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Monday, December 7, 2015


Lyme disease is the most common vector-borne illness . The spirochete, which causes the disease, is transmitted by Ixodes ticks, For a person to develop Lyme disease, he or she must be bitten by an infected tick and the organism is transmitted only if the tick is infected and if the tick feeds long enough for more than 36 hours. The major sign in early localized Lyme disease is the bull’s eye rash: erythema migrans. The rash begins at the tick bite site and expands over days to reach diameters in excess of 5 cm. Generally, the border of the rash is erythematous, with central clearing, although at times the center is erythematous or even purplish. Fever, malaise, aches and pains often accompany the rash. The rash resolves with or without antibiotic therapy. Some patients will develop early disseminated disease in which there are multiple erythema migrans. Cranial nerve palsies, most often the seventh nerve, may occur in this stage. Aseptic meningitis occurs in some patients and can be difficult to distinguish from viral meningitis. However, the onset is generally more insidious than viral meningitis. Carditis occurs in this stage but is rare in children; carditis presents as heart block. Late disease is characterized by arthritis, generally Central nervous system disease and peripheral neuropathy are rare manifestations of late Lyme disease. Prevention relies on avoidance of tick bites or prompt removal of the tick before transmission of the spirochete occurs. Ticks are most common in high grass or weeds. In general, if you can see your shoes, you are not likely to be bitten. This was shown in a study of golfers that correlated likelihood of Lyme disease with time spent in the rough. Tick checks are important so that the tick can be removed promptly. Lyme disease treatment ;Treatment depends upon the stage of the infection. For children aged 8 years and older, doxycycline is given for 2 to 3 weeks; amoxicillin is used in younger children or those who cannot tolerate doxycycline. Parenteral therapy is reserved for patients with persistent arthritis or meningitis; however, many experts would consider repeating an oral course of antibiotics for arthritis and using doxycycline for meningitis. As with many infections, symptoms often persist after completion of an effective antibiotic course. There is no evidence that prolonged antibiotic courses are needed or are helpful. read more here;

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