Borrelia Burgdorfi/Lyme's disease

Question 1

Burgdorfi is spread by?

Answer 1

Ticks

Question 2

What triggers dormant bacterium

Answer 2

o Mammalian blood activates the dormant bacterium

• Tick’s salivary glands inject the bacterium into host skin

Question 3

Know potential importance of plasminogen/plasmin to B. Burgdorfi

Answer 3

o B. Burgdorfi binds to plasminogen and converts it to plasmin, which is a protease.
• May help B. Burgdorfi invade host tissue

Question 4

Stage 1?

Answer 4

localized infection

Question 5

Stage 1, details

Answer 5

• Bacteria multiply at site of bite.

* Causes a lesion known as Erythema Migrans

Question 6

stage 2?

Answer 6

disseminated infection

Question 7

stage 2 details

Answer 7

• Muscle pain, skin lesions, meningitis, conjunctivitis are all caused by IL-1 and TNF alpha
• Can remain latent for 6 months to 30 years

Question 8

stage 3?

Answer 8

arthritis, effects on CNS and on Skin (acrodermititis chronica and atrophicans)

Question 9

stage 3, arthritis?

Answer 9

• Antibiotic therapy cures arthritis in some patients, in others immune response continues to be stimulated even in the absence of the bacterium

Question 10

stage 3, CNS effects

Answer 10

Memory, mood, sleep

Question 11

Skin lesions may gradually lead to what?

Answer 11

atrophy of skin: • Acrodermatitis Chronica Atrophicans

Question 12

Diagnose Lyme’s disease

Answer 12

o Lyme disease is found by testing for antibodies against the bacterium
• ELISAs and Western Blots are most reliable

Question 13

Know how Lyme’s disease is treated, including which antibiotic is not effective

Answer 13

o Pennicilin is not very effective
o Patients with arthritis: 1 or more months of doxycycline or amoxicillin
o Patients with neurologic symptoms: 3rd generation cephalosporin drugs intravenously