Lyme Disease

Question 1

What causes lyme disease and how is it spread?

Answer 1

It is caused by the spirochaete Borrelia burgdorferi and is spread by ticks

Question 2

Describe the Stages of Lyme Disease (Borreliosis)?

Answer 2

• 1st Stage - Erythema migrans (target lesions) 3-36 hours after infection - not always present.
• 2nd Stage
  
  • Disseminated Lyme disease.
  • Days to Months after.
  • Flu-like illness +/- N&V.
  • RARE: Meningitis, heart problems (myocarditis and heart block) and mild encephalitis, CN palsy.
• 3rd Stage:
  
  • ​Polyneuropathy, chronic encephalomyelitis, vertigo, psychosis.

Question 3

What is this?

Answer 3

Erythema migrans

Question 4

If you think someone might have lyme disease, what do you do?

Answer 4

• 2 Stage Tests:
• 1st test: ELISA for Borrelia Burgdorferi.
• If positive then PCR for antibodies to Borrelia burgdorferi

Question 5

How do you treat lyme disease?

Answer 5

• 2 weeks of Doxycycline if early disease.
  
  • Amoxicillin is an alternative if doxycycline is contraindicated (e.g. pregnancy)
• Ceftriaxone if disseminated disease

Question 6

What can sometimes happen after initiating therapy for Lyme Disease?

Answer 6

A Jarisch-Herxheimer reaction

It is a reaction charactisterised by fever, rash, tachycardia after first dose of antibiotic.

(more commonly seen in syphilis, another spirochaetal disease)

Question 7

What is Post-Lyme Syndrome?

Answer 7

• Occurs in 5% of people who suffer from Lyme disease
• Symptoms occur despite treatment.
• Symptoms are similar with Chronic Fatigue Syndrome or Fibromyalgia.