Mono & Lyme Flashcards
Cause of Mono
EBV
Cancer linked to EBV
Burkitt’s lymphoma
Mono incubation period
1-2 months
What type of infection is mono?
B-cell infection w/ T-cell reaction
Mono prodrome
3-5 days of HA, fever, malaise, fatigue
Mono presentation
Sore throat
Symmetrical LAD
Fever
Hepatomegaly (sometimes)
Downey cells
Atypical lymphocytes found in circulation during mono infection (T-cells)
Transmission of EBV
Person-to-person
Peak incidence of mono
17-25
EBV Diagnosis
Heterophile antibodies***
Agglutination of horse RBCs
IgM anti-VCA (confirmatory)
Pre-teen pts may not have strong heterophile antibody response due to immature immune system (use anti-VCA)
Penicillin rash
Treating mono w/ abx
CMV
Similar to EBV, but does NOT produce heterophile antibodies
CMV is problematic for…
Transplant pts
Immune suppressed
Pregnant pts
Reservoir for CMV
Children with “minor colds”
Outbreaks of mumps
“Breakthrough” cases
Juvenile arthritis
Lyme disease
Stages of Lyme disease
- Acute localized (70-80%)
- Subacute disseminated (70%-untreated)
- Chronic Disease
Acute localized disease
- Bulls eye rash at bite site, fades in a month
- Flu-like symptoms.
Subacute disseminated disease
- Weeks to months after infection.
- Flu-like symptoms
- Asymmetric arthritis (brief duration) of large joints (60%)
- New annular skin lesions (50%)
- Hepatitis (20%)
- Meningitis (15%)
- Conjunctivitis (10%)
Chronic lyme disease
MSK manifestations primarily:
- More persistent arthritis attacks
- 2 to 3 yrs after infection
Cause of lyme
Borreliella burgdorferi (N. America & Europe)***
B. garinii - Eurasia
B. afzelii - Eurasia
Lyme disease vector
Ticks (Ixodes sp)
- Deer OR
- Black-legged
Lyme reservoir
Small mammals and birds:
- Rodents
- Rats
- Mice***
Lyme diagnosis
Clinical findings in endemic area
Serology:
- EIA plus western blot if EIA positive
- False positives with syphilis, mono, SLE, RA, oral infections with spirochetes
- Pts positive by 4th WEEK of infection
Lyme prevention
Repellents with DEET
Remove tick promptly (w/in 24 hours)
Control tick sources (ie. mice)
Vaccine WAS available
Post Treatment Lyme Disease Syndrome
10-20% treated have lingering symptoms of fatigue, pain, and joint problems
May reflect residual tissue damage and auto-immune responses
Most improve with time
Other tick bite consequences
Red meat allergy