lyme disease

what is lyme disease caused by?

borrelia burgdorferi

what time of bacteria is borrelia burgdorferi?

spirochete

how is lyme disease acquired?

tick bite

what are the two stages of lyme disease?

early and late

what are the timings of the early and late phases?

early - 30 days

late > 30 days

what are the early features of lyme disease?

- erythema migrans

- systemic features

what is erythema migrans?

- characteristic bulls-eye rash

- 1-4 weeks after bite

- painless >5cm diameter

what are the systemic features?

- headache

- lethargy

- fever

- arthralgia

what are the two groups of later features?

- cardiovascular

- neuro

what are the cvs symptoms?

- heart block

- peri/myocarditis

what are the neuro symptoms?

- facial nerve palsy

- radicular pain

- meningitis

how can lyme disease be diagnosed?

clinically - if erythema migrans is present

how else can lyme disease be diagnosed?

ELISA for antibodies ot borrelia burgdorferi

what is the management of asymptomatic tick bites?

- remove tick with fine-tipped tweezers - then wash area

- no antibiotic treatment

what is the management of suspected/confirmed lyme disease?

- doxycylcine if early disease

- amoxicillin if pregnant

what should be given in disseminated disease?

ceftriaxone

what can happen after initiating therapy?

jarisch-herxheimer reaction

what happens in a jarisch-herxheimer reaction?

- fever

- rash

- tachycardia

(also seen in syphilis, another spriochaetal disease)