A 27-year old white female presented at the walking clinic of her local physicia

Question

A 27-year old white female presented at the walking clinic of her local physician on August 15. On physical exam, the patient had a fever of 38.5C. She appeared fatigued, had tender joints, and complained of a headache, a stiff neck and a backache. The physician noticed a circular "rash" about 5 inches in diameter, with a bright red leading edge and a dim center in the form of a "bull’s eye". The physician noted an irregular heart beat. The patient complained of lack of ability to concentrate.

The patient gave the following history: She is a graduate student in the wildlife program at the university in town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of biting flies, mosquitoes and ticks in the area. She felt well until about 2 weeks after returning to her home. Since that time, many of her symptoms had progressed. She finally found that she could take it no more.

What is your best diagnosis of this case?

What features are critical to your diagnosis?

Which diagnostic procedures/tests would you run to confirm your diagnosis?

What further steps should be taken to clear up the problem in this patient?

Explanation / Answer

This could be a case of Lyme disease. This is caused by a bacteria of Borrelia type and get spreads by ticks. Once the infected tick bites a person, symptoms starts to appear within 3 days to one month.

The disease can be identified by the presence of an infected red area with a clear center. A structure similar to bull's-eye are also seen in pateints. Rashes mostly accompanied by tender joints, stiff neck, fever and also the symptoms appreared almost one moth after she attended the wildlife program.

To confirm whether she has lyme disease and to identify the presence of the bacteria ELISA test can be performed, ELISA mehod can be used to detect whether antibody agaisnt the bacteria of Borrelia type is present or not.

Lyme disease could be treated with antibiotics like Doxycycline, Amoxycylline.

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.