Case Study Solution

Lyme Disease and Peripheral Vascular Disease

Case Study

Lyme Disease Case Study

1. In patients with tick bite history, the erythema migrans rash is considered a cardinal sign of Lyme disease. (Mead, 2015).

2. IgM antibodies are usually detectable in the first weeks after the beginning of the infection, and IgG antibodies are found elevated after 4 weeks of illness onset. Usually, both antibodies still elevated for years after the infection resolve. (Mead, 2015).

3. A high ESR, chiefly, has an undeniable cause, in this condition is elevated due to the inflammation process caused by the infection Borrelia burgdorferi transmitted by the bite of an Ixodes tick (Battaglia, 2017).

4. According CDC guidelines patient with erythema rash or presenting symptoms of Early stage of Lyme disease doxycycline per 21 days is the first choice of treatment, except for pregnancy woman or child less than 8 years old, who need to be treated with amoxicillin if no history of penicillin allergy. In addition, in patients with neurologic or cardiologic clinical presentation of disease parenteral antibiotic as cefuroxime is chosen as pharmacology therapy (Mead, 2015).

Peripheral Vascular Disease Case Study

1. The patient experienced pain after mild exercise because blood flow in his right leg was below demand. This happens when the main arteries have obstructions mostly areas where the vessels are so constricted that it reduces blood flow through the area of obstruction (Hiatt, 2001). In such instances blood flow to the rest of the leg is highly reduced and insufficient to meek the nourishment requirements of the cells. The pain the patient experienced was an indicator that his muscles were not receiving enough blood flow because of an obstructed artery. The muscle cells were not receiving enough oxygen and nutrients to support prolonged walking at the required rate.

2. The right leg also showed decreased hair compared to the left one showing that the patient was losing hair on that leg. The reason for this occurrence is decreased replenishment of skin cells where the hairs grow. The limited resources distributed in the limited blood flow are not enough to support hair growth (Gerhard-Herman, Gornik, Barrett, Barshes, Corriere, Drachman & Lookstein, 2017).

3. Preventing a recurrence after surgical interventions is crucial and this involves maintaining an active lifestyle with regular exercises. It is equally important to monitor the progress of the patient after surgery to ensure blood flow rate in the affected leg meets the requirements. Gerhard-Herman and colleagues (2017) suggest some of the strategic tests to assess the patient’s circulation like arterial branchial index (ABI) measurement, duplex arterial ultrasound, and segmental Doppler pressure (SDP) testing.

4. For patients diagnosed with intermittent Claudication, there are various treatment options to consider. Pharmacological interventions are aimed at reducing the probability of an acute artery occlusion from occurring and involves the use of angiotensin-converting enzyme (ACE) inhibitors and antiplatelet medications (Hiatt, 2001). Exercises are also recommended to recover the functionality of the limb. Norgren and colleagues (2007) note that this prevents the limb from dying which would require an amputation. Changing lifestyles is also helpful for instance quitting tobacco use also help prevent the occurrence of the disease.

References

Battaglia, G., (2017). Improving Diagnosis of Lyme Disease: Laboratory and Clinical

Approaches. Retrieved from:

https://www.contagionlive.com/publications/contagion/2017/november2017/improving-

diagnosis-of-lyme-disease-laboratory-and-clinical-approaches

Gerhard-Herman, M. D., Gornik, H. L., Barrett, C., Barshes, N. R., Corriere, M. A., Drachman, D. E., … & Lookstein, R. (2017). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 69(11), e71-e126.

Hiatt, W. R. (2001). Medical treatment of peripheral arterial disease and claudication. New England Journal of Medicine, 344(21), 1608-1621.

Mead, P. S. (2015). Epidemiology of Lyme disease. Infectious Disease Clinics, 29(2), 187-210.

Treatment | Lyme Disease | CDC. (n.d.). Retrieved from

https://www.cdc.gov/lyme/treatment/index.html

Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., & Fowkes, F. G. R. (2007). Inter-society consensus for the management of peripheral arterial disease (TASC II). Journal of vascular surgery, 45(1), S5-S67.