Lyme Disease



Lyme disease is the topic for this video and Lyme disease is something that happens to a lot of people who live in heavily wooded areas I try to make these videos geographically independent since people from all over the world are watching them but this is one of those conditions that sort of is based in certain geographic regions so let's talk a little bit about what's happening you go into the woods and you get bit by a tick and the type of tick that causes Lyme disease has a special name it's called Exodus Exodus whatever the pronunciation is and there's different types but this is the main name and then what happens is this tick then transmits an organism into your body called a spirochete and the name of the spirochete is Borrelia burgdorferi and that's important to remember so don't get confused the tics name is the EXO de stick and the spirochete which is the organism that the tick essentially introduces into your body it's called Borrelia burgdorferi then what happens is it involves the the skin because that's where the tick bite occurs eventually this organism the spirochete the Borrelia will enter into your lymphatic system and later will disseminate into your bloodstream and when that happens that can cause systemic symptoms so a lot of disease essentially if you have symptoms there's three types of symptoms there's their localized but they're also characterized by stage so you have early equalised you have early disseminated and then you have late so early localized which have a appears in 75% of patients is really referring to that rash and that rash has at the side of the tick bite has a special name it's called erythema migrans erythema migrans and I'll show you a picture of that rash this is what it looks like as you can clearly see the area is a large area with the center and a periphery resembling a bull's eye if you can kind of see and it can appear most commonly on the thigh or buttock or axilla in this photo it's actually on the back so that's the first initial presentation what's the organism that spirochete disseminates into the bloodstream you can get systemic symptoms and those are systemic symptoms that include malaise fatigue chills fever headache and myalgia is in our thorough Jia's which in layman's terms are muscle pain and joint pain this will occur about 3 to 32 days after the tick bite and this is a few weeks after the tick bite and then also in about 15% of patients in the early disseminated phase you can also get neurologic symptoms like meningitis and Bell's palsy facial palsy that's important to remember all right now we have the late the late stage and this can happen now years later if it's not treated months to years months we'll put months tears and what is this late symptomatology involves arthritis severe arthritis commonly affecting the knees all right so how do you diagnose this well the diagnosis is really a combination of history where a person you know presents with a rash with the classic history of exposure to an endemic area area that's endemic to Lyme disease history of a tick bite and some of the classic initial symptoms but then there are some blood tests that are done and those blood tests are actually given this very easy to remember name Lyme titers and the Lyme titers can come back to be helpful in the diagnosis and that's really that's all there is to it really sometimes physicians I can also do blood cultures and then also you can do a CSF cultures as well if you feel it's necessary and also since the the knees are involved the joints joints are involved joint fluid can be tested aspirated and tested but really the history and the the Lyme titers usually are the way to diagnose it treatment well the treatment of Lyme disease is involving antibiotics most commonly doxycycline but they both there's also amoxicillin and ceftriaxone and then the arthritis is managed with non-steroidal anti-inflammatory drugs all right now I like to show a couple clinical vignettes about this disease a 40 year old woman vacationing is bitten by a tick she does not seek medical treatment and eventually develops chronic arthritis of the knee and hip turrets and paralysis of the left facial muscles a physical exam during the early stages of the disorder would most likely have revealed well this is a classic vignette it's nice that they don't actually mention Lyme disease it kind of makes you think but the history is pretty classic with the ticker than the arthritis and my opinion is she probably hasn't gotten treated for eat months two years because the arthritis is actually as you remember too late presentation so what they're asking you is when she first had it what would she have had and it's actually right above you she would have had that classic rash which is known as erythema chronic migraines and finally we have a epidemiological question global eradication of Lyme disease is unlikely because if you remember there's a tick called exodus' and it transmits the spirochete relia burgdorferi and the tick is acts as a reservoir for that organism and as a result because the tick is endemic to certain geographic regions Borrelia burgdorferi can be maintained in nature forever pretty much by this tick so therefore a where it says Borrelia burgdorferi can be maintained in nature indefinitely by a tick vector is the correct answer

9 comments

  1. In the US lyme disease was first discovered in Conneticut in the 1970's. It has been known in Europe for overs 100 yrs….known as human borreliosis.
    It is endemic in the whole US…..esp in Pennsylvania…the rash you say appears most commonly on thigh-buttock–??it usually first appears in area WHERE ONE IS BITTEN! Late stage involves much more than just arthritis—-also it can mimic alzheimers –the bacteria has been found in autopsy of brain in some alzheimers patients….

  2. il y a aussi problème cardiaque au stade 2 bloc cardiaque transitoire ou myocardite avec problème neurologiques et arthrite
    merci pour les videos

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