Day 11 - Ms2

Question 1

Lyme disease p/w & clinical course

Answer 1

Early, localized disease (80%): w/i mo of onset, erythema chronicum migrans; Early disseminated disease: weeks to mo after bite, meningitis, unilateral or b/l CN palsies (especially CN VII bell’s palsy), radiculopathy, peripheral neuropathy, carditis; Late: mo to yr after onset, arthritis (especially knee), subacute encephalitis

Question 2

Tx Lyme disease

Answer 2

Early disease: Doxycycline over 10 days (v. 7 days - RMSF), Amoxicillin, or Cefuroxime ; Late disease: Ceftriaxone for 2 wks to 1 mo.