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Explain Lyme disease
The disease - About 70-80% of patients infected by B. burgdorferi develop the characteristic skin lesion, erythema migrans, which occurs at the site of the tick bite 3 to 30 days after the tick has detached. Fever, headache, malaise, arthralgias and myalgia usually accompany early disease. Multiple (secondary) skin lesions occur in about 15% of patients. Patients with untreated Lyme disease may develop cardiac involvement, neurologic disease or migratory musculoskeletal pain.
Late manifestations of Lyme disease include arthritis, typically of the knee, and various neurologic conditions, including peripheral neuropathy and subtle encephalopathy with cognitive defects. Clinical manifestations of the disease are somewhat different in Europe because other borrelia species cause human infection there.
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Results : In critical pulmonary stenosis in infancy, surgical mortality is 6 per cent. For children and adults with isolated pulmonary valve stenosis, the mortality approaches 0
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