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1) Lyme Disease::
Tick... Bites.... Small rodents... Take Bacteria from Small rodents... Than bites human and causes.
Reservoir for Bacteria... Rodents.
Reservoir for Ticks........ White Tail deer.
Tick... Bites.... Small rodents... Take Bacteria from Small rodents... Than bites human and causes.
Reservoir for Bacteria... Rodents.
Reservoir for Ticks........ White Tail deer.
2) Three Stages of Disease::
STAGE1::
Early localised, occurs after 7-14 days of Bite, Fever, Rash, Headache & Myalgia are prominent. É.Migrans
STAGE1::
Early localised, occurs after 7-14 days of Bite, Fever, Rash, Headache & Myalgia are prominent. É.Migrans
3) STAGE2::
After weeks, CNS(Subacute Onset, Neuritis, Meningitis, Cranial Nerves), CARDITIS(Myocarditis, Heart Blocks)
Acute Active Arthritis large joints
After weeks, CNS(Subacute Onset, Neuritis, Meningitis, Cranial Nerves), CARDITIS(Myocarditis, Heart Blocks)
Acute Active Arthritis large joints
4) STAGE3::
Months to Years, Chronic Arthritis, Encephalo-Myelitis, Polyneuropathy(axonal) , Mononeuritis Multiplex, Dementia, NeuroPsychiatric sequel.
Months to Years, Chronic Arthritis, Encephalo-Myelitis, Polyneuropathy(axonal) , Mononeuritis Multiplex, Dementia, NeuroPsychiatric sequel.
5) Diagnosis::
ELISA... Looking for Antibodies, If Positive than we go for Blot.If Negative we stop here.
WESTERN BLOT...
IgG 10bands....>5/10... Positive
IgM 3bands.....>2/3......Positive
IgM+IgG... Sx less than 30days
IgG only.... Sx more than 30days.
ELISA... Looking for Antibodies, If Positive than we go for Blot.If Negative we stop here.
WESTERN BLOT...
IgG 10bands....>5/10... Positive
IgM 3bands.....>2/3......Positive
IgM+IgG... Sx less than 30days
IgG only.... Sx more than 30days.
6) 48% sensitivity in Erythema Migrans(low sensitivity in Early Disease, <30days)
97-100% sensitive in Late Lyme(>30days).
IgG may persist upto 20 years in 25%.
97-100% sensitive in Late Lyme(>30days).
IgG may persist upto 20 years in 25%.
7) Clue to Lyme Meningitis:
Lymphocytic, Subacute Onset(7days),history of Tick Bite or Erythema Migrans, warmer months, wooded area, Nerve palsy like 7 or 8th Nerves, Joint Symptoms, Carditis.
Lymphocytic, Subacute Onset(7days),history of Tick Bite or Erythema Migrans, warmer months, wooded area, Nerve palsy like 7 or 8th Nerves, Joint Symptoms, Carditis.
8) Treatment ::
Doxycycline... All patients except Pregnancy and childrens
Amoxycilline.... Pregnant and children
Ceftriaxone, AzithroMycin, cefotaxime are alternative drugs.
Doxycycline... All patients except Pregnancy and childrens
Amoxycilline.... Pregnant and children
Ceftriaxone, AzithroMycin, cefotaxime are alternative drugs.
9) #Neurology #neurologyresident #neurologist #MedTwitter #NeuroTwitter #meningitis #virus #encephalitis #cns
Neuro-Lyme Disease: MR Imaging Findings
In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting
https://pubs.rsna.org/doi/10.1148/radiol.2531081103?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting
https://pubs.rsna.org/doi/10.1148/radiol.2531081103?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
