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General Illness Information

Common Name:
Lyme Disease

Medical Term:

 None Specified
Description: Lyme disease is an infection caused by the bite of an infected tick. The tick is so small that you may not notice the tick or its bite. Because not all ticks are infected, a bite does not always result in Lyme disease. Even if the tick is infected, it may not transfer the disease to you. It is important to note that the longer the infected tick is attached to your skin, the greater your risk of getting Lyme disease.

It is an inflammatory disorder caused by a spirochete and spread by tick-bites. It is characterized by a skin rash, followed in weeks to months by central nervous system, cardiovascular system and joint symptoms.

 
Causes: Infection with spirochete (microscopic organism), borrelia burgdorferi, transmitted by a deer tick bite.                     Many patients report a tick bite at the site of the lesion 3 days to 3 weeks prior to the rash.

In the US the white-footed mouse is the primary host and animal reservoir for the nymphal ticks and the spirochete. Deer are an important preferred host for the adult ticks.

Domestic animals such as cats, dogs, horses, and cows can also carry the infected ticks to places where people live.

 
Prevention: In areas with ticks;

Wear protective clothing with tight collars and cuffs.

Use effective insect repellents, such as 100% DEET.

Have dogs and cats wear tick-repellent collars.

 
Signs & Symptoms

If left untreated, Lyme disease may progress through these three general stages:
Stage 1:

Three to 32 days after the bite of an infected tick a skin rash, called a bull's-eye or target rash, occurs at the site of your bite. The rash begins as a red, flat or raised area and slowly expands after several days, often in a circular fashion.  Although the rash can be located anywhere, the thigh, groin, and armpit are common sites. This may be associated with a flu-like illness.

 
Stage 2:After several weeks to several months, about 15% of people develop neurologic problems, which may include:
  • meningitis (inflammation of the covering of the brain and spinal cord)
  • encephalitis (inflammation of the brain)
  • cranial neuritis (inflammation affecting the cranial nerves, which are attached to the brain and pass through the openings of the skull); for example, Bell's palsy (facial paralysis) on one or both sides of the face.

Within several weeks after onset of illness, about 8% of people develop heart problems, including carditis (inflammation of the heart) and problems with the rhythm of the heart.

During this stage, you may have pain in your joints, tendons, muscles, or bones, usually without joint swelling. These symptoms usually disappear within a few weeks.

 
Stage 3: Within weeks to two years after the beginning of infection, about 60% of people develop arthritis, with joint pain and swelling. The knee is the most commonly affected joint.

In stage 3 you may have bouts of episodic arthritis or chronic (persistent) arthritis and, much less common, chronic neurologic or skin diseases.

Later nervous system symptoms associated with Lyme disease may include:

  • numbness or tingling in hands and feet
  • difficulty in concentrating
  • weakness in arms or legs
  • depression.
 
Risk Factors

Areas where ticks are numerous, such as long grass or brush.
Most infections occur during the summer when you are most likely to be exposed to ticks. Hikers, campers, hunters, and people living in wooded or rural areas are at a high risk for Lyme disease.
Diagnosis & Treatment
For diagnosis, laboratory blood studies, and skin biopsy may be required.
General Measures:
Early treatment is important to prevent progression and irreversible neurological damage.
Heat relieves joint pain. Take hot baths or use heating pads, heat lamps or whirlpool treatment.
Use crutches to keep weight off affected joints, if necessary.
Medications:
An oral antibiotic, such as tetracycline,  for 14-21 days for early stage of the disease.
Intravenous antibiotics may be prescribed for late stages.
Non-steroidal anti-inflammatory drugs.
Cortisone drugs to reduce the inflammatory response in the heart or central nervous system.
Activity:

Rest in bed until symptoms of active inflammation subside. Then resume normal activities.
Diet:
No special diet.
Possible Complications :
Congestive heart failure.
Permanent joint deformity.
Permanent brain damage (rare).
Nerve disorder (peripheral neuropathy).
Prognosis
The skin rash is curable in some patients in 10 days with treatment, and this may prevent development of other symptoms. If not, symptoms in the joints, central nervous system and cardiovascular system usually subside slowly over 2 to 3 years. Symptoms often recur after several years without another tick bite.
Other

 'Nothing Specified'.