Spirochetes Flashcards
Which infection is considered to be the most widespread zoonosis in the world?
Leptospirosis
A 15 year old was on a camping trip with his family as well as the family dog. After returning, he came down with an illness involving myalgia, fever, headache, and his lab work was notable for liver dysfunction (in particular, elevated bilirubin.) The boy and the dog swam a lot. What infection do you suspect?
Leptospirosis
What might you expect to see on a complete metabolic profile in a patient with leptospirosis?
LFTs elevated but bilirubin elevated more so.
A patient has an illness due to a spirochete. He did not have a tick bite. What organism should you suspect?
Leptospirosis
What is the treatment for leptospirosis?
Penicillin, ceftriaxone, or doxycycline
What is the cost to the agent of Lyme disease?
Borrelia burgdorferi
A Boy Scout found a tick attached to his forearm and he is certain he could only have been there for about one hour. His mother brings him in for evaluation after he returned from camp. She is concerned about Lyme disease. What should you tell her regarding her son’s risk?
He is at low risk since the text did not have at least two days of feeding.
How long must a tick be attached in order to transmit lyme disease?
Usually at least two days
What is the cardiac complication associated with Borellia burgdorferi?
Heart block
What neurologic complications are associated with lyme disease?
- Bell’s palsy
- Foot drop
They mother brings her 10 year old daughter in for evaluation. She had a tick bite, and several weeks later she had a rash that based on description was erythema migrans. What is the next best step?
- Observation
- check an immunoflorescent assay for Borelia burgdorferi
- check and enzyme-linked immunoassay for Borelia burgdorderi
- Treat for lyme disease
- check a Western blot
- Just treat. The rash is pathognomonic.
- If there was concern for lime but no history of the rash, you would first check EIA or IFA and then if positive, check Western blot.
How do you diagnose leptospirosis in the first 4 to 7 days of infection? In the second week of infection?
- Blood culture
- Urine culture
Isolation of these organisms is difficult and so PCR is probably more useful.
Hey child visits a Lyme prone area for several hours. On return from his visit, a tick is noted. The tick was likely attached for between two and three hours. What is the appropriate therapy for this child?
None. The tick must be attached for two days.
What is the proper treatment for lyme disease in the following stages?
- Early disease and isolated Bell’s palsy
- Lyme arthritis
- Non-responders
- Cardiac and neuro sequelae
- doxy or amox (if , 8 yo) 14-21 days
- Same, 28 days
- Retreat with the same agent or ceftriaxone
- Ceftriaxone or PCN G x 21 days
A 15 year old adolescent in an endemic area for lyme presents with chronic fatigue as his only symptom. Physical exam is normal. Is it appropriate to check Lyme titers?
No. The findings are too non-specific.
