Lyme Disease Post Test

The following are true of Lyme disease:

With regard to Erythema migrans, which of the following are true?

Which of the following forms of Borrelia infect humans?

Which of the following statements are true regarding symptoms of Lyme disease?

A 25-year-old male with erythema migrans is seen in your ED having given a history of hiking several weeks before.  He is thought to have Lyme disease.  A colleague suggests you send an ELISA test and then start azithromycin if the test is positive.

What is your advice?

A 47-year-old male has been brought in by ambulance to the ED with a history of collapse. His HR is 40/min and BP is 80mmHg systolic. His ECG is shown below. Furthermore, a few months back he consulted his GP for complaints of fever, malaise and rash, treated with chlorpheniramine.

He is generally fit and well and, in fact, went on a trek a few weeks ago. He says the rash was accidentally noticed and was not painful or itchy but is still present (see image).

What management should be initiated in this patient?

A 37-year-old female presents to the ED with ongoing symptoms of malaise and joint pains. She first saw her GP for these symptoms over three months ago and was subsequently diagnosed with Lyme disease after two blood tests (at an accredited laboratory). She was then given 28 days of doxycycline but despite this she still feels unwell.

You should: