Case 3

Question 1

A 46-year-old patient K. visited an internal medicine physician with complaints of a rise in body temperature up to 37.5 °С, moderate headache, and malaise. In the neck area, there was a focus of hyperemia (size 75 cm) with well-defined contours; it was hot to the touch and moderately tender. Enlarged regional lymph nodes were palpable. Epidemiological history data: 6 days ago, a tick attached to the patient’s neck; the duration of tick attachment was several hours. The patient removed the tick himself. The patient did not take the tick for tick-borne disease testing (tick-borne encephalitis and Lyme disease). Task 1. Make a clinical diagnosis and justify it..

Answer 1

acute ixodic tick-borne borreliosis, erythematous form, moderate severity

Clinical diagnosis: Lyme borreliosis with erythema migrans. The patient’s symptoms, along with the history of tick bite and the presence of a characteristic erythematous lesion with central clearing, are consistent with early-stage Lyme borreliosis.

Question 2

Make a plan of specific tests.

Answer 2

Plan of specific tests: The patient should be tested for Lyme borreliosis using serological tests, such as enzyme-linked immunosorbent assay (ELISA) and Western blot. The tests should be performed on both acute and convalescent serum samples.

Question 3

What would be the treatment strategy in this case

Answer 3

Plan of specific tests: The patient should be tested for Lyme borreliosis using serological tests, such as enzyme-linked immunosorbent assay (ELISA) and Western blot. The tests should be performed on both acute and convalescent serum samples.

Question 4

What are the possible outcomes of the infection in patients with this disease?

Answer 4

Treatment strategy: The patient should be treated with antibiotics, such as doxycycline, amoxicillin, or cefuroxime, for 2-4 weeks. Symptomatic treatment for headache and malaise may also be provided. If the patient experiences neurological symptoms, intravenous antibiotics may be necessary.

Question 5

What are the possible outcomes of the infection in patients with this disease

Answer 5

. Possible outcomes: If left untreated, Lyme borreliosis can progress to later stages, which may involve the joints, heart, or nervous system. However, early treatment with antibiotics is usually effective in preventing the progression of the disease. In rare cases, patients may develop post-treatment Lyme disease syndrome, which involves persistent symptoms such as fatigue, joint pain, and cognitive difficulties.