Diagnosis of Lyme Disease

While there have been very few documented cases of Lyme disease in Oklahoma, diagnostic testing is often considered. This is a concise summary of the evidence regarding diagnostic tests for Lyme disease and how and when to use or not use them. James W. Mold, MD, MPH

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Lyme disease is the most common tick-borne illness in the US, occurring predominantly in the Northeast, the upper Midwest, and Northern California, with increasing incidence and geographic range.1 Lyme disease can cause a skin lesion at the site of the initial tick bite as well as disseminated disease, including neuropathy, meningitis, acute myocarditis/pericarditis (often with associated conduction abnormalities), and arthritis. Accurate diagnosis is the first step in the optimal management of Lyme disease.

Author/s:

Pitrak, D, Nguyen, C. T., Cifu, A. S.

Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement

Saige Blanchard — Thu, 16 Sep 2021 05:00:00 +0000

Date Added:

September 16, 2021

Journal/Publication:

Journal of the American Medical Association

Publisher:

Journal of the American Medical Association

Publication Date:

September 14, 2021

Issue:

Volume:

326

Pages:

949-956

URL:

Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2021.14081

Keywords

Chlamydia

gonorrhea

Recommendation Statement

Sexually Transmitted Infection

Young Adults

PMID (1):

34519796

MeSH

adolescent

gonorrhea

Urethritis

Pelvic Inflammatory Disease

Updated recommendations regarding routine screening for Chlamydia and Gonorrhea in women. James W. Mold, MD, MPH

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Importance: Chlamydia and gonorrhea are among the most common sexually transmitted infections in the US. Infection rates are highest among adolescents and young adults of both sexes. Chlamydial and gonococcal infections in women are usually asymptomatic and may lead to pelvic inflammatory disease and its associated complications. Newborns of pregnant persons with untreated infection may develop neonatal chlamydial pneumonia or gonococcal or chlamydial ophthalmia. Infection in men may lead to urethritis and epididymitis. Both types of infection can increase risk of acquiring or transmitting HIV.

Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for chlamydia and gonorrhea in sexually active adolescents and adults, including pregnant persons.

Population: Asymptomatic, sexually active adolescents and adults, including pregnant persons.

Evidence assessment: The USPSTF concludes with moderate certainty that screening for chlamydia in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection has moderate net benefit. The USPSTF concludes with moderate certainty that screening for gonorrhea in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection has moderate net benefit. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men.

Recommendation: The USPSTF recommends screening for chlamydia in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection. (B recommendation) The USPSTF recommends screening for gonorrhea in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men. (I statement).

Author/s:

M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Krist, A. H., Kubik, Li, L., Ogedegbe, G., Pbert, Silverstein, Simon, M. A., Stevermer, J., Tseng, C., Wong, J. B.