Lyme_Disease pathgenesis , rx , investigation _Slide.pptx

lyme disease pathogenesis , rx , investigation

1. LYME DISEASE -DR- Sachin Kulkarni Medicine Resident 20/06/24

2. Lyme D isease Pathogen: Borrelia species

3. Lyme Disease Transmission

4. Lyme Disease Vector

5. Lyme Disease Vector

6. Most Common Reported Tickborne Diseases

7. Lyme Disease Reported Cases Kugeler et al. 2021. EID 27(2).

8. Lyme Disease Seasonal Risk

9. Clinical Management of Tick Bites Tick Removal & Lyme Disease Prophylaxis

10. Tick Removal

11. Tick Removal

12. Tick Removal

13. Post- Exposure Prophylaxis (PEP) to Prevent Lyme Disease

14. Determine if Lyme Disease PEP is Appropriate

15. Lyme Disease PEP: Clinical Decision- Making Aid

16. Post- Exposure Prophylaxis (PEP) to Prevent Lyme Disease Doxycycline safety among children: Short courses (<21 days) are safe to use in children of ALL ages.

17. After a Tick Bite

18. Should Removed Ticks Be Tested for Pathogens?

19. Tick Bite Prevention Counseling Use EPA- registered insect repellents. Perform daily tick checks. Bathe within 2 hours after coming indoors. Put clothes in dryer on high heat after coming indoors to kill ticks. Avoid tick habitat. Prevent tick bites in pets. Reduce tick habitat through yard management.

20. Lyme Disease Vaccination

21. Lyme Disease Early Signs & Symptoms

22. Lyme Disease: Clinical Overview

23. Typical Lyme Disease Manifestations

24. Typical Lyme Disease Manifestations

25. Typical Lyme Disease Manifestations

26. Frequency of Lyme Disease Manifestations

27. Erythema Migrans

28. Disseminated Lyme Disease

29. Erythema Migrans Typical patch is round and erythematous. Can be warm Rarely painful or itchy Expands slowly over multiple days. Usually >5 cm in diameter May be up to 30 cm in diameter Central clearing can occur as the rash enlarges. Sometimes results in a bull’s-eye appearance

30. Erythema Migrans in People with Darker Skin Tones

31. Disseminated Lyme Disease

32. Lyme Disease Reinfection

33. Blacklegged ticks may also transmit pathogens that cause: Anaplasmosis Babesiosis Ehrlichiosis Borrelia miyamotoi disease Borrelia mayonii (Lyme disease) Powassan virus disease Risk of coinfection is geographically localized. If you are concerned that your patient might have a coinfection, talk to your local public health department to learn about the risk in your area. Lyme Disease Coinfection with other Tickborne Diseases

34. Lyme Disease Coinfection with other Tickborne Diseases

35. Lyme Disease Diagnosis & Testing

36. Interpretation of Lyme Disease Serologic Test Results https:// www.aphl.org/aboutAPHL/publications/Documents/ID-2021- Lyme- Disease-Serologic- Testing- Reporting.pdf CDC recommends diagnostic tests for Lyme disease that have been evaluated and cleared by the FDA. Two- step serologic tests are the only FDA- cleared test for Lyme disease. APHL provides suggested laboratory reporting and provider interpretation for Lyme disease serologic test results.

37. Two- Step Lyme Disease Serologic Testing

38. Western Blot for Lyme Disease

39. Western Blot for Lyme Disease

40. Modified Two- Step Serology Protocol

41. Modified Two- Step Serology Protocol

42. When to test for Lyme Disease? Clinical Questions to Determine Pretest Probability Has the patient been in an area where Lyme disease is common? Was the patient likely exposed to ticks? Does the patient have symptoms that are characteristic of Lyme disease?

43. Lyme Disease Test of Cure?

44. Lyme Disease Clinical Management & Treatment

45. Lyme Disease Treatment Overview Lyme disease can be treated effectively with antibiotics. Recommended antibiotic regimens range in duration from 10 days to 4 weeks. Most patients have complete resolution of illness following treatment, but sequelae are possible, especially when patients are diagnosed and treated at later stages of disease.

46. Treatment for Erythema Migrans

47. Lyme Disease Treatment Considerations

48. Treatment for Neurologic Lyme Disease

49. Treatment for Lyme Carditis

50. Treatment for Lyme Carditis

51. Treatment for an Initial Episode of Lyme Arthritis

52. Treatment for Lyme Arthritis

53. Lyme Disease Treatment Considerations

54. Lyme Disease Treatment Considerations

55. Post- Treatment Considerations

56. Post- Treatment Considerations

57. Post- Treatment Considerations More than two courses of antibiotics are NOT recommended for the treatment of Lyme disease.

58. THANK YOU….!