Lyme Disease

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Published on February 20, 2014

Author: PeterDobie

Source: authorstream.com

Lyme Disease: Lyme D isease Dr. Peter Dobie PowerPoint Presentation: Lyme disease was named in 1977 when arthritis was observed in a cluster of children in and around Lyme, CN Conditions suggested that this was an infectious disease probably transmitted by an arthropod Further investigation revealed that Lyme disease is caused by the bacterium Introduction PowerPoint Presentation: Causative Organism Borrelia burgdorferi Loosely coiled spirochete 8-20 micrometers PowerPoint Presentation: Ticks that cause Lyme disease Black-legged Tick Rocky Mountain Tick Lone Star Tick PowerPoint Presentation: Localized rash – erythema chronicum migrans Dissemination to multiple organ systems Chronic disseminated stage often with arthritic symptoms Three Stages of Disease PowerPoint Presentation: Localized Rash PowerPoint Presentation: Dissemination Signs of early disseminated infection usually occur days to weeks after the appearance of a solitary erythema migrans lesion Neurologic – Bell’s Palsy Musculoskeletal manifestations may include migratory joint and muscle pains Late disseminated Lyme disease is intermittent swelling and pain of one or a few joints. PowerPoint Presentation: Chronic arthritis Chronic axonal polyneuropathy Lyme disease morbidity may be severe, chronic, and disabling. Rarely, if ever, fatal Chronic Disseminated PowerPoint Presentation: Diagnosis Diagnosed clinically, confirmed serologically. Often appropriate to treat patients with early disease solely on the basis of objective signs and a known exposure. CDC recommends testing initially with a sensitive first test, ELISA or an IFA test, followed by testing with the more specific Western immunoblot (WB) test to corroborate equivocal or positive results obtained with the first test. Serology: Serology Patients with early disseminated or late-stage disease usually have strong serological reactivity Antibodies often persist for months or years following successfully treated or untreated infection. S eroreactivity alone cannot be used as a marker of active disease Problems with Serology: Problems with Serology IFA false positive may occur if patient has syphilis, relapsing fever or RA. IFA interpretation highly subjective EIA lacks sensitivity in early disease. EIA false positives with syphilis, other treponemes , IM and autoimmune disease. Western Blot: Western Blot Must be used if the Lyme IgG / IgM antibody serology is equivocal or positive " Osp " refers to o uter s urface p rotein of the bacteria. " kDa " is the abbreviation for " kilodalton ," which is used for molecular weight designations. Lyme antibodies of importance are against the following molecular weights of the B. burgdorferi antigens: 23-25 kDa ( Osp C); 31 kDa ( Osp A); 34 kDa ( Osp B); 39 kDa ; 41 kDa ; and 83-93 kDa 7 . Treatment: Treatment Single dose doxycycline shortly after tick bite. Lyme disease give doxycycline followed by amoxacillin Neuroborreliosis requires IV antibiotic therapy. Thank You: Thank You Dr. Peter Dobie Address: SUITE 3A, EDGECLIFF COURT , 2 NEW McLean ST, EDGECLIFF , NSW 2027   Email: info@drpeterdobie.com   Telephone: 02 9362 0493   Fax: 02 9363 0767

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