lyme disease

Question 1

agent

Answer 1

borrelia burgedoffi (spirochete )

Question 2

moa

Answer 2

bite from ixodes tick

Question 3

spsicif features

Answer 3

1.ECM eythema chronicum migrans at the sire of inoculation
2. lympocytoma - a solitary bluish red nodule or papule in children mostly on earlobe and adults nipple

Question 4

where does the disease typically spread to

Answer 4

heart + joints

Question 5

rf

Answer 5

visiting the wood

Question 6

stages

Answer 6

stage 1:
non specific signs
EM- non pruritic and expands begins as a small papule clears and expand
can also have panniculitis
lymphocytoma
transient alopecia
hypersensitivity to tick antigen can occur in some people - hives

stage 2 - early disseminated
cns- meningitis encephalitis, cn palsies
+ cardiac involvement - av blocks, carditis (which usually presnets as heart block
lesions resemble stage 1 but smaller, migrate less+ lack central induration

stage 3 - late disseminated
chronic arthritis
acrodermatitis chronic atrophica ‘cigarette tissue paper’ especially with b. atzelli

Question 7

what type of disease

Answer 7

zoonotic-rats and mice

Question 8

Characteristic for the rash is

Answer 8

Nonpruritic

Question 9

ip

Answer 9

3-32 days which is why we ask people after they get bitten to montior and check for signs up to around 45 days (ip)

Question 10

cranial nerve associated

Answer 10

facial - especially kids

Question 11

treatment

Answer 11

depends on the stage

stage 1
amoxicillin(<9( or doxy (>9)

stage 2-3
ceftriaxone

Question 12

diagnosis

Answer 12

clinical presentation ‘bulls eyes’
serology - ig m and ig g levels
skin biopsy - see spirochetes
culture the bacterium special media

ELISA

Question 13

hair loss?

Answer 13

Many people don’t think of alopecia when they think of Lyme disease, but sometimes, the two go hand-in-hand. When the infection does cause hair loss, it often appears in patches. The hair may look “motheaten”, and could also be accompanied by lesions that are crusted over with blood

Question 14

nital symptoms

Answer 14

flu like symptoms- fever, chills myalgia
Tender local adenopathy (local, not diffuse)
Erythema migrans (EM) - Rash

Question 15

what does CDC

Answer 15

For serologic testing, the CDC recommends the following two-tier procedure [2] :

Step 1: Enzyme immunoassay (EIA) or immunofluorescence assay (IFA) - Total Lyme titer or IgG and IgM titers
Step 2: Western blot testing

Question 16

WHAT HAPPENS IF YOU TREAT LYME DISEASE TOO LATE

Answer 16

Patients, especially adults, who receive late treatment or initial treatment with antibiotics other than doxycycline or amoxicillin may develop chronic musculoskeletal symptoms and difficulties with memory, concentration, and fatigue. These symptoms can be debilitating and hard to eradicate.

Question 17

EPIDEMIILOGY

Answer 17

Most cases of erythema migrans occur from late spring through early fall, because that is when ticks in the nymphal stage are seeking a blood meal, and nymphs account for 90% of Lyme disease cases.

Question 18

REINFECTON

Answer 18

Because people who engage in activities that put them in risk for tick bites tend to continue those activities, reinfection is not uncommon. Patients who have previously had erythema migrans can be reinfected (meaning that the first infection has been successfully treated, and they have a new infection with B burgdorferi). This has been clearly demonstrated in reinfected patients who were culture positive and had different serotypes isolated in the first and second infections.

Reinfections manifest in much the same ways as first infections, although a tendency towards less hematogenous spread is noted. In contrast, relapse (as opposed to reinfection) is very unusual in patients who have been treated with appropriate antimicrobials. [9]