Tick Borne

Question 1

Buzz words: Northeast region, fever, shaking chills, drenching sweats, no rash.
blood smear shows “ring forms”, Maltese cross, or tetrad., Anemia, reticulocytosis (aka hemolysis)

Answer 1

Babesiosis

Question 2

Treatment of babesiosis:

mild to moderate and severe

Answer 2

mild to moderate –> azithromycin + atovaquone

severe –> quinine + clindamycin

Question 3

Treatment of erythema migrans

Answer 3

doxycycline

if pregnant - amoxicillin

Question 4

Treatment of early disseminated Lyme disease

Answer 4

IV PCN/ CTX –> oral doxy

Question 5

Features of disseminated lyme disease

Answer 5

cardiac: primary/secondary/third degree heart block
neurology: aseptic meningitis, Bell’s palsy, foot drop

Question 6

Dx of disseminated or late disease Lyme disease

Answer 6

Western blot IgG

Question 7

For patients presenting with aseptic meningitis and cerebrospinal fluid findings typical for viral infection, the “rule of 7s” can classify a patient at?

Answer 7

Low risk for having Lyme disease (headache duration <7 days, <70% mononuclear cells, and absence of a seventh facial nerve palsy)