ID-Ticks Flashcards
Name of the bacteria that causes Lyme disease? What kind of tick causes it?
Borrelia burgdorferi
Ixodes or black legged tick
What tick diseases does the Ixodes tick transmit?
Lyme Disease
Anaplasmosis
Babesiosis
*coinfection may occur!
If erythema migrans is present, do you need other diagnostic testing?
No! Go ahead and treat
If erythema migrans is present, what do you treat with?
This suggests a localized infection with an inoculation that occurred 1-4 weeks ago. Treat with doxycycline, amoxicillin, or cefuroxime
How is early disseminated lyme disease diagnosed? What are the clinical features? What is the timing?
Timing: weeks to months
S/S: multiple erythema migrans, fever, headache, myalgias, heart block, myocarditis, cranial nerve palsies, meningitis
Testing: Serologic
Treatment: Doxycycline, amoxicillin or cefuroxime, if a patient is pregnant… DON’T USE DOXY! If a patient has other neurological manifestations outside of cranial nerve palsy use ceftriaxone or IV penicillin G
How is early disseminated lyme disease diagnosed? What are the clinical features? What is the timing?
Onset: Months to years
S/S: Oligoarticular arthritis, encephalopathy or encephalomyelitis
Testing: Serologic, PCR of synovium or synovial fluid
Treatment: If just arthritis, then use doxycycline or amoxicillin, but if recurrent or with neurological changes described above, then use ceftriaxone or IV penicillin G
What are the cardiac manifestations of Lyme Disease? Treatment?
1st degree through 3rd degree heart block
The higher the degree of heart block the more likely one will need IV (if 1st degree, oral doxy okay… if 3rd degree IV doxy ceftriaxone or penicillin G)
Pacemaker not indicated because the heartblock is reversible
Describe the serologic testing for Lyme Disease
- Screen with an ELISA test (sensitive, screening test)
- If ELISA test is positive or Equivocal confirm with a western blot test
- If negative, consider alternative diagnosis
- If IgM or IgG are positive, suggests that there is either a current or past infection
If the initial ELISA Is negative and suspicion is still high bc of clinical symptoms, consider retesting ELISA on a convalescent sample
What cells are infected in babesiosis?
Erythrocytes!
What bacteria causes babesiosis?
Babesia microti
Clinical signs of babesiosis
Myalgias, headache, fatigue, splenomegaly, hepatomegaly, jaundice
What are risk factors for higher parasite burden?
Asplenia
Older age
Immunocompromised
In babesiosis what are some clinical features of severe disease?
Acute respiratory failure DIC kidney injury splenic rupture hemolytic anemia (anemia, elevated retic, decreased haptoglobin)
What does babesiosis look like under the microscope?
Ring form trophozoites inside erythrocytes
OR
maltese cross
Use Giemsa or Wright stain
How to diagnose babesiosis
Observe on microscope
PCR
serology not recommended
