|
Lyme Disease
OVERVIEW: Lyme disease is a multisystem infection caused by a microbe transmitted by deer ticks.
• Stage 1 includes a characteristic expanding ringlike skin rash and flulike symptoms.
• Stage 2 may involve one or more organ systems; neurologic and cardiac disease are most common.
• Stage 3, chronic Lyme disease, involves arthritis and chronic neurological symptoms.
SIGNS AND SYMPTOMS: • Stage 1
• Expanding bull's-eye rash
• Fever
• Headache
• Muscle and joint pain
• May be no symptoms
• Stage 2:
• Multiple ringlike rashes
• Inflammation of facial nerves
• Meningitis
• Heart disorders
• Inflammation of the testicles or liver
• Arthritis
• Stage 3:
• Recurring joint and muscle inflammation
• Brain disorders (psychosis, dementia, memory loss, depression, stroke-like symptoms)
• Nerve disorders
• Eye disorders
CAUSES: Infection with Borrelia burgdorferi, transmitted by the bite of deer tick
SCOPE: Lyme disease affects 5.2 out of 100,000 persons in the United States. It is most prevalent in Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Wisconsin, and Maryland.
MOST OFTEN AFFECTED: Lyme disease can occur in all ages, but it is most common in children under age 15 and in
25-44 year olds. Males and females are affected in equal frequency.
RISK FACTORS: Exposure to tick-infested area; most common from May to September
DIAGNOSIS PHYSICAL EXAMINATION: • The Physician will perform a physical examination to identify the presence of Lyme disease.
• Similar signs and symptoms may be caused by juvenile rheumatoid arthritis, viral infection, or many other diseases.
TESTS AND PROCEDURES: • Blood tests
• A sample of spinal fluids may be obtained by lumbar puncture (spinal tap).
TREATMENT GENERAL MEASURES: • Early stages of Lyme disease can be treated in the outpatient setting.
• Management of Stages 2 and 3 may require more intensive treatment, based on symptoms.
ACTIVITY: No restriction
DIET: No special diet
MEDICATIONS COMMONLY PRESCRIBED DRUGS: • Doxycycline (Vibramycin)
• Amoxicillin
• Ceftriaxone (Rocephin), cefotaxime (Claforan), penicillin G
• Steroids
CONTRAINDICATIONS: • Allergy to drug
• Doxycycline is contraindicated in children and in women who are pregnant or breast feeding.
PRECAUTIONS: Read drug product information.
DRUG INTERACTIONS: • May cause sensitivity to sunlight; use sunscreen
• The dosage of oral blood thinners (anticoagulants) may need to be reduced.
• Oral contraceptives may be less effective.
Other Drugs: Cefuroxime (Ceftin)
FOLLOW UP PATIENT MONITORING: Individuals with Stages 2 and 3 disease should see the doctor often over a period of months to
years, based on the severity of symptoms.
PREVENTION/AVOIDANCE: • Prevention of infection is possible by careful examination of skin for ticks after outdoor activities. Deer ticks are extremely small.
• Remove ticks promptly.
• Wear clothing that covers the ankles in endemic areas.
• Use insect repellant.
COMPLICATIONS: • Doxycycline (Vibramycin)
• Amoxicillin
• Ceftriaxone (Rocephin), cefotaxime (Claforan), penicillin G
• Steroids
WHAT TO EXPECT: • Early treatment with antibiotics can shorten the duration of symptoms and prevent later disease.
• Response of late-stage disease is variable.
MISCELLANEOUS OTHER FACTORS: N/A
PEDIATRIC: N/A
GERIATRIC: N/A
OTHERS: Ticks are commonly found on deer. Hunters may be at increased risk.
PREGNANCY: Pregnant patients with active disease should receive intravenous (IV) antibiotics. Doxycycline should not be used in pregnancy.
(see
images)
Want to discuss this term? Visit
our forum or our chat
room.
SEE ALSO (Enter the keywords below
into our search box or click on the link):
n/a
|
IE 5.0