Lyme
The pathogen responsible for this infection.
What is Borrelia burgdorferi?
The two most common vectors associated with disease transmission for Anaplasmosis and Ehrlichiosis, respectively.
What is Ixodes scapularis (or the blacklegged tick) and Amblyomma americanum (or the Lone Star tick).
The quickest way to diagnose this Rocky Mountain Spotted Fever.
What is indirect fluorescent antibody staining of a skin biopsy (faster turnaround than PCR in most but not necessarily all settings)?
Best test to monitor asymptomatic patients.
What is a PCR (3 mo) after the clinical diagnosis?
Note: Patients on treatment are best monitored by a peripheral blood smear and parasite counts.
IgE to alpha-gal >0.1 IU/mL
What is the diagnostic test for alpha-gal in a symptomatic patient? Note: A positive test in an asymptomatic patient does not establish disease.
The specific vector responsible for transmitting this infection.
What is Ixodes scapularis or the blacklegged tick (either answer acceptable)?
A buffy coat smear demonstrating intracytoplamic inclusions.
What are morulae?
The most common vector associated with Rocky Mountain Spotted Fever transmission.
What is Dermacentor variabilis (or the dog tick)?
Best treatment for mild-moderate illness.
What is azithromycin and atovaquone?
Typical time for symptom onset after a patient with alpha-gal ingests the antigen.
What is 2-6 hours (3-5 hr. is also acceptable)?
The two regions where disease is endemic in the US.
What is the northeast and north central regions?
Most sensitive test to establish a diagnosis.
What is PCR?
Characteristics of the rash associated with this disease.
What is maculopapular (90%), day 3-5 of illness, beginning on the extremities (palms and soles) and petechial in half (may not appear until day 6 of illness)?
The quickest, although not the most sensitive method for diagnosis.
What is a peripheral blood smear?
The most sensitive test is the PCR.
Strategies to prevent acquiring the "red meat allergy".
What is insect repellent (DEET, picaridin, IR3535), permethrin-impregnated clothing, and reducing the deer population.
Preferred antibiotic for heart block.
What is ceftriaxone?
Drug of choice for anaplasma and ehrlichia.
What is doxycycline?
The five states accounting for the majority of Rocky Mountain Spotted Fever cases.
What is Missouri, Arkansas, Oklahoma, Tennessee, and North Carolina?
Note: It can occur anywhere in the continental US.
Common co-infection pathogens.
What is Lyme and Anaplasma?
A recently described species of Ehrlichia transmitted by Ixodes scapularis (the blacklegged tick) in the upper Midwest region.
What is Ehrlichia muris eauclarensis?
How would you interpret a positive IgM and negative IgG Western blot for Lyme in a patient with more than 1 month of symptoms compatible with summer flu?
What is a false-positive test result?
The optimal way to differentiate among these two illnesses clinically
What is geography, the travel history, hobbies, and exposures (environmental, animal, vector)?
Drug of choice in children and pregnancy.
What is doxycycline?
Treatment duration for immunocompromised patients.
What is 6 or more weeks?
A serious viral infection causing meningoencephalitis, spread by Ixodes scapularis (blacklegged tick).
What is Powassan virus infection?