The doctor did an oral exam on Meg to determine the diagnosis and the causative microorganism of the infection through different tests such as a gram stain. The most probable diagnosis from the oral history examination would be Borrelia burgdorferi, which is the leading cause of the Lyme diseases in the United States (CDC, 2019b). It is among the common tick-borne infections often transmitted through the bite of a black-legged tick infected with the disease. These ticks are known as deer ticks. Deer ticks that cause Lyme disease are prone to heavily wooded areas, and grassy locations where they get their habitat and allowing the deer ticks that carry the Borrelia burgdorferi to thrive (CDC, 2019b). It is therefore critical to take precautions of such tick-infested areas and protect oneself from infection. In a Gram stain, Borrelia burgdorferi gets a weak Gram-negative by default due to the safranin, which is present in the bacteria (CDC, 2019b). Borrelia burgdorferi similar to other spirochetes do not have outer membranes with substances, LPS an inner membrane and a periplasmic space that has a small layer of peptidoglycan (CDC, 2019a). Therefore, the Gram stain test on the bacteria does not turn gram-negative or gram-positive.
There are different ways through which Meg most likely got her infection. Lyme disease is a common vector-borne disease in the United States, which is a disease Meg is most probably infected with. The Lyme disease is often caused by a bacterium Borrelia burgdorferi (Shapiro, 2014). The typical signs and symptoms of infection include fatigue, headache, fever and a particular kind of skin rash that is known as erythema migrant (Shapiro, 2014). If this condition is not treated, it usually moves to the nervous system, the heart and the joints. The diagnosis of the Lyme disease is generally based on physical findings, symptoms and the possibility of being exposed to the infected ticks. In this, therefore, there is a need for laboratory testing, and this is usually done using validated, and correct methods and they illustrate the presence of the disease (Shapiro, 2014). This disease is often moved to humans by vector ticks such as from the bite of infected black-legged ticks. These black-legged ticks are present in north-central, mid-Atlantic, and northeastern United States (Shapiro, 2014).
Vector HabitatThe diagnosis would differ if the camp Meg had attended was in Arizona. Deer ticks are mostly associated with the Northeast, they live in most parts of the eastern and the central United States, primarily due to the presence of their favorite hosts such as rodents and deers (Shapiro, 2014). The western black-legged ticks live in the west f the Rocky Mountains, and they are also vectors for the Lyme disease (Shapiro, 2014). Therefore, if Meg had attended a different camp in Arizona, she would not have been infected with the bacteria due to the absence of deer ticks
Joints are common symptoms that follow rashes. The typical signs of the bacterial infection are fatigue, headache, fever, and erythema migraines, which is a characteristic skin rash (Shapiro, 2014). If the disease is left untreated, it usually moves to the nervous system, heart and the joints. Joint pains are bouts of swelling and joint problems that are typically likely to affect the knees, and the pain can move from one joint to another (Shapiro, 2014). Joint pain is a common symptom that accompanies the symptoms that Meg has and this is the reason the doctor asked. Furthermore, the doctor wanted to determine the progression of the infection since joint pains occur after a while, usually when the disease is left untreated.
Treatment of the Infection
Some ways can be used in the treatment of the infection Meg has. Borrelia burgdorferi is usually treated using antibiotics. This is typically a standard treatment for the early stage in the infection for the Lyme disease. This is generally done with the inclusion of doxycycline for children above the age of 8 and adults, cefuroxime or amoxicillin for adults, breast-feeding and pregnant women, and younger children (CDC, 2019a). Lyme disease is often better treated in the early stages of infection. The treatment is often maintained in a simple 10-14 days course that is aimed at removing the infection (CDC, 2019a). Intravenous antibiotics are usually common in progressive forms of Lyme disease such as those that involve the central nervous system and the cardiac system (CDC, 2019a). Healthcare providers move to the oral regimen after improvement, and it is meant to finish the course of treatment. The entire treatment course takes from 14 to 28 days (CDC, 2019a). If Lyme arthritis is present, which is a late-stage symptom of the Lyme disease, which is usually present in some people may be treated with oral antibiotics for about 28days.
Prevention of the Infection
After hearing the diagnosis laid out on Meg, Meg's mom declares that Meg will not go back to the camp. However, Meg loves the camp, and she had plans to attend the camp in the next summer, which means that there is a need for Meg to take preventive precautions to protect herself from getting infected again (CDC, 2019a). While most of the cases of the Lyme disease can be treated without a problem after a few weeks of antibiotics, some steps can be used in the prevention of Lyme disease (CDC, 2019a). These steps include using insect repellants, prompt removal of ticks, application of pesticides, reduction of the tick habitat (CDC, 2019a). Ticks that participate in the transmission of the Lyme disease can also transmit different other tick-borne diseases.
CDC. (2019a, December 17). Lyme Treatment. Retrieved August 31, 2020, from https://www.cdc.gov/lyme/treatment/index.html
CDC. (2019a, December 16). Lyme Disease. Retrieved August 31, 2020, from https://www.cdc.gov/lyme/index.html#:~:text=Most cases of Lyme disease, other tick-borne conditions as well.
Shapiro, E. D. (2014). Borrelia burgdorferi (Lyme disease). Paediatrics in review, 35(12), 500.
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