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afya
Lyme Disease
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> caused by the spirochaete Borrelia burgdorferi and is spread by ticks ''Features'' early: erythema chronicum migrans + systemic features (fever, arthralgia) CVS: heart block, myocarditis neuro: cranial nerve palsies, meningitis ''Investigation'' serology: antibodies to Borrelia burgdorferi ''Management'' doxycycline if early disease. Amoxicillin is an alternative if doxycycline is contraindicated (e.g. pregnancy) ceftriaxone if disseminated disease Jarisch-Herxheimer reaction is sometimes seen after initiating therapy: fever, rash, tachycardia after first dose of antibiotic (more commonly seen in syphilis, another spirochaetal disease)
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