Lyme Disease - Bakken

Question 1

How long must a tick be attached in order to transfer the bacterial infection to the host?

Answer 1

36 hours (even then it’s not even a sure thing)

Question 2

Bacteria responsible for lyme disease?

Answer 2

B. Burgdorferi

Question 3

Skin lesion indicative of lyme disease?

Answer 3

Erythema migrans (not all cases)

Question 4

What types of symptoms do you see in early disseminated lyme disease?

Answer 4

Constitutional - EM lesions, lympadenopthy

Musculoskeletal - arthalgia, migratory arthritis

Neurologic - facial nerve palsy, radicular pain, poly neuritis

Cardiac - AV block

Question 5

SYmptoms of late lyme disease?

Answer 5

Chronic arthritis
Acrodermatitis chronicum atrophicans
Neuro impairment

Question 6

Lab tests used most commonly for confirming diagnosis?

Answer 6

ELISA + EIA to check for antibodies

PCR

Question 7

Problems with serologic testing?

Answer 7

• Often get false positives
• IgG and IgM antibodies persist for years after initial infection
• Tests poorly standardized
• Absolute titer of Ab doesnt correspond to severity of infection

Question 8

What would you need to make a lyme disease diagnosis?

Answer 8

History of exposure to Ixodes endemic area
History of tick bite
Clinical manifestations

Confirm using serology and PCR

Question 9

What treatment do you use for early localized or systemic lyme disease?

Answer 9

Doxycycline
Amoxycillin
Cefuroxime

Question 10

What drug can be used to treat both B. Burgdorferi and A. phagocytophilum?

Answer 10

Doxycycline can be used to treat both

Question 11

What drug should you use to treat joint CNS and Cardiac Lyme Disease?

Answer 11

Arthritis and CNS Lyme
-use Doxycycline or ceftriaxone

Cardiac Lyme
-Use ceftriaxome

Question 12

Is prophylactic doxycyline after a tick-bite important?

Answer 12

Probably not, just monitor well and treat as soon as any symptoms occur. Could be helpful though