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 ID: 775432
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Slide1
Lyme disease
Slide2Borrelia
Borrelia
burgdorferi
sensu
stricto
Borrelia
garinii
Borrelia
afzelii
Slide3Life cycle of ticks
Slide4Life cycle of ticks
Slide5Two adult deer ticks
Slide6Ticks are pretty small…
Slide7Stage one (early infection)
Erythema migrans3 days to 1 month following biteOccurs in 60-80% (ie doesn’t always occur)Expands to characteristic “bulls eye”
Slide8Stage one (early infection)
Slide9Not 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.
Erythema
migrans
persists longer, but usually subsides within 3-4 weeks.
Slide10Stage two (dissemination stage)
F
atigue
F
ever
Headache
M
uscle and joint pain
Lymphadenopathy
S
econdary annular skin lesions
Slide11Stage three (persistent infection)
Months or years following bite
T
ypically involves intermittent episodes of joint pain
Meningitis
Bell's palsy, numbness, pain
C
ardiac arrhythmias
M
igratory pain to joints, tendons, muscle and bone.
Slide12Stage three (persistent infection)
Rheumatological
Chronic Lyme arthritis in11% - erosion of cartilage and/or bone
Neurological
Depression, disturbances in memory, mood, or sleep patterns, tingling, numbness
Slide13Diagnosis
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
erythema
migrans
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.
Slide14Treatment
DoxycyclineLate treatment can result in persistent symptoms
Slide15Prevention
Avoid tick-infested areas, especially in May, June, and July
I
nsect 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
?
Slide16Summary
A third of patients don’t have a rashStage 2 symptoms are vagueStage 3 consequences are seriousDiagnosis is difficultAwareness of the disease is poor
Slide17