10-20-2010, 09:20 PM
lyme dx is caused by tick bite (ixodes scapularies), through the transmission of the org, borellia burgdoferi. common in individuals who have been on recent camping trip. incubation period is about 3-30 days. About 80% of people will dev. the so called 'bull's eye' rash (erythema migrans rash); an erythematos rash with central clearing. this devs few days after the bite. the rash can clear after a few weeks without rx. few weeks later, some patients dev. facial nerve palsy which may be bilateral; some can go on to dev. meningitis, encephalitis, also myocarditis, pericarditis and some heart block and various forms of arrythmias. arthritis can dev few months to years in 60% of patients.
diagnosis.
the presence of the rash and one late manifestation + lab confirmation might be sufficient to make a dx. you use serology testing: ELIZA and WESTERN BLOT. this serology testing would not be +ve in an early dx so serology is not required, you make your dx based on stong clinical suspicion.
treatment.
treat rash, arthritis and facial nerve palsy with doxycycline or amoxicillin.
treat cardiac and severe neurologic symptom with i.v ceftriaxone.
NB:About 25% of patients can also have babesia microti infection.
diagnosis.
the presence of the rash and one late manifestation + lab confirmation might be sufficient to make a dx. you use serology testing: ELIZA and WESTERN BLOT. this serology testing would not be +ve in an early dx so serology is not required, you make your dx based on stong clinical suspicion.
treatment.
treat rash, arthritis and facial nerve palsy with doxycycline or amoxicillin.
treat cardiac and severe neurologic symptom with i.v ceftriaxone.
NB:About 25% of patients can also have babesia microti infection.