Question

The patient is a 45-year-old man who presents to the clinic complaining of intermittent fevers, joint pain, myalgias, and generalized fatigue. He noticed a rash several days ago that seemed to appear and disappear on different parts of his abdomen. He noticed the lesion below this morning and decided to come in for evaluation. He denies recent international travel and the only difference in his usual routine was clearing some underbrush from his back yard about a week ago. Past medical history non-contributory with exception of severe allergy to penicillin resulting in hives and difficulty breathing. Physical exam: Temp 101.1 ˚F, BP 128/72, pulse 102 and regular, respirations 18. Skin inspection revealed a 4-inch diameter bull’s eye type red rash over the left flank area. The APRN, based on history and physical exam, diagnoses the patient with Lyme Disease. She ordered appropriate labs to confirm diagnosis but felt it urgent to begin antibiotic therapy to prevent secondary complications.  

What is Lyme disease and what patient factors may have increased his risk developing Lyme disease?

Answer 1

Lyme disease is a tick borne illness caused by bacterium Borrelia burgdoferi.It is a vector borne disease.It was transmitted by mosquitoes,ticks or fleas.In recent years approximately 20,000 to 30,000 confirmed cases of lyme disease per year and that have been reported to centers for Disease control and prevention.

The most common risk factors are

• Spending time in wooded or grassy areas
• In the United States ,deer ticks are found mostly in heavily wooded areas of Northeast and Midwest.
• Children who spend a lot of time outdoors in these regions are especially at the risk.

Most people with lyme disease recover completely with appropriate antibiotic treatment to prevent secondary complications.

People treated with appropriate antibiotics in early stages of lyme disease usually recover rapidly and completely.

Some commonly used antibiotics for oral treatments include doxycycline,amoxicillin or cefuroxime axetil.

Peoples with neurological or cardiac forms of illness may require intravenous treatment with antibiotic treatment such as ceftriaxone or penicillin.