Lyme disease Flashcards
What is Lyme Disease
An infection caused by Borrelia burgdoferi
Transmitted by bite of an deer tick
Was identified in Lyme, Connecticut in 1975
Most common vector borne disease in US- Carried by something else
Summer months are peak season
Symptoms
Mimic those of multiple sclerosis, mononulceosis and meningitis.
Most characteristic clinical symptom is erythema migrans. Bull’s eye rash.
Starts with red macule or papule
Expands slowly to a red outer ring upto 12 inches
Not itchy or painful
Other Symptoms
Flu like symptoms
Low grade fever
Chills
Headache
Stiff neck- mimicks menigitis
Fatigue
Swollen lymph nodes
Joint and muscle pain
Loss of tone in facial muscles-Mimics bells palsy
Complications
Can disseminate to heart, joints and CNS
Chronic neurologic complaints: short term memory loss, cognitive impairment, shooting pains, numbness and tingling in the feet
Cardiac: heart block, myocarditis
60% of persons with untreated infection develop arthritic pain and swelling of large joints
Diagnosis
History of exposure to high risk areas-North eastern states, Wisconsin, Minnesota, parts of cali and washington
Clinical symptoms
two step testing- step 1 –EIA
If EIA is positive the Step 2: Western Blot test
Results are diagnostic of Lyme disease if both the tests are positive.
CSF fluid test if neurologic involvement
Treatment
Oral antibiotics: Doxycycline, Cefuroxime, amoxicillin are effective*** i_n early stage infection_***
Patients with neurologic or cardiac complications require IV therapy : Ceftriaxone or PCN G for 2-4 weeks
