Lyme Disease complication admission

Patient can have Flu like illness initially or present with late complications like Meningitis, radiculopathy, AV Block etc

Hospitalist:

Erythema Migrans (>5cms, lasts 2 weeks and expands) and Spirochetemia happen in first month

IgM and IgG peak by approx. in one month and IgM goes down in 6 months but IgG remains for long time

Late Musculoskeletal and Neurological disease after 3-4 months

Arthritis usually involves 100% knee jt.

2 Step approach: 1. ELISA antibody test, if positive,

2. Western Blot test-Ig G requires 5 bands out of 10 and IgM requires 2 bands out of 3

Treatment: If patient has tick bite, give One dose of Doxycycline 200mg PO for prophylaxis

For Erythema Migrans, Doxycycline for 2-3wks

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