Lyme Disease

Question 1

3 main genera of spirochetes

Answer 1

Borrelia, Treponema, Leptospira

Question 2

How are spirchetes differentiated

Answer 2

Nature of Spiral

Arrangement of flagella

Question 3

Lyme Disease Epidemiology

Answer 3

Borrelia Burgoferi
Reservoirs- Small mammals and Birds
Ixodes TICK
Strong Correlation w/ Outdoor activity

Question 4

Name other organisms that use Ixodes

Answer 4

Borrelia
Anaplasma
Babesia

Question 5

Most important host in Ticks

Answer 5

White footed mouse

Question 6

What does Ixodes mean?

Answer 6

Hard Body tick
Ixodes scapularis
ixodes pacificus

Question 7

Tick Factors

Answer 7

No transovirial
4 stages Egg Larvae Nymph Adult
Feed once
Full feeding 3-6 days

Question 8

What type of Ticks does Transvarial passage happen?

Answer 8

Ornithodoros– relapsing fever

Question 9

Important about Ixodes

Answer 9

Only nymph and adult can infect

Must eat ofr 24-48 hrs to infect

Question 10

Nymph Stage

Answer 10

Major Vector Human Infections

Peak Feeding is summer

Question 11

Borrelia Burgodoferi

Answer 11

gram Neg spirochete
Microaerophile
linear chromosome
Linear and circular plasmids
Slow Grower
BSK medium
Motile

Question 12

Borrelia Virulence factors

Answer 12

OSP
• OSP A --binds tick midgut
• OSP C --invasion of bacteria into skin, mammalian host
No lipid A endotoxin
Produce Lipoproteins
NO TOXINS OR PROTEASES

Question 13

3 stages of borrelia

Answer 13

1- Early
2- Disseminated
3- Late/Persistent

Question 14

Stage 1

Answer 14

Erythema Migrans
Bulls Eye
Spriochetes isolate from leading edge
NON SPECIFIC SYMPTOMS

Question 15

Stage 2

Answer 15

wks to months after infection
Lymphohematogenous spread
Spirochetemia, lymphadenopathy,
Moves to spleen joints liver heart

Question 16

Manifestation of stage 2

Answer 16

secondary erythema
arthralgia arthritis
nuerological Manifestations
Cardiac Disease

Question 17

Stage 3

Answer 17

months to years
Lyme arthritis
Lyme neuropathy

Question 18

Early stage diagnosis/ treament

Answer 18

No isolation required

treat with antibiotics

Question 19

Diagnosis for disseminated

Answer 19

serologic testing
travel to endemic
ELISA
Western Blot

Question 20

Treat early disseminated

Answer 20

IV or oral for 3-4 weeks

Question 21

Jerisch Herxheimer

Answer 21

Cause by massive release cyto kines after treatment
IL6, TNF alpha and IL8
Rigors, temp respiration increase
fllowed by sweating and drop in temp

Question 22

Prevention Lyme disease

Answer 22

No Vaccine

Question 23

Lyme Like Disease

Answer 23

Borrelia Stari
vector: ambylomma americanum
Hard body
Larvae and nymph and adult all bite
southeast united stated

Question 24

How is Stari infection different than burgdoferi

Answer 24

More likely to recall
Erythema Migrans
Flu Like symptoms
recovers more rapidly