Infectious Diseases - Cellulitis & Lyme Disease

Question 1

What are infectious wounds?

Answer 1

All wounds by their nature are contaminated and have potential to become infected.
Appropriate hygiene and wound management will prevent this in most cases, but if
infectious organisms (especially Staphylococcus aureus) proliferate then infection will occur.

The Clostridium family of bacteria are responsible for some particularly nasty wound infections – C. perfringens from soil contamination of a wound causes gangrene, while C. tetani (again from soil in a wound) causes tetanus.

Question 2

What are risk factors for cellulitis?

Answer 2

This is a bacterial wound infection.

Risk factors:
* Injury
* Immunosuppression
* Pre-existing skin conditions
* Lymphoedema

Symptoms:
* Swelling
* Tenderness
* Pain
* Warmth
* Fever
* Chills
* Spots
* Blisters
* Skin dimpling

Question 3

What is Lyme disease?

Answer 3

• A multisystem illness caused by infection with Borrelia spp. transmitted through bites from the Ixodes tick species.
• Tick attachment needs to exceed 36 hours for transmission of disease causing Borrelia.
• The incubation period is 3-30 days, after which time the bacteria migrate systemically beginning with the rash.

Question 4

What causes or triggers Lyme disease?

Answer 4

Living or holidaying in endemic areas and spending a lot of time in environments
favoured by the ticks (heavily wooded or grassy areas)

Question 5

What are the signs and symptoms of Lyme disease?

Answer 5

• ‘Bullseye’ rash (erythema migrans, see image on right) spreading slowly over the course of several days, warm to touch
• Fever, chills, myalgia, headache, swollen lymph nodes, fatigue, neck stiffness
• Later symptoms/complications – joint pain and swelling (especially knees), neurological issues (meningitis, Bells palsy, increased limb weakness and impaired movement)
• Less commonly – heart, eye and liver involvement, severe fatigue

Complications:
Impacts on ability to work
Difficulties engaging with domestic responsibilities and relationships
Mental health challenges
Reduced/loss of ability to participate in hobbies

Question 6

What is conventional diagnosis and treatment of Lymes disease?

Answer 6

Diagnosis:
* Careful case history, although as Lyme symptoms mirror other conditions, unless the
characteristic rash is present then diagnosis is challenging
* Blood tests – the enzyme linked immunosorbent assay (ELISA) and the Western blot test are the key blood tests to detect antibodies to the Borrelia infection

Conventional treatment:
In most cases where Lyme is diagnosed, oral antibiotics are prescribed over the course of two or three weeks. The earlier in the disease a diagnosis is made, the better chance of fully resolving the Condition.