Lyme Disease
Pathophysiology of Lyme Disease
Lyme disease is an
1) infection with Borrelia burgdorferi via tick bite
2) previous thinking held tick vector was Ixodes but transmission is now thought by some experts to be possible with additional tick species
3) occurs in stage I and stage II days to weeks after infection and in stage III months to years after infection (usually with preceding latency period
Signs and Symptoms
Stage I
1) characteristic expanding annular rash with central clearing (“bull’s eye or “target” rash) that occurs in only 40% of infections
Stage II
2) multiple secondary annular skin lesions
3) migratory musculoskeletal pain
4) heart block
5) shortness of breath
6) meningitis
7) headache
8) cranial and peripheral neuritis
9) abdominal pain
10) urinary dysuria and frequency
Stage III
11) encephalopathy
12) acrodermatitis
13) arthropathy
14) psychiatric disturbances (depression, hostile behavior)
Characteristic Test Findings
Laboratory
1) elevated sed rate
2) anti-Lyme antibodies (40%)
3) increased TNF and cytokines (organism is intensely proinflammatory)
Radiology
4) brain lesions indistinguishable from multiple sclerosis on MRI
Histology and Gross Pathology
1) fastidious microaerophilic organism
2) grows best on Barbour, Stoenner, Kelly medium
3) microvasculitis
Associated Conditions
1) diagnosis of Lyme disease mandates testing for babesiosis, ehrlichiosis, anaplasmosis, and Bartonella
2) some experienced Lyme clinicians also test for mycopl...
Source: Inside Surgery - Category: Surgeons Authors: Editor Tags: Infectious Disease babesia bulls eye rash coinfections deer tick erythema migrans hyperbaric ixodes target rash Source Type: blogs
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