Saturday, May 1, 2021

Lyme's disease - a review


Lyme's disease/ Lyme borreliosis

A patient with a typical history of frequent visits to the woods with bull's eye rash, neurologic features, cardiac abnormalities, and musculoskeletal features.

- caused by Borrelia burgdorferi (spirochete, visualised on LM)

- transmitted by Ixodes deer tick's bite

- co-infection with Anaplasma phagocytophilum.

- occurs in phases, though the patient may directly present with stage 2 or 3 manifestations without a past history of prior signs/symptoms.

- pathognomic/characteristic "bulls-eye'' skin lesions known as erythema migrans. (may develop early- within weeks, or late- within months)

- AV nodal block (often fluctuating)

- facial (Bell's) palsy, bilateral.

- Bone and joints: osteomyelitis, osteopenia, septic migratory arthralgias (type III HSR, knee and hip, several months after infection, may persist for years, chronic with exacerbations and remissions; HLA DR4)

- ocular manifestations: salt-and-pepper fundus

- signs of meningeal irritation/ aseptic meningitis.


That's all for now

- Jaskunwar Singh

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