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Case Study Best Diagnosis

The given case scenario presents a woman displaying symptoms of fatigue, backache, and severe headache. These symptoms, accompanied by the irregular heartbeat of the female and the rash and the related risk factors, in this case, all point towards the probability that the woman is suffering from Lyme disease. The cause of this disease is the infection by B. burgdorferi. This infection is generally carried by certain vector insects, such as mosquitoes, flies that bite and ticks. These organisms act as carriers for the disease.

Moreover, the symptoms presented by the woman, such as pain in the joints, severe backache and headache and fever are generally not specific to the disease. These are nonspecific systems that point towards various forms of infections. However, the medical and personal history of the patient would prove very important to gain information about her residence and hence the presence of vector organisms like tiny mammals or ticks.

Critical Features

It is not very easy to effectively diagnose Lyme diseases in the initial stages of its development. The disease is characterized by a number of symptoms and signs that may be regarded as general ones as these symptoms, like fever, general pain in the joints and body malaise point to numerous infectious diseases apart from Lyme disease. However, the presence of specific and important signs, like the presence of certain small mammals that act as a residence of vectors and the presence of ticks to transmit the disease are significant indicators of Lyme disease. Moreover, the irregularity of the heartbeat and the difficulty to concentrate point towards the suggestion that other systems of the body are also involved. It is a typical sign of the expansion of an infection.

Tests and Diagnostic Procedures for Diagnosis Confirmation

Although the initial diagnosis is that the woman is suffering from Lyme disease, it is very important to confirm the diagnosis to effectively treat her. As already mentioned, a majority of the signs of Lyme disease are general in nature and are also present in other infections, the first step towards the confirmation of the diagnosis is to ask her about her medical history. Next, a physical exam is imperative.

The diagnosis can be further confirmed by certain laboratory tests for the identification of the antibodies acting against the bacteria. However, it is noteworthy that these tests prove to be more accurate after few weeks have passed. It gives the body the time to form antibodies. The important diagnostic tests in this regard are the Enzyme-linked Immunosorbent Assay (ELISA) and the western blot.

ELISA is the most commonly used diagnostic tests to assess Lyme disease. The test works by the detection of the antibodies against the B. burgdorferi. However, the test may also produce results that are false positive, hence merely relying on ELISA test is not a wise decision. Also, the test is not very effective in the initial stages of the disease.

In the case the results of the ELISA test are positive, the diagnosis should be further confirmed and any doubts removed by administering the western blot test. It assists in the detection of the antibodies to various B proteins.

Further Steps to clear up the Problem

The disease can be managed by prescribing a number of antibiotics. Currently, the drug, doxycycline is regarded as the most effective in treating Lyme disease. As in the present case, the major symptoms, like the rash, are already present in the patient, and the diagnosis is already confirmed by the ELISA and western blot tests, the involvement of the heart should also be assessed. It can be accomplished by using echocardiograms and electrocardiograms. Also, MRI and spinal tap would prove to be very helpful in the determination of the pathological changes in the patient’s central nervous system (CNS). In the case of such changes, further antibiotic treatment is necessary.

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