Who goes hiking ? Dont bring Lyme or giardiasis !! - triplehelix

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agree

lyme arthritis

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E. septic arthritis

virtuoso

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The answer is C.

Lyme borreliosis is caused by a spirochete, Borrelia burgdorferi, that is transmitted by the tick Ixodes ricinus complex. The principal vector is the northeastern United States from Maine to Maryland and the Midwestern states of Wisconsin and Minnesota. Lyme disease can also be seen in northern California and Oregon. Characteristic of early infection is the expanding annular lesion erythema migrans (EM). Most patients do not remember the tick bite, and up to 20% do not exhibit EM. Stage 2, or disseminated, infection may present as diffuse symptomatology or even meningitis with neurologic deficits. Eight percent of patients develop cardiac involvement, usually in the form of an atrioventricular block. This patient has a classic description of arthritis secondary to Lyme disease. It typically affects the knees and may last for weeks to months. Gout is not the diagnosis because there is no evidence of crystals on the arthrocentesis. Pseudogout, or calcium pyrophosphate dihydrate disease, is possible because the rhomboid crystals in this disease are often difficult to find; however, the definitive diagnosis can be made only if the crystals are identified or there are classic findings of chondrocalcinosis on radiography. Inflammatory effusions are not typical of osteoarthritis, and although septic arthritis must always be considered in the differential diagnosis of a monoarthritis, the Gram stain did not support this diagnosis. The diagnosis of Lyme arthritis can be made by serologic testing of the synovial fluid by ELISA and Western blot for anti“B. burgdorferi antibody. Synovial fluid for PCR of the Borellia genome can be performed, but there is concern about laboratory standards and the significance of a positive finding. Recommended treatment is either penicillin or ceftriaxone.

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Lyme