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Organism
- B burgdorferi
- microaerophilic
- Multipe OMPs, Ag variation
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Epidemiology
- Complex life cycle with mouse, ticks, and deers
- Acquired form tick nymphs
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Pathogenesis
- OspA is major OSP expressed in ticks
- OspC in host, stimulates protective Ab
- Chronic disease has aspects of autoimmunity
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Manifestations
- Erythema migrans
- Relapsing arthritis, most persistant finding
- Primary lesion one month after bite
- Fever, fatigue, myalgia, headache, joint pains
- Arthritis marks chronic syndrome -> large joints
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Diagnosis
Exposure and clinical findings
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Treatment
- Doxycycline and amoxicillin
- Continuation 30-60 days
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