Lyme disease and lyme like disease

Question 1

Causes

Answer 1

Lyme disease (known as Lyme borreliosis) is caused by;

• a spirochete, Borrelia burgdorferi

Transmitted by Ixodes ticks, in particular the deer tick.

It is not endemic in NZ and is usually seen in travellers from affected regions.

Question 2

Symptoms & Diagnosis

Answer 2

Diagnostic serology should be considered for pts with;

a history of tick bites

typical rash (a doughnut-shaped red rash ~6 cm in diameter) at the bite site

heart disorders (esp. arrhythmias)

unusual joint arthralgia or

CNS disease (usually large joints, e.g. knees)

Question 3

Treatment

Answer 3

After removing the tick (see tick removal 457) Rx is with;

• penicillin,
• tetracycline or
• cephalosporins (e.g. doxycycline 100 mg bd for 21 d).