Tick-Borne infections Flashcards
Lyme disease is caused by ____________ and transmitted by black legged ticks (Ixodes scaplularis , Ixodes pacificus (western backlogged tick))
B. burgdorferi
The most common manifestation of a tick bite is early localized ___________ that presents with rash in a _________ pattern
erythema migraines (days to weeks)
Bullseye
Lyme disease that presents with vague muscle aches, fatigue, cardiac conduction issues, encephalopathy/meningitis and for a duration of < 3 months is known as ________
Early, disseminated disease
Lyme disease that presents with neurologic confusion, fatigue, encephalitis, multiple joint arthritis for a duration of > 3 months is known as _____
late persistent disease
Non drug measures to prevent against tick bites include
1
2
3
4
1 wear light coloured long sleeve shirt pants
2 shower within 2 hours of being outdoors
3 conduct tick check
4 use DEET
Post exposure prophylaxis for tick bite is given within 72 hours of a HIGH RISK bite which is if
1
2
3
1 Ixodes spp tick
2 highly endemic area
3 attached >36 hours
The local rate of B. burgdorferi infection in ticks is more than 20%.
Tick is identified as a blacklegged tick (Ixodes species).
Time of attachment was at least 24 hours. Since timing is sometimes difficult to determine, assessment of the degree of tick engorgement may be helpful. This is an important predictor of subsequent disease. An engorged tick means that the tick has started to feed on the host and that it is likely >24 hours after attachment.
The treatment for post exposure prophylaxis tick bite is ___
Doxycycline x 1 dose within 72 hours of tick removal
The benefit of a single doxycycline dose, even in children <8 years of age who are in a known endemic area and have had a high risk exposure (e.g., all 3 of the above postexposure prophylaxis criteria are met), may outweigh the risk of potential side effects. Prophylactic amoxicillin for Lyme in this age group has not been studied and, due to its short half-life, is unlikely to be effective as a single dose. Amoxicillin should not be used for this indication.
Doxycycline was previously contraindicated in pregnant and breastfeeding patients due to the theoretical risk of permanent tooth discoloration and possible effect on bone formation in the fetus;[5][29] however, to date, no such risk has been identified in pregnant[29] nor breastfeeding individuals.[36] The SOGC suggests that doxycycline may be considered for postexposure prophylaxis if the pregnant or breastfeeding individual meets the 3 criteria listed in Postexposure Prophylaxis, after discussion of risks versus benefits with the individual. Remains C/I for TREATMENT, use Cefuroxime or Amoxicillin in TREATMENT
Treatment for Lyme disease erythema migrans (early disease)
Adults
1
2
3
Children (<8 yo)
1
2
3
1doxycycline x 10 d
2 cefuroxime x 14d
3 amoxicillin x 14 d
Azith if Beta lactam allergy
1 amoxicillin
2 cefuroxime
3 doxycycline (case by case, if duration <21 days)
True or False:
First-generation cephalosporins (e.g., cephalexin) are not effective for treatment of Lyme disease.
True
