"Hassett and colleagues reported that rates of psychiatric comorbidity and other psychological factors (eg, depression, anxiety, tendency to catastrophize pain) were higher in patients with “chronic Lyme disease” ... than in other patients commonly seen in Lyme disease referral centers, and that those factors were related to poor functional outcomes.”
"With any regimen, neurologic symptoms may take 6 months to reach maximum improvement."
"Response to treatment is usually slow and may be incomplete. Retreatment is not recommended unless relapse is shown by reliable objective measures."
"Conjunctivitis and photophobia in stage 1 Lyme disease require no therapy. Bell palsy in stage 2 Lyme disease is self-limited, but patients require supportive therapy to prevent the complications of exposure keratitis.”
"The best approach for these patients might be a trial of antibiotic therapy, in which patients receive 2-3 weeks of intravenous penicillin or ceftriaxone. If patients respond to treatment, the trial is successful, ocular Lyme disease is diagnosed, and no further therapy is needed. Recurrences of Lyme uveitis, once adequate intravenous therapy has been given, can be treated with judicious corticosteroids.”
"Penicillins provide effective treatment of Lyme disease.”
"Despite appropriate antibiotic treatment, patients with Lyme disease may experience lingering symptoms similar to fibromyalgia (eg, fatigue, pain, joint and muscle aches). This condition has been termed chronic Lyme disease or, more precisely, post-treatment Lyme disease syndrome (PTLDS).  These symptoms have not been shown in any controlled trials to be responsive to antibiotic therapy.”
"Acrodermatitis chronica atrophicans is usually treated with 1-month course of oral antibiotics, usually a beta-lactam or doxycycline. One study showed fewer relapses with 30 days compared with 20 or fewer days of therapy. In the same study, 30 days of oral antibiotics were more effective than 15 days of intravenous ceftriaxone (2 g/d).  It is important to ensure that no neurologic manifestations are present before embarking on oral therapy.”
"Co-transmitted infective organisms can include the following:
"Transmission of infection is unlikely if the duration of tick attachment is less than 24 hours, but is very likely for ticks attached for longer than 72 hours."
"The use of forceps and gloves represents an optimal method of removal. However, removal of the tick should not be delayed in order to obtain forceps and it is extremely unlikely that one can become infected by touching an engorged tick even if the tick is carrying Borrelia (which most of them are not, even in endemic areas).”
"Routine prophylaxis after a recognized tick bite is not recommended.”
"Consultation with a neurologist is recommended in patients with persistent or chronic manifestations of Lyme disease, such as chronic fatigue syndrome.”
"In early Lyme disease, lack of prompt resolution should lead the physician to question the original diagnosis.”
"Cefuroxime is a second-generation cephalosporin that is the only drug approved by the Food and Drug Administration (FDA) for use in Lyme disease. Cefuroxime is approved for use in adults. Its principal limitation is its expense."
John Meyerhoff- Maryland Rheumatologist
Quote- “We often have patients sent to us because their doctors are concerned they may have serious diseases, which I get to tell them they don’t have.”
Meyerhoff- 2 minute video
Co-editor, Gerald Zaidman- NY Medical College- Ophthalmology Department
It appears (??) Zaidman had the same study published on ocular manifestations of Lyme disease 4 years apart. [Gregory Glass at Johns Hopkins was doing similar studies over and over again, basically because for a long time there was no oversight. That fact was eventually brought to the attention of those controlling the State’s budget and it appears he has not published on Lyme since, but instead is listed on a number of rat studies, many from outside the USA.]
More from Meyerhoff
"Unfortunately, this study may not convince proponents of long-term therapy who believe post–Lyme-disease symptoms may represent concurrent symptoms of ehrlichiosis and babesiosis (8), both of which should be treated with antibiotics. … For patients with post–Lyme-disease symptoms, the best recommendation is referral to a rheumatologist or infectious-disease specialist knowledgeable about Lyme disease and experienced in fibromyalgia.”