The Forest

You examine the rash, which is shown below.

Describe and name this rash associated with Lyme disease? (1 mark)

You decide to start treatment for both the father and his 5-year-old daughter. Both father and child are otherwise systemically well and they do not have any known drug allergies.

What is the first-line treatment specific for Lyme disease for this child and for this adult? (0.5 marks for each correct component; maximum 1 mark)

After starting treatment the father gets worse and reattends your ED later that evening and complains of worsening fever, chills, muscle pains and headache. There are no new rashes. This adult patient is speaking in full sentences and his airway is patent. There is no respiratory or cardiovascular compromise.

What is this reaction known as? (1 mark)