferred regimen: Doxycycline
- Preferred regimen: Chloramphenicol OR Ciprofloxacin] OR Doxycycline OR Ampicillin OR trimethoprim-sulfamethoxazole
- Preferred regimen: Doxycycline OR Azithromycin ± Rifampin
- preferred regimen: Ceftriaxone OR Cefotaxime OR Penicillin G
- Preferred regimen: Doxycycline AND Fluoroquinolone AND Rifampin
- Preferred regimen: Doxycycline
- Preferred regimen: Ampicillin OR Trimethoprim-sulfamethoxazole AND Gentamicin
- with meningitis
- Preferred regimen: Dexamethasone
- without meningitis
- Preferred regimen: Isoniazid OR Rifampin OR Pyrazinamide OR Ethambutol
- Preferred regimen: Azithromycin OR Doxycycline OR Fluoroquinolone
- Preferred regimen: Doxycycline
- Alternative regimen: Chloramphenicol
- preferred regimen: Ceftriaxone OR Penicillin G
- Preferred regimen: Ceftriaxone for 2–4 weeks, followed by Trimethoprim-sulfamethoxazole OR Cefixime for 1–2 years
- Fungi
-
- Preferred regimen: Fluconazole
- Alternative regimen: Itraconazole OR Voriconazole OR Amphotericin B (intravenous and intrathecal)
- Preferred regimen: Amphotericin B deoxycholate AND flucytosine for 2 weeks, followed by fluconazole for 8 weeks ORv Lipid formulation of amphotericin B AND flucytosine for 2 weeks, followed by fluconazole for 8 weeks OR Amphotericin B AND flucytosine for 6–10 weeks
- Preferred regimen: Liposomal amphotericin B for 4–6 weeks, followed by itraconazole for at least 1 year and until resolution of CSF abnormalities
- Protozoa
-
- Preferred regimen: Trimethoprim-sulfamethoxazole AND rifampin AND ketoconazole OR Fluconazole AND sulfadiazine AND pyrimethamine
- Preferred regimen: Azithromycin OR Clarithromycin AND pentamidine AND flucytosine AND fluconazole AND sulfadiazine AND thioridazine OR trifluoperazine
- Preferred regimen: Amphotericin B (intravenous and intrathecal) AND rifampin AND azithromycin OR sulfisoxazole OR miconazole
- Preferred regimen: Quinine OR quinidine OR artesunate OR artemether
- Alternative regimen: Atovaquone OR proguanil OR Exchange transfusion (less than 10% parasitemia or cere- bral malaria)
- Preferred regimen: Pyrimethamine AND Sulfadiazine OR Clindamycin [[and}} Pyrimethamine
- Alternative regimen (1): Trimethoprim-sulfamethoxazole
- Alternative regimen (2): Pyrimethamine AND atovaqone OR Pyrimethamine AND clarithromycin OR Pyrimethamine AND azithromycin OR Pyrimethamine AND dapsone
- Preferred regimen: Eflornithine OR Melarsoprol
- Preferred regimen: Melarsoprol
- Helminths
-
- Preferred regimen: Corticosteroids
- Alternative regimen: Albendazole AND diethylcarbamazine
- Preferred regimen: Albendazole OR Ivermectin
- Preferred regimen: Albendazole OR Corticosteroids
- Alternative regimen: Praziquantel
- Prion
-
- Preferred regimen: supportive
Epidural abscess
References
- ↑ Wormser, Gary P.; Dattwyler, Raymond J.; Shapiro, Eugene D.; Halperin, John J.; Steere, Allen C.; Klempner, Mark S.; Krause, Peter J.; Bakken, Johan S.; Strle, Franc; Stanek, Gerold; Bockenstedt, Linda; Fish, Durland; Dumler, J. Stephen; Nadelman, Robert B. (2006-11-01). "The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 43 (9): 1089–1134. doi:10.1086/508667. ISSN 1537-6591. PMID 17029130.
- ↑ Halperin, J. J.; Shapiro, E. D.; Logigian, E.; Belman, A. L.; Dotevall, L.; Wormser, G. P.; Krupp, L.; Gronseth, G.; Bever, C. T.; Quality Standards Subcommittee of the American Academy of Neurology (2007-07-03). "Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology". Neurology. 69 (1): 91–102. doi:10.1212/01.wnl.0000265517.66976.28. ISSN 1526-632X. PMID 17522387.