Lyme Disease Flashcards
things that can happen in early disseminated lyme dz
Carditis: 8% of patients Heart block (electrical) or mild myopericarditis
Neurologic:
Lymphocytic meningitis – stiffness in neck, LP may have some lymphocytic WBC predominance
Cranial nerve palsies (esp. 7th nerve – bilateral or unilateral)
Radiculoneuritis – follow nerve in radicular pattern of pain and numbness
This triad (the above 3) is more common in Europe and known as Bannwarth’s syndrome
late dz of lyme
Late disease can occur months to years after the onset of the infection
Musculoskeletal:
Arthralgias
Intermittent episodes of arthritis- usually monoarthritis often involving the knee
Chronic monoarthritis (often in knee)
Tertiary Neuroborreliosis- uncommon
Encephalopathy
Neurocognitive dysfunction
Peripheral neuropathy
Acrodermatitis chronica atrophicans in Europe
Atrophy of skin, whitish discoloration distal parts of ams and legs, hes never seen it
how do you dx lyme dz
not based off of serology- used to confirm
historical and physical features that explicitly suggest the diagnosis is dx basis
dx tests
ELISA
Western blot
if ELISA is - do you do the WB
no
what do you do if ELISA is +
confirm with WB
tx of early localized lyme
Doxycycline 100 mg BID for 10-21 days
Avoid doxy and tetra below 8 y/o b/c can cause
yellowing of the teeth
Amoxicillin 500 mg TID for 14-21 days
Cefuroxime 500 mg BID for 14-21 daystx for Early disseminated disease (no meningitis or third degree heart block)-if they have Bells
Doxycycline 100 mg BID for 14-21 days
Amoxicillin 500 mg TID for 14-21 days
tx for Early disseminated disease with meningitis or third degree heart block
Ceftriaxone 2 grams IV daily for 14-28 days
Preferred
Cefotaxime 2 grams IV every 8 hours for 14-28 days
Penicillin G 18-24 million units in 6 divided dosages for 14-
28 days
