Lyme Disease

Question 1

Ticks cause Lyme Disease.

What time of yr do the ticks tend to appear?

Answer 1

Late spring - early summer

Question 2

What does the bacteria look like?

Answer 2

Spiral - spirochaete bacterium

Question 3

Erythema migrans:

At the site of tick bite.

Describe it?

How do you know it is not cellulitis or anaphylaxis

What other symptoms do people get after a bite?

How long does it last for?

Answer 3

Round - increases in size - may have central clearing

Not itchy, hot or painful

Fever
Headache
Flu-like symptoms

Usually becomes visible from 1to4weeks (but can appear from 3days to 3months)

Question 4

Neurological symptoms:
- What do they get?

Cardiac symptoms:

• What HB could they develop?
• What other cardiac pathology could they develop?

Monthly to 1 yr after exposure:

Answer 4

Facial palsy 
Mononeuritis multiplex 
Radiculitis 
====================
HB

Pericarditis

Question 5

Late signs:

Months to > 1 yr after exposure:
- What happens to their joints and which joint is commonly affected?

Also get dermatological features.

Answer 5

Knee - arthritis - inflammatory

Question 6

INV and Diagnosis:

If Erythema Migrans is present, a clinical diagnosis is made and treatment is started.

If EM is not present, what test should be offered?

If negative, alternative diagnosis or retesting in a few wks.

If above is positive, what test should be offered next?

Answer 6

ELISA test

An enzyme-linked immunosorbent assay, also called ELISA or EIA, is a test that detects and measures ANTIBODIES in your blood.

Immunoblot

An immunoblot identifies the specific PROTEINS to which the patient’s antibodies bind. Although there are no proteins that specifically diagnose B burgdorferi infection, the number of proteins recognized in the immunoblot assay is correlated with diagnosis.

Question 7

Treatment:

What AB is given?
How many days

When is IV Ceftriaxone needed?

Answer 7

Doxycycline 21 days

Meningitis
Radiculopathy
CN palsy - facial palsy