Lyme disease

Question 1

How is lyme disease spread?

Answer 1

Via the bite of Ixodes ticks

Question 2

What is the cause of Lyme disease?

Answer 2

By spriochaete bacteria called Borrelia burgdorferi

Question 3

What is the presentation of stage 1 lyme disease?

Answer 3

Tick bite
Flu-like symptoms
Regional lymphadenopathy
Erythema chronicum migrans - circular, target shaped lesion

Question 4

What is the presentation of stage 2 lyme disease?

Answer 4

Continued flu-like symptoms
Neuroborreliosis
- Facial nerve palsies
- Aseptic meningitis
- Encephalitis
Cardiovascular involvement
Early painful arthritis

Question 5

What is the presentation of stage 3 lyme disease?

Answer 5

Recurrent attacks of arthritis
Late neurological disorders
- Polyneuropathy
- Dementia
- Psychosis
Discoloration at extensor surfaces (acrodermatitis chronica atrophicans)

Question 6

What is the diagnostic investigation for Lyme disease?

Answer 6

ELISA testing for Borrelia species

Question 7

What is the first line management of suspected or confirmed lyme disease?

Answer 7

Oral doxycycline

Question 8

What is the management of an asymptomatic tick bite?

Answer 8

Removal of tick
Monitoring for signs of infection

Question 9

What reaction may occur in patients taking antibiotics for Lyme disease?

Answer 9

Jarisch-Herxheimer reaction

Question 10

What is the management of a Jarisch-Herxheimer reaction?

Answer 10

The patient can continue antibiotics as long as there are no features of allergy/anaphylaxis