Lyme Botteliosis Flashcards
What is the most common tick borne disease in north America/ Eurasia ?
Lyme borreliosis
North america: burgdorferi Arthritis
Euroasia afzelii, garinii
Skin and neuro
Which type of bacteria is borrelia spp
Spirochetes
Feeding period needed for transmission of lyme
24-36h
Stage 1 of lyme
Erythema migrans
Borrelial lymphocytoma
Erythema migrans
Apparent after 7-14 days
Diameter > 5 cm
Heals without scar
Vesicle or pustule present at the center in 5%
False erythema migrans (tick bite hypersensitivity)
48h and <5 cm
Borrelial lymphocytoma
Rare
Only in europe
Bluish red nodule
On ear lobe, ear helix, nipple, scrotum, areola mamma
Occur at site of bite
Appear later and last longer than erythema migrans
Untreated may stay month to years
Treatment of early localized inf lyme disease
Duration 14-21days, 10 days for doxycycline
Doxy: 2x100 mg
Kifds : 4mg/ kg
Amox: 3x500 mg
Kids 50mg/kg
Cefuroxime axetil
2x500 mg
Kids: 30mg/kg/day
Human Granulocytic anaplasmosis
Rickettsial infection of neutrophils
Bacteria: anasplasma phagocytophilium
Vector: Ixodes
Painless bite
Symptoms of anaplasmosis
Fever!!! Headache Muscle pain Malaise Chills Nausea Cough Confusion Rash-> rare
Anaplasmosis
Most case mild and self limited 30 days even without treatment
In immunocompromised: can be fatal Difficulty breathing Hemorrhage Renal failure Neurological problems
May be transmitted through blood infusion
Diagnosis of anaplasmosis
Leukopenia
Thrombocytopenia
Elevated liver enzymes
Microscopic examination of blood smears in 1st week
(Morulae) of WBC in 20% of patients
Antibodies after 7-10 days of illness (immunofluorescence)
PCR in 1st week
Treatment of anaplasmosis
Should not be delayed
Doxycycline adult and children
Dose: adults 100 mg every 12h
Children under 45kgs : 2.2 mg/kg
Pregnant: rifampicin
7-14 days
Babesiosis etiology
Microscopic parasites that infect red blood cells Babesia microti
Transmission: Vector: ixodesscapularis 36-48h need to transmition By the nymph stage people don’t remember Other: blood transfusion delivery
Babesiosis symptoms
Incub period
On exam
1-9 weeks
Symptoms: many dont have
Flu like symptoms
On exam: fever hepatosplenomegaly jaundice
Lab hemolytic anemia
Can be severe life threatening in: asplenic Immunocompromised Kidney liver chronc disease Elder Complications: ards dic HF renal failure coma
