Australian Doctor 15th September 2023 AD 15th Sept Issue | Seite 23

23

How to Treat .

EARN CPD OR PDP POINTS

23

Complete How to Treat quizzes via ausdoc . com . au / how-to-treat
Female deer in the wild .
Gil Paradis / bit . ly / 3Z4j17d
NEED TO KNOW
Lyme disease is a tick-borne infection caused by Borrelia sp . found in Europe , North America and parts of Asia .
There is no evidence of Australian-acquired Lyme disease .
Lyme disease manifestations can be early localised , early disseminated or late .
The diagnosis is mostly made by detection of anti-B . burgdorferi antibodies in the patient ’ s serum .
Treatment is dependent on the stage and clinical manifestation of Lyme disease ; the mainstay of therapy is oral doxycycline , with IV ceftriaxone reserved for late and more severe disease .

How to Treat Quiz

RACGP : 0.5 hours EA 0.5 hours RP ACRRM : 0.5 hours EA 0.5 hours RP Earn CPD or PDP points .
Go to ausdoc . com . au / how-to-treat
Lyme disease – like illness and debilitating symptom complexes attributed to ticks ( DSCATT ) is a term used in patients without diagnosed Lyme disease but with chronic debilitating symptoms associated with a tick bite .
Antibiotic therapy is not indicated in patients considered to have Lyme disease – like illness or DSCATT and may cause serious harm .

Is this Lyme disease ?

Dr Hayley Heaton ( left ) Infectious diseases and microbiology advanced trainee , Canberra Hospital , ACT .
Professor Peter Collignon
AM ( right ) Infectious diseases physician and microbiologist , Canberra Hospital ; professor , Australian National University medical school , ACT .
First published online on 31 March 2023
INTRODUCTION
LYME disease , or Lyme borreliosis , is a
tick-borne disease ( see figure 1 ) caused by the spirochaetes in the Borrelia burgdorferi sensu lato complex .
Lyme disease was initially described in 1982 following the persistence of parents in Lyme , Connecticut , US , who were concerned about an epidemic of inflammatory arthritis in local children , which was initially misdiagnosed as rheumatoid arthritis . 1 This prompted an investigation by the Connecticut State Health Department and ultimately led to characterisation of the disease .
B . burgdorferi sensu lato ( sl ) is known to be endemic in North America and Europe , with increasing reports of Lyme disease in Asia . In Australia , though , there is no evidence of locally acquired classical Lyme disease or that the causative bacteria ( B . burgdorferi sl ), or closely related forms , exist in Australia .
The natural course of B . burgdorferi sl infection varies greatly and has three distinct clinical stages : early , disseminated and late . The classical early clinical manifestations of Lyme disease usually include fever , characteristic erythema migrans rash and
Figure 1 . Infected female deer tick on human skin .
lymphadenopathy . However , once disseminated to other organs or tissues , there can be a wide range of manifestations , such as arthritis , meningitis or carditis . Early antibiotic treatment
of Lyme disease usually leads to full recovery , but antibiotic treatment of late-stage Lyme disease is associated with more variable degrees of recovery .
The prompt diagnosis of Lyme disease usually relies on appropriate epidemiological risk factors for acquisition of B . burgdorferi sl infection , corresponding clinical