Lyme Disease

Question 1

What is Lyme disease?

Answer 1

A: Lyme disease is an infection caused by the bacterium Borrelia, a type of spirochaete.

Question 2

Which parts of the body does Lyme disease commonly affect?

Answer 2

A: Lyme disease can affect the skin, central nervous system, joints, heart, and, rarely, the eyes and liver.

Question 3

What causes different subtypes of Lyme disease in North America and Europe?

Answer 3

A: Different subspecies of Borrelia bacteria, with B. burgdorferi sensu stricto in North America, and B. burgdorferi sensu stricto, B. afzelii, and B. garinii in Europe.

Question 4

A: Different subspecies of Borrelia bacteria, with B. burgdorferi sensu stricto in North America, and B. burgdorferi sensu stricto, B. afzelii, and B. garinii in Europe.

Question 5

A: Different subspecies of Borrelia bacteria, with B. burgdorferi sensu stricto in North America, and B. burgdorferi sensu stricto, B. afzelii, and B. garinii in Europe.

Question 6

A: Different subspecies of Borrelia bacteria, with B. burgdorferi sensu stricto in North America, and B. burgdorferi sensu stricto, B. afzelii, and B. garinii in Europe.

Question 7

Which animals are the main hosts for ticks that carry Borrelia?

Answer 7

A: Small to medium-sized animals in Europe and deer in North America.

Question 8

What tick species are common vectors of Lyme disease in North America?

Answer 8

A: Ixodes scapularis, I. pacificus, and four other tick species.

Question 9

Who is most at risk for Lyme disease?
A: Children, adults, forestry workers, and those engaging in recreational activities in tick-prone areas.

Question 10

What are the three stages of Lyme disease?

Answer 10

A: Localized Lyme disease, early disseminated Lyme disease, and late Lyme disease.

Question 11

What are symptoms of localized Lyme disease?

Answer 11

A: Erythema migrans, flu-like symptoms, and borrelial lymphocytoma (red-blue patch on earlobe, nipple, or scrotum).

Question 12

What are common signs of early disseminated Lyme disease?

Answer 12

A: Multiple erythema migrans, facial or Bell’s palsy, aseptic meningitis, polyradiculitis, arthritis, and carditis

Question 13

What are symptoms of late Lyme disease?

Answer 13

A: Acrodermatitis chronica atrophicans, chronic Lyme arthritis (usually in large joints), and chronic neurological disorders such as memory loss and shooting pain.

Question 14

What is erythema migrans?

Answer 14

A: Erythema migrans is a red, expanding patch of skin that is the most common sign of Lyme disease, present in 70–80% of cases.

Question 15

: When does erythema migrans typically appear after a tick bite?

Answer 15

A: It usually appears 7–14 days after a tick bite but can appear within 3–33 days.

Question 16

What does erythema migrans look like?

Answer 16

A: It often appears as a red patch with a central spot surrounded by clear skin, ringed by an expanding red rash, resembling a bull’s-eye. It can also appear as a uniform red patch or one with central hardening and blistering.

Question 17

Is erythema migrans usually symptomatic?

Answer 17

A: It is mostly asymptomatic, but it may feel itchy, sensitive, or warm to the touch and is rarely painful.

Question 18

What other symptoms might accompany erythema migrans?
A: Symptoms can include fatigue, chills, headache, low-grade fever, muscle and joint pain, and nearby swollen lymph glands.

Question 19

Q: How long does erythema migrans last if untreated?

Answer 19

A: It usually disappears on its own within 3–4 weeks, but untreated Lyme disease may progress to more advanced stages.

Question 20

Which tests are used to confirm a Lyme disease diagnosis?

Answer 20

Antibody titres to B. burgdorferi using ELISA or immunofluorescent assay, with positive results confirmed by Western immunoblot. Skin biopsy and PCR can also detect the organism in skin specimens.

Question 21

What antibiotics are used for early Lyme disease treatment?

Answer 21

Antibiotics for erythema migrans include doxycycline, amoxicillin, and cefuroxime, with macrolides (azithromycin and erythromycin) as second-line treatments.

Question 22

Which antibiotics are used for more advanced Lyme disease?

Answer 22

A: Intravenous penicillin and ceftriaxone are used for more advanced stages, especially in cases of neuroborreliosis.

Question 23

How long is the antibiotic treatment for Lyme disease?

Answer 23

Treatment duration varies from 10 to 30 days, depending on the stage and organ involvement.

Question 24

What is post-treatment Lyme borreliosis syndrome?

Answer 24

It is a condition with persistent or recurrent symptoms of unknown origin after antibiotic treatment, possibly due to an autoimmune response. Prolonged antibiotics do not improve cure rates.