Erythema migrans

Question 1

What is the vector that trasmisses lyme disease (which tick, and what organism)?

Answer 1

Ixodes tick

spirochete=borrelia burgdorferi

Question 2

How long does tick need to be attached to transmit lyme?

Answer 2

at least one day, more often > 48 hours

Question 3

How long after tick detachment does erythema migrans occur?

Answer 3

1-2 weeks

Question 4

What are the symptoms of:

• Early localized lyme
• early disseminated disease
• chronic disease

Answer 4

Early: flu like symptoms and LAD

early disseminated: Bell’s palsy, arthralgias, AV block, iritis

Chronic: arthritis, encephalopathy, acrodermatitis chronica atrophicans (chronic sclerosing dermatitis)

Question 5

Treatment for lyme? What if pregnant or < 8 y/o?

Answer 5

Doxycycline 100mg bid x 2 weeks

• if pregnant or < 8 then amoxicillin

Question 6

When does peak IgM response for Lyme occur?

Answer 6

3-6 weeks into infection