CLINICAL FEATURES Stage Iborreliosis Erythema marginatum.

Meningism (g) Tender muscles (h) Tender enlarged liver and spleen Complictions - Severe are - myocardtlis. hepatic failure, severe bleeding associated with thrombocytopenia, DIC, secondary bacterial infection Tick-borne - Attacks generally milder and shorter, but may be followed by more relapses. DIAGNOSIS -(a) Louse-bome - Appearance of spirochetes In peripheral blood during a paroxysm (b) Tick -borne Infection - intraperitoneal lnjection of blood into mouse or rat produces numerous spirochetes in the rodents tail blood within 3-5 days. TREATMENT - Louse-bome relapsing lever - Adults - Tetracycline 250 mg .IV single dose Children - Erythromycin lactobionate 10 mg/kg IV single dose Tick-bome - Adults- Tetracycline 500 mg. p.o. q.d.s for 10 days Chitfren - Erythromycin 125-250 mg. q.d.s. FOR 10 days. 15. LYME DISEASE Lyme disease is caused by the tick-bome spirochaete Borrelia burgdoferi. Erythema migrans is the early skin lesion, and is the most common clinical mamfestation Transmision usually lakes place when an inlecfed tick (lxodid tick) bites. CLINICAL FEATURES Stage Iborreliosis Erythema marginatum. aofcalized erythematous rash appearing 2-30 days alter a bite. There may beofcal lymphadenopathy Stage II borreliosis After dissemination, the organsm can affect many tissues, principally the nervous, musculoskeletal (persistent arthralgia and small joint arthritis) and cardiovascular system (conduction defects, rarely cardomyopathy), and the skin There may be 'flu-like'illness Multiple areas of erythema migrans can occur. Stage III borreliosis: is unusual Chronic lyme arthritis of knee. Acrodermatitis chronica atrophicans Rarely chronic progressive encephalomyelitis. DIAGNOSIS - Antibody tests Specimens found reactive on Initial testing should be invesiigated using Western blot. TREATMENT - Amoxicillin, doxcyclin and cephalosporin’s, or azithromycin orally. Puerperal antibiotics include benzylpanicillin. cefotaxime and ceftriaxone. 16 WORM INFECTIONS Fllariasis Etiology - Filartal Infections are caused by parasistic tissue-dwelling, filarial nematode warms, which are transmited by blting Insects. Two main types of filariasis are: 1. Lymphatic fallrisis is. Transmited by mosqutoes.