ID - Lyme Disease and Rashes Flashcards Preview

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Flashcards in ID - Lyme Disease and Rashes Deck (16)
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0
Q

Erythema marginatum? Seen in?

A

Non-pruritic, and erythematous papules over trunk - spares the face

Rheumatic fever

1
Q

Early localized stage of Lyme disease?

A

Within the first month of bite.

Presents with viral like syndrome and erythema migrans usually around belt-line or axilla.

2
Q

Rash of

  1. lyme disease
  2. rheumatic fever
  3. Rocky Mountain spotted fever
  4. toxic shock syndrome
  5. measles
  6. Rubella
A
  1. Erythema migranns
  2. Erythema marginatum
  3. Rash begins on the wrist and ankles and spreads centrally (also appears in palms and soles)
  4. Diffuse erythema followed by desquamation after a week
  5. Rash proceeds from the hairline down, sparing palm and soles
  6. Same as Measles
3
Q

Rocky Mountain spotted fever symptoms? Treatment?

A

Headache, myalgias, abdominal pain, rash

Doxycycline, tetracycline

4
Q

Symptoms of measles? Treatment?

A

Cough, conjunctivitis, coryza,
**Koplik spots

Supportive therapy, antibiotics for otitis and pneumonia

5
Q

Early disseminated Lyme disease?

A

Days to months after initial tick bite

Joints: Musculoskeletal pain without joint inflammation
Cardiac – conduction disturbances myocarditis, pericarditis, heart block
Neurologic: bilateral facial nerve palsy, meningitis, encephalitis, radicular pain

6
Q

Patient in early disseminated stage of lime disease – most appropriate next step?

A

Lumbar puncture to evaluate for meningitis and look for antibodies

7
Q

Bannwarth syndrome?

A

In Asia and Europe first characteristic neurological time is radicular pain followed by CSF Pleocytis

8
Q

Third stage of disease?

A

Years after initial inspection

Joint: polyarthritis with intermittent oligo arthritis
Neuro: Encephalitis, neurocognitive dysfunction, peripheral neuropathy

9
Q

Cardiac manifestations of lyme disease? Can progress to?

A

Conduction disturbances, myocarditis, pericarditis.

Cardiomyopathy or permanent Heart block

10
Q

Neurological manifestations of lyme disease? Present when?

A

Facial palsies, meningitis with lymphocytic pleocytosis, encephalitis, sensory radiculoneuropathy

Present after several weeks or months

11
Q

Aspiration of joint food from lime disease will show?

A

25,000 WBCs with the predominance of PMNs

12
Q

Treatment choices of Lyme

Disease?

A

Doxycycline 100 mg
Amoxicillin 500 mg
Cefuroxine 500 mg
Erythromycin 250 mg

13
Q

If patient has third degree heart block or neurologic manifestations, treatment?

A

IV:
Ceftriaxone 2 g
Cefotaxime 2 g
Penicillin G5

14
Q

Treatment time?

A

14 days for localized infection
21 days for early disseminated infection
One month for patients with arthritis, neurologic, cardiac involvement

15
Q

When to treat Asymptomatic rock bite?

A
#Ixides tick identified
#tick attached for more than 24 hours
#engorged nymph-stage tick
#Endemic area

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