Infestations Flashcards
What are the management options for insect bites?
Prevention with repellents
Topical steroids + antihistamines
Which organism causes lyme disease?
Borrelia Burgdorferi
What is the first stage of lyme disease and when does it start?
Erythema chronicum migrans
About 14 days post tick bite
What are the clinical features of erythema chronicum migrans?
Solitary macule or ring shaped lesion –> can be quite large
+/- mild systemic symptoms
What is the second stage of lyme disease and when does it start?
Borrelia lymphocytoma
About 6 months post bite
What are the clinical features of borrelia lymphocytoma/
Firm blueish red swelling --> earlobe in children, nipple in adults Tender, local lymphadenopathy Numbness/arthralgia/myalgia Facial paralysis Meningitis Arrhythmia
What is the third stage of lyme disease and when does it start?
Acrodermatitis Chronica Atrophicans
1-8 years after initial infection
What are the clinical features of Acrodermatitis Chronica Atrophicans?
Blue/red discolouration on hands --> atrophy of hands Can effect any system e.g. - arthritis - neuro problems - chronic pain
How is lyme disease diagnosed?
Clinical –> rash is diagnostic
Serology not usually required for confirmation
What is the treatment for lyme disease?
If mild –> oral doxycycline, amoxicillin or cefuroxime
If severe –> IV penicillin or ceftriaxone
Antibiotics for 2-3 weeks
Which reaction can occur on initiation of antibiotics for lyme disease?
Jarisch Herxheimer reaction in first 24 hours
Killed organisms release endotoxin
–> fever, malaise, headache
Occurs in 15% of cases
What are the clinical features of scabies?
Extreme itch
Burrows –> mite is a small black dot at the end of the burrow
Fingers, web spaces, flexor wrists, nipples, genitals, feet in infants
How is scabies diagnosed?
Can extract mite from burrow with a needle
Skin scrapings + potassium hydroxide –> microscopy
What is the treatment for scabies?
Permethrin cream head to toe for 8 hours
- do this twice, one week apart
Treat all contacts once
How long does the itch take to settle in scabies?
May take up to 4 weeks after treatment, doesn’t mean treatment hasn’t worked
