Lyme Disease

Question 1

What is lyme disease caused by?

Answer 1

Spirochete - Borrelia burgdorferi

Question 2

how is lyme disease transmitted?

Answer 2

by ticks.
tick bite –> blood circulation –> spread to lymph nodes, producing rash on the bite site , may look like a bulls eye.

Question 3

Symptoms of Lyme disease?

Answer 3

Rash, fever, headache, body aches, stiff neck, fatigue – can begin 1-2 weeks after the tick bite.

Question 4

During what season is lyme disease most commonn?

Answer 4

summer and early fall , heavily wooded areas

Question 5

how to prevent tick/insect bites?

Answer 5

DEET

Question 6

how long must a tick be attached to the body to transmit lyme disease?

Answer 6

36 hours

Question 7

what is the advantage of starting treatment in the early stages/prophylaxis?

Answer 7

recovery more likely to occur within 1-2 weeks

Question 8

What is the local rate of B. burgdorferi infection in ticks?

Answer 8

more than 20%

Question 9

When is prophylaxis started?

Answer 9

within 72 hours of tick removal after the estimated attachment time of > 36 hrs.

Question 10

When is prophylaxis NOT needed?

Answer 10

> 72 hrs after tick removal and no symptoms.

Question 11

What are the early symptoms of Lyme disease?

Answer 11

Widespread aches, pain in tendons and joints

Question 12

First line therapy for treatment of early lyme disease?

Answer 12

1. amoxicillin 500 mg TID (10-21 ds)
2. doxycycline 100 mg BID (10-21ds)
3. cefuroxime 500 mg BID (10-21ds)
4. azithromycin 500 mg daily x 7 days (less effective)

Question 13

Which organs are affected after lyme disease infection?

Answer 13

skin, heart, CNS, eyes, arthritis in almost 60%

Question 14

Treatment for lyme disease + bells palsy?

Answer 14

doxy or amoxicillin

Question 15

tx for LD + meningitis (w/ or w/o encephalitis)?

Answer 15

1. ceftriaxone IV
2. penicillin G IV
3. doxycyline PO
4. chloramphenicol PO

all for 14-28 days

Question 16

tx for LD + cardiac manifestations (like AV block)?

Answer 16

1. ceftriaxone 2 g IV/day x 14 d
2. penicillin G 20 mill U IV qd x 14 d
3. doxycycline 100 mg bid x 21 d
4. amoxicillin 500 mg tid x 21 d

Question 17

tx for LD + Arthritis ?

Answer 17

1. amoxicillin + probenecid 500 mg po QID x 30 ds
2. doxycycline PO x 30 ds
3. ceftriaxone IV x 14-28 ds
4. penicillin G IV x 14-28 ds