Infectious Diseases

Question 1

features of Lyme disease?

Answer 1

erythema chronicum migrans (‘bulls-eye’) rash is seen in ~ 80%.
+ fever, arthralgia
cardiovascular: heart block, myocarditis
neurological: facial nerve palsy, meningitis

Question 2

Ix of Lyme Disease?

Answer 2

clinical diagnosis if erythema migrans present -> indication to start abx.

1st line: ELISA antibodies to Borrelia burgdorferi

(if equivocal -> immunoblot test for Lyme disease. if negative and still suspected -> Repeat ELISA 4-6 wks later)

Question 3

Management of suspected/ confirmed Lyme disease?

Answer 3

Doxycycline

• in pregnancy -> amoxicillin

Question 4

Management of disseminated Lyme disease?

Answer 4

Ceftriaxone