Lyme disease Borrelia burgdorferi

Lyme diseaseLyme disease
  • Facts:
    B. burgdoferi (Sprirochete)
    Usually in summer months, endemic to the Northeast
    Ixodes tick on white tailed deer and white footed mice
    MC vector-borne disease in N. America
  • History / PE:
    Erythematous, non pruritic/painful rash
    Cranial nerve palsy (MC is facial)
    Intermittent inflammatory arthritis (lyme arthritis)
  • Diagnosis:
    ELISA and Western Blot
    Tissue culture/PCR
  • Treatment:
    Doxycylcine (early disease) ceftriaxone (late disease)

    Amoxicillin (pregnant pts and children)
  • Pneumonic:
    Fever and rash? "Tiny GERMS"

    Typhoid fever

    Gonococcemia
    E ndocarditis
    RMSF
    Meningococcemia
    Sepsis (bacterial)
  • Notes:
    PRIMARY (early, localized disease)

    Erythema migrans "bulls eye" rash

    SECONDARY (disseminated disease)

    Migratory polyarthropathies
    Neurologic phenomena (eg. Bell's palsy)
    Meningitis and/or myocarditis
    Conduction abnormalities (3rd degree heartblock)

    TERTIARY (late disease)

    Arthritis
    Subacute encephalitis (memory loss and mood change)
  • See Also:
    Babesiosis (no rash)



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August 6th 2010