Flashcards in ID - Lyme Disease and Rashes Deck (16):
Early localized stage of Lyme disease?
Within the first month of bite.
Presents with viral like syndrome and erythema migrans usually around belt-line or axilla.
Erythema marginatum? Seen in?
Non-pruritic, and erythematous papules over trunk - spares the face
1. lyme disease
2. rheumatic fever
3. Rocky Mountain spotted fever
4. toxic shock syndrome
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
Rocky Mountain spotted fever symptoms? Treatment?
Headache, myalgias, abdominal pain, rash
Symptoms of measles? Treatment?
Cough, conjunctivitis, coryza,
Supportive therapy, antibiotics for otitis and pneumonia
Early disseminated Lyme disease?
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
Patient in early disseminated stage of lime disease – most appropriate next step?
Lumbar puncture to evaluate for meningitis and look for antibodies
In Asia and Europe first characteristic neurological time is radicular pain followed by CSF Pleocytis
Third stage of disease?
Years after initial inspection
Joint: polyarthritis with intermittent oligo arthritis
Neuro: Encephalitis, neurocognitive dysfunction, peripheral neuropathy
Cardiac manifestations of lyme disease? Can progress to?
Conduction disturbances, myocarditis, pericarditis.
Cardiomyopathy or permanent Heart block
Neurological manifestations of lyme disease? Present when?
Facial palsies, meningitis with lymphocytic pleocytosis, encephalitis, sensory radiculoneuropathy
Present after several weeks or months
Aspiration of joint food from lime disease will show?
25,000 WBCs with the predominance of PMNs
Treatment choices of Lyme
Doxycycline 100 mg
Amoxicillin 500 mg
Cefuroxine 500 mg
Erythromycin 250 mg
If patient has third degree heart block or neurologic manifestations, treatment?
Ceftriaxone 2 g
Cefotaxime 2 g
14 days for localized infection
21 days for early disseminated infection
One month for patients with arthritis, neurologic, cardiac involvement