Lyme Disease

Rosacea Free Forever

Rosacea Free Forever Cure By Laura Taylor

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This is a disorder caused by the spirochaete Borrelia Burgdorferi, characterised by relapsing and remitting arthralgia associated with a characteristic skin rash (erythema chronicum nigrans) and neurological features. The organism, related to the treponemes, is prevalent throughout Europe and North America and is carried by ixodes ticks.

Clinical features

Only a minority of persons bitten by an infected tick develop the disease. Spirochactocidal activity in normal serum and the immune response normally provide protection. It rarely occurs in HIV patients. Stage 1: Spring/summer -

Tick bite -ยป flu-like symptoms, arthralgia and skin rash (erythema chronicum nigrans). Treatment with antibiotics is usually curative.

1 Untreated and small number of treated patients. Stage 2: Several weeks/months later -

Subacute lymphocytic meningitis - both illnesses are often mild, clear

Subacute encephalitis spontaneously and occasionally are unrecognised.

Cranial nerve involvement - Facial nerve palsy with or without subacute lymphocytic meningitis. Peripheral neuropathy - Subacute demyelinating and axonal sensory/motor neuropathy associated with severe root pain (radiculitis). - Bannwarth's syndrome. CSF examination in stage 2: Lymphocytosis Elevated immunoglobulins.

Oligoclonal bands. Elevated awiBurgdorferi antibodies. An unknown proportion progress.

Stage 3: Several months/years later -Arthritis

Diffuse CNS involvement - chronic/subacute encephalitis.

- focal brain disease.

- psychiatric disease with fatigue and diffuse muscle pain.

Diagnosis

Antibody tests

- Immunofluorescence assay (IFA)

- Enzyme-linked immunoabsorbent assay (ELISA). In endemic areas up to 5% of the population are positive, although with lower titres than symptomatic patients.

In patients from endemic areas:

in serum and CSF.

diagnosis is definite, but in stage 3 this is often uncertain and blind trials of therapy are given.

with meningitis/CN palsy encephalitis/radiculitis + CSF profile + positive serology

Treatment

Stage 1 - Oral antibiotics: penicillin, erythromycin or tetracycline.

Stage 2 - I.V. penicillin G. 20 million units for 10 days (or cefotaxime).

If symptoms persist - wrong diagnosis with misleading titres, or - immune mediated damage.

Steroids can be used in late stages when symptoms have not responded to antibiotics

PCR if available gives the definitive answer.

MRI is abnormal in 25% with subcortical (T2) white matter lesions.

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