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Lyme disease

Lyme disease. Borrelia. Borrelia burgdorferi sensu stricto Borrelia garinii Borrelia afzelii. Life cycle of ticks. Life cycle of ticks. Two adult deer ticks. Ticks are pretty small…. Stage one (early infection ). Erythema migrans 3 days to 1 month following bite

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Lyme disease

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  1. Lyme disease

  2. Borrelia Borreliaburgdorferisensustricto Borreliagarinii Borreliaafzelii

  3. Life cycle of ticks

  4. Life cycle of ticks

  5. Two adult deer ticks

  6. Ticks are pretty small…

  7. Stage one (early infection) Erythemamigrans • 3 days to 1 month following bite • Occurs in 60-80% (ie doesn’t always occur) • Expands to characteristic “bulls eye”

  8. Stage one (early infection)

  9. Not all rashes are Lyme disease • Allergic reactions to tick saliva usually occur within hours to a few days after the tick bite, usually do not expand, and disappear within a few days. • Erythemamigrans persists longer, but usually subsides within 3-4 weeks.

  10. Stage two (dissemination stage) • Fatigue • Fever • Headache • Muscle and joint pain • Lymphadenopathy • Secondary annular skin lesions

  11. Stage three (persistent infection) • Months or years following bite • Typically involves intermittent episodes of joint pain • Meningitis • Bell's palsy, numbness, pain • Cardiac arrhythmias • Migratory pain to joints, tendons, muscle and bone.

  12. Stage three (persistent infection) • RheumatologicalChronic Lyme arthritis in11% - erosion of cartilage and/or bone • NeurologicalDepression, disturbances in memory, mood, or sleep patterns, tingling, numbness

  13. Diagnosis • Serodiagnosis to detect anti-borrelia antibodies is not useful until in later stages of illness. • B. burgdorferi can be cultured from 80% or more of biopsy specimens taken from early erythemamigrans lesions. However, the diagnostic value of this procedure is limited because of the need for special bacteriologic media (BSK medium) and protracted observation of cultures.

  14. Treatment • Doxycycline • Late treatment can result in persistent symptoms

  15. Prevention • Avoid tick-infested areas, especially in May, June, and July • Insect repellent containing DEET • Wear a hat and a long-sleeved shirt • Walk in the centre of trails to avoid overhanging grass and brush. • After being outdoors, remove clothing and wash and dry it at a high temperature • Remove ticks • Preventive antibiotic treatment with erythromycin or doxycycline?

  16. Summary • A third of patients don’t have a rash • Stage 2 symptoms are vague • Stage 3 consequences are serious • Diagnosis is difficult • Awareness of the disease is poor

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