Lyme Disease

Write a 2- to 3-page paper that addresses the following:
�Explain the disorder Lyme disease, include its pathophysiology and epidemiology.
�Explain a protocol for the diagnosis, management, and follow-up care of this disorder.
�Explain how culture might impact the care of patients who present with the disorder you

Lyme Disease

Many different kinds of body infections exist hence, is prudent for advanced practice
nurses to understand (APN) them to provide better diagnosis, management, and even follow up.
Lyme disease is one of such body system disorders that APN need to know to manage the same
well. The author therefore, deliberates on Lyme disease, its epidemiology and pathophysiology,
explains protocol from diagnosis, management, and follow-up, and explains how culture might
affect the care of patients suffering from this disease.


Lyme disease

Despite the fact that the prevalence of Lyme disease is becoming prevalent in
communities, many APN as well as physicians are still unfamiliar with it. Lyme disease known
by another name as Lyme borreliosis is among the common vector borne diseases (Pearson,
2014). The disease is infectious as a bacterium known as Borrelia burgdorferi belonging to the
spirochaetes causes it. The disease is usually transmitted through the bite of an infected tick.
The moment an infected tick bites a human being, B. burgdorferi is left in the skin and
henceforth begins to spread. Signs and symptoms of the disease manifest due to the immune
response to the spirochete in the tissues of the body (Beard, Nelson, Mead, Petersen, & Raoult,
2012). During the bite, the saliva of the tick is released together with spirochete as the tick feeds
and this disrupts the immune response at the site where the bite occurred (Glatz, Resinger,
Semmelweis, Ambros-rudolph, & Müllegger, 2015). Therefore, such a point is conducive to
spirochete to establish an infection which grows and multiplies on the surface of the skin
(dermis). The inflammatory response of the host leads to the formation of a circular EM lesion
(Halperin, 2014). Because Neutrophils fails to appear to destroy spirochetes, the EM lesion
develops and spread on the entire body. Few days after the bite, the spirochetes spread through
blood stream to other parts of the body such as heart, joint, distant skin sites and nervous
systems. In case, the bacteria is not treated immediately, it may persist in the body for months or
even years, regardless of the production of B. burgdorferi.


The disease is prevalence in the northern hemisphere and more incidences have been on
increase across the world. Reasons for this are changes in biodiversity, climate change, land
management, human interactions with nature and increasing awareness about the disease.
Laboratory findings in UK found that Lyme cases have increased nearing to 1200 in a year even
though true incidence is not known because of many cases that go unreported (Pearson, 2014).
Incidences of Lyme disease are higher in Southern England, including, Scottish highland, and
London. Level of public and health care professionals’ awareness about the disease in UK is still
lacking. The disease has as well been reported in various countries across Africa, Europe, north
and South America and Asia. Highest cases are among people aged between 45-65 years
followed by those in age bracket 24-44 years (Pearson, 2014).
Diagnosis, management, and follow-up care

Lyme disease has treatment, and the journey begins from diagnosis. Those eligible for
diagnosis are those with the history of tick bite, other signs, and symptoms of Lyme disease and
erythema migrans (Pearson, 2014). Diagnosis should be clinically based and should be based on
careful history taking, examination and getting information from carers, and ensuring careful
interpretation of results. Other tests can as well be undertaken as part of the diagnosis to
ascertain the infections. Treatment should then start immediately after diagnosis. Even though a
range of antibiotics is available, the choice of the best is under debate as some have side effects.
Some of the antibiotics recommended include amoxicillin, and doxycycline administered in
different dosages depending on the age of the patient (Pearson, 2014). Patients require close
monitoring to ensure they take the right medication, dosage until they recover.

Culture Aspect in Care of Patients


The culture of people differs and may have adverse effects on patients with Lyme
(Aenishaenslin, Ravel, Michel, Gern, Milord, Waaub & Bélanger, 2014). Some people believe
that this disease is for animals and therefore, health care providers may be adamant to take care
of such patients. Therefore, the attitudes and beliefs of people, especially the carers can have a
negative implication on the health care that is provided to patients. It becomes important for all
public health professional and public to be sensitized about the disease for them to accord respect
and assistance to Lyme patients.


Lyme disease like any other body disease needs proper management and treatment. The
disease is spreading across the world because of increased sensitization. Cultural factors can halt
efforts to manage the disease and is appropriate for all relevant authorities to step up their
awareness campaigns to sensitive more health providers and public for better management of this


Aenishaenslin, C., Ravel, A., Michel, P., Gern, L., Milord, F., Waaub, J., & Bélanger, D. (2014).
From Lyme disease emergence to endemicity: a cross sectional comparative study of risk
perceptions in different populations. BMC Public Health, 14(1), 1070-1091.


Beard, C. B., Nelson, C. A., Mead, P. S., Petersen, L. R., & Raoult, D. (2012). Bartonella spp.
bacteremia and rheumatic symptoms in patients from Lyme disease-endemic region.
Emerging Infectious Diseases, (11), 1918.
Glatz, M., Resinger, A., Semmelweis, K., Ambros-rudolph, C. M., & Müllegger, R. R. (2015).
Clinical Spectrum of Skin Manifestations of Lyme Borreliosis in 204 Children in Austria.
Acta Dermato-Venereologica, 95(5), 565-571. doi:10.2340/00015555-2000
Halperin, J. J. (2014). Lyme Disease: Neurology, Neurobiology, and Behavior. Clinical
Infectious Diseases, 58(9), 1267-1272.
Pearson, S. (2014). Recognising and understanding Lyme disease. Nursing Standard, 29(1), 37-

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