Lyme Disease Flashcards
The tick must be attached for how long in order to transmit organism?
24 hours
The most common manifestation is
Rash (erythema migrans)
The rash occurs how long after the bite?
5-14 days
What is the most common symptom if not treated?
Joint pain
Joint pain caracteristics
Oligoarthritis (few joints) Knee is the most commonly affected joint Very frequent if lyme is not treated Joint fluid non remarkable: 25000 WBC/uL Ddx: gout, pseudogout
Neurological manifestations caracteristics
10-15%
CNS or perioheral
Meningitis, encephalitis CN palsy
Most common neuro manifestation of lyme disease
Facial palsy
Cardiac manifestations caracteristics
Any part of myocardium or pericardium
Myocarditis or ventricular arrhythmia
Most common cardiac manifestation
Transient AV block
Diagnostic tests
When you see a typical rash, start tx (no need for serologic tx)
Do serology if : joint, neuro or cardiac manifestations (most 7th CN palsy, arthralgia and AV block are not caused by lyme)–> IgM, IgG, ELISA, western blot and PCR
A patient comes with an asymptomatic tick bite, what is the treatment?
None
A patient presents with a hx of tick bite and a typical rash, what is the tx?
Doxycycline or amoxicillin
A patient presents with lyme and joint pain or 7th CN palsy, what is the tx?
Doxy, amoxi
A patient presents with lyme and cardiac manifestations, what is the tx?
IV ceftriaxone
A patient presents with lyme and neurological manifestations, what is the tx?
IV ceftriaxone
