lyme disease

Question 1

definition of lyme disease

Answer 1

infection spread to humans via ticks

Question 2

causative organism of lyme disease

Answer 2

borrelia species - Spirochetes

Question 3

risk factors for lyme disease

Answer 3

exposure to tics
tick bite duration
outdoor activities

Question 4

signs and sx of lyme disease

Answer 4

erythema migricans

fever
headache
myalgia
fatigue
arthralgia

Question 5

Ix for lyme disease

Answer 5

enzyme immunoassay or immunoflurescence assay
if in early disease and this is -ve then repeat more than 2 wks later

Question 6

Mx of lyme disease

Answer 6

known ixodes tic bite in highly endemic area:
* postexposure prophylaxis: doxycycline within 72 hrs of tick removal

erythema migricans
* doxycycline / amox / cefuroxime / phenoxymethylpenicillin

cardiovascular involvement
* no risk of severe cardiac complications -> oral abx
* risk -> IV abx

neuro
* oral or IV abx

arthritis
* oral abx

recurrent/persistent arthritis
* IV abx therapy

Question 7

complications of lyme disease

Answer 7

• Peripheral nerve involvement - radiculopathy, cranial neuropathy, mononeuropathy multiplex
• facial palsy
• lymphocytic meningitis and rarely encephalomyelitis

AV block
Myocarditis

borrelial lymphocytoma

arthritis

encephalomyelitis, peripheral neuropathy, or encephalopathy. Peripheral neuropathy presents as mild diffuse polyneuropathy in a glove and stocking distribution.