|
Year |
2001 |
|---|---|
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Question Number |
21 |
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Category |
Select |
Question
A 17 year old boy with knee effusions is diagnosed with Lyme disease. What is the current recommended treatment?
1 – Tetracycline
2 – Amoxicillin
3 – Cephalexin
4 – Ciprofloxacin
5 – Imipenem
Figures
Answer (click for answer)
Pref resp 2
Lyme disease is caused by the bacteria Borrelia burgdorferi (gm neg). It is borne by the tick Ixodes dammini in the eastern US and by I pacificus in the western US.
Stage 1, erythema migrans 3-32 days after the bite.
Stage 2, migratory pain without swelling of joints and surrounding soft tissue
Stage 3, arthritis affecting predominantly the large joints (usually the knee) 6 months after infection.
Treatment-Early-Amoxicillin for 10-30 days depending on severity. Late stage requires doxycycline or amoxicillin for 30 days, with IV Ceftriaxone for nonresponders. Other therapies include steroid injections or synovectomy.
Reference: Beaty JH (ed):OKU 6. Rosemont, IL, AAOS, 1999, pp 191-203.