Reference no: EM132704748
An 18-year-old woman complained of knee pain that started 2 weeks previously. Three months earlier, soon after vacationing in Connecticut, she noticed a circular area of redness on her lower leg; it was approximately 10 cm in diameter. During the next 2 weeks, the area enlarged and the border became more clearly demarcated; however, the rash gradually disappeared. A few days after the rash disappeared, the woman experienced the onset of headaches, an inability to concentrate, and nausea. These symptoms also gradually abated. The pain in her knee developed approximately 1 month after these symptoms disappeared. On examination of the knee, mild tenderness and pain were elicited. A small amount of serous fluid was aspirated from the joint, and it had an elevated white blood cell count. Antibodies to Borrelia burgdorferi were present in the patient's serum, confirming the clinical diagnosis of Lyme arthritis.
-What are the initial and late manifestations of Lyme disease?
-What in her history is suggestive of this disease? Describe the disease transmission, name vectors and reservoirs, if available.
-What major virulence surface factors are expressed by this organism and where/when?
-In the absence of the characteristic rash, how is this disease diagnosed.
-What are the limitations of the following diagnostic tests for Lyme disease: microscopy, culture, and serology?
-She was appropriately treated with antibiotics and did well. Name the antibiotics available for treatment of this disease. What complications can occur in untreated patients?
-What antigens would you choose to develop an appropriate vaccine?