CASE HISTORY
Sharon,the CEO of a start-up company,lives in Westchester County,a wooded community north of New York City.She spends her summer weekends e-mailing her managers from the outdoor deck of her home,shaded by tall oak trees.The acorns attract mice and deer,and the leaf litter is full of ticks (Ixodes scapularis).
One evening Sharon's husband noticed a red rash on her back,consisting of a ring shape several centimeters across,surrounding another red spot in the middle.Sharon recalled seeing this "bull's-eye" type of rash on the Internet.The rash was described as the hallmark of Lyme disease,or borreliosis,caused in the United States by the tick-borne bacterium Borrelia burgdorferi (in Europe,by the closely related species Borrelia afzelii).The distinctive rash,erythema migrans ("migrating redness"),begins at the site of a tick bite and expands concentrically as the bacteria migrate outward.Sharon recalled that a neighbor's child had suffered crippling arthritis caused by an undetected case of Lyme disease.Another neighbor who contracted Lyme disease had suffered from meningitis (inflammation of the brain lining)and neurological abnormalities,including facial paralysis,ultimately losing his job and his million-dollar home.
The next day Sharon went to her doctor and was treated with the antibiotic doxycycline,a tetracycline derivative that targets the bacterial ribosome.Doxycycline is the antibiotic of choice for B.burgdorferi.Sharon was fortunate to make a full recovery before serious symptoms appeared.
The bull's-eye rash that is a hallmark of Sharon's infection is associated with movement of the bacteria from the initial site of tick bite and infection.Discuss how these bacteria move and the cell structures associated with movement.
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