22 - Lyme Disease Flashcards
Lime disease overview?
Infection - spirochete
- borrelia burgdorferi
- Ixodes ticks (deer ticks)
Common locations of lyme disease?
Maryland to maine
Wisconsonsin and minnesota
Some - N california
How long does the tick need to be attached?
2-3 days
Pathophys of lime disease?
Tick feeds
- bacteria multiply in gut of tiick
- migrate to salavary glands
- inject bacteria into the victim
Times of lime disease infection?
Nymph stage - 85% of tome
- spring - summer
Adult stage - 15%
- fall
False positive for lyme disease?
False pos or asymptomatic infection
5-10% of pts in endemic pts are positive w no hx of symptoms
After initial bacterial invasion 3 things can happen?
- Clear the infection
- no manifestations - B burgdorferi spreads -> the body
- symptoms by direct invasion
- evidence of bacterial infection - Induces an immune response
- little evidence of bacterial invasion
Stages of lyme disease?
3 stages Early - localized - Disseminated Late - persistent
Persistent lyme disease is considered?
Late infection
- w/in 1 yr of infection
Early/localized s/s of lyme?
7-14 days of bite
- erythema migrans (EM)
- fever
- chills
- myalgias
- arthralgias
- tender adenopathy
Describe the erythemia migrans (EM) rash
2/3 of pts get it
- confluent patch of erythema
- may have central clearing
- typically expands over days
S/s of late disease?
Weeks to months later
- arthritis (differentiate arthritis from arthralgia)
Usually no hx of EM
Hallmark of late lyme disease?
Arthritis
- usually large joints
- knee 90%
- rarely destructive disease
Progression of the lyme arthritis?
Begins as a migratory polyarticular process
Evolves over 1-2 days
- monoarticular process
- knee-> ankle -> wrist
2/3 of patients
- 1st episode w/in 6 o of EM
- last approx 1 week
- become less freq and sever
- resolve over 10 yr period
Chronic manifestations of lime?
Arthritis
Possible association
- meningoencephalitis
(Mood, memory, sleep)
- fibromyalgia and chronic fatigue
- chronic neuropathy
(Paresthesias, radicular pain)
