Lyme Disease Group Presentation - OT 7141

Lyme disease is primarily caused by the Borrelia burgdorferi bacterium transmitted through tick bites, particularly from deer ticks.
Symptoms include joint pain, muscle stiffness, fatigue, headaches, and characteristic rashes (erythema migrans).
Early diagnosis and treatment are critical for successful management.

Patient Profile: 30-year-old female.
Symptoms: Joint pain, muscle stiffness, extreme fatigue, persistent headache, and rashes.
History: Recent camping trip in northern Minnesota 1 month prior; symptoms worsened over the last 2 weeks.
Diagnosis: Confirmed Lyme disease through blood testing.

Stage One - Early Localized Disease (3 to 30 days post-bite)
- Common Symptoms: Fever, headache, muscle aches, joint stiffness, extreme fatigue, and rash.
- Rash is a prominent indicator but not guaranteed; may also present swollen lymph nodes.
Stage Two - Early Disseminated Disease (3 to 10 weeks post-bite)
- Symptoms expand beyond the initial stage, including:
  - Multiple rashes.
  - Neck pain and stiffness.
  - Facial muscle weakness.
  - Cardiac irregularities due to immune response.
  - Back pain radiating to hips.
  - Sensory symptoms like numbness and vision changes.
- This is where the current patient falls.
Stage Three - Late Disseminated Disease
- Most severe stage with symptoms from earlier stages persisting.
- Commonly involves arthritis, especially in large joints (knees), lasting pain, stiffness, and potential complications after treatment.

Start with patient history and symptom timeline, including exposure risk.
Look for characteristic rashes and swelling, which may lead to considerations of arthritis.
Blood testing includes:
- ELISA test to check for antibodies; it may need to be followed up with a Western blot test for accuracy.
If neurological symptoms arise (e.g., facial palsy), a spinal tap may be conducted to analyze cerebrospinal fluid.

Treatment varies based on disease stage and patient factors:
- Antibiotics: Doxycycline is standard; alternatives for children/pregnant women.
- May require IV therapy in later stages or if severe symptoms arise.
- In cases of heart block, temporary pacemaker may be necessary.
Co-infections may be treated simultaneously with the same antibiotics.
Post-treatment Lyme Disease Syndrome (PTLDS) may occur and is managed with support for pain and fatigue rather than further antibiotics.

ADLs, IADLs, health management, rest, education, work, leisure, and social participation are all impacted.

Symptoms can mimic flu-like conditions, resulting in fatigue, aches, and stiffness, which can severely affect daily functioning.
Advanced stages may lead to additional challenges, including neck stiffness, tissue damage, and decreased cardiovascular function.

Activity Modifications: Alter environmental demands for those with arthritis.
Energy Conservation: Prioritize tasks to manage fatigue effectively.
Task Pacing: Incorporate rest periods and maintain proper posture.
Adaptive Equipment: Use of tools like grab bars, raised toilet seats, and adaptive clothing for daily tasks.
Feeding Aids: Tools designed to assist with eating and meal preparation.
Health Promotion: Focus on sleep hygiene and coping strategies to alleviate fatigue.

Comprehensive examination of Lyme disease etiology, symptoms, diagnosis, treatment options, and impacts on occupational therapy.