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Lyme Disease

Lyme Borreliosis

Lyme disease is a form of tick–borne illness first recognized in the year 1975. The disease is more prevalent in North America and Europe [1].


Presentation

In the preliminary stages, Lyme disease manifests as skin rashes and flu like symptoms. When the individual is first bitten by ixodid tick, a small red bump may develop in the affected area. After few days, the red bump expands to a larger area resembling “bull’s eye pattern”. Such a kind of rash is known as erythema migrans [8]. Many individuals develop multiple lesions which is also a major characteristic of Lyme disease. In addition to rash, affected individuals would also experience fever, body ache, fatigue and headache.

In the later stages, as the disease progresses, individuals complain of joint pain and neurological problems set in. Neurological conditions such as Bell’s palsy, meningitis, weakness of one or both limbs and impaired muscular movements are some of the grave problems experienced.

Some of the less common signs and symptoms of Lyme disease include inflammation of the liver and eyes, development of cardiac problems and extreme fatigue.

Generalized Lymphadenopathy
  • Generalized lymphadenopathy is not a classic feature of Lyme disease, but a Borrelial lymphocytoma may develop at the site of antecedent tick bite.[doi.org]
Fever
  • Some synonyms in other countries include "tick typhus", "tobia fever" in Columbia, "São Paulo fever" or "febre maculosa" in Brazil and "fiebre manchada" in Mexico.[web.archive.org]
  • Abstract We present a 49-year-old man with subacute onset of fever, weakness, shortness of breath, unilateral lower extremity oedema and pancytopenia who was found to have positive serology for Lyme disease.[ncbi.nlm.nih.gov]
  • These bacteria range from tick-borne, relapsing fever-inducing strains detected in some soft ticks, such as B. mvumii, to those from bat ticks resembling B. turicatae.[ncbi.nlm.nih.gov]
  • This disease used to be called "break-bone" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Health experts have known about dengue fever for more than 200 years.[niaid.nih.gov]
  • A dry cough, fever, generalized maculopapular rash, and myositis developed in a 67-year-old woman; she also had markedly abnormal liver function test results.[ncbi.nlm.nih.gov]
Pain
  • BACKGROUND: Neuropathic pain is a relatively common outcome of Lyme disease. Pain management options for these patients have been limited to pharmaceutical treatments.[ncbi.nlm.nih.gov]
  • These include shooting pains, numbness or tingling in the hands or feet, and problems with short-term memory. Arthritis Pain and swelling in the large joints (such as knees) can occur.[web.archive.org]
  • OUTCOMES: The patient was not progressing with commonly accepted interventions and began to have "arthritis-like" shoulder pain in the uninvolved left shoulder.[ncbi.nlm.nih.gov]
  • In multivariate analyses, persons with previous Lyme disease (mean time from infection to study evaluation, 6.0 years) had more joint pain (odds ratio for having joint pain in any joint, 2.1 [CI, 1.2 to 3.5]; P 0.007), more symptoms of memory impairment[doi.org]
Fatigue
  • This common disorder of women, frequently, but not always causing pelvic pain, can present simply as chronic fatigue.[ncbi.nlm.nih.gov]
  • All cases presented with typical erythema migraines, fever and fatigue. The serological findings were positive for Borrelia burgdorferi, for 3 cases.[ncbi.nlm.nih.gov]
  • Some patients with a history of Borrelia burgdorferi infection develop a chronic symptomatology characterized by cognitive deficits, fatigue, and pain, despite antibiotic treatment.[ncbi.nlm.nih.gov]
  • Results: Prior to antibiotic treatment, patients experience notable symptoms of fatigue and pain statistically higher than controls.[ncbi.nlm.nih.gov]
  • The majority of these patients also had the chronic fatigue syndrome or fibromyalgia; the others usually had rheumatic or neurological diseases.[dx.doi.org]
Weakness
  • OBSERVATIONS: A 64-year-old man presented with a 1-month history of rapidly progressive weakness involving bulbar, upper limb and lower limb muscles. The physical examination showed widespread weakness, atrophy, fasciculation, and brisk reflexes.[ncbi.nlm.nih.gov]
  • Abstract We present a 49-year-old man with subacute onset of fever, weakness, shortness of breath, unilateral lower extremity oedema and pancytopenia who was found to have positive serology for Lyme disease.[ncbi.nlm.nih.gov]
  • We report a probable case of Lyme disease in a woman, living in Jagůaré slum (São Paulo), who showed characteristics skin lesions of erythema chronicum migrans, with fever, weakness, headache, muscular pain, cough, arthralgia and sensitive radicular neuropathy[ncbi.nlm.nih.gov]
  • In this case we report a 31-year-old male who was diagnosed with Lyme disease and GBS with relevant clinical presentation including progressive numbness and weakness in bilateral hands and feet for the past 1week along with areflexia.[ncbi.nlm.nih.gov]
  • Abstract Laboratory diagnosis of Lyme disease is difficult and presently dependent on detecting Borrelia burgdorferi-specific antibodies in patient serum with the disadvantage that the immune response to B. burgdorferi can be weak or variable, or alternatively[ncbi.nlm.nih.gov]
Chronic Fatigue Syndrome
  • The majority of these patients also had the chronic fatigue syndrome or fibromyalgia; the others usually had rheumatic or neurological diseases.[dx.doi.org]
  • PURPOSE: To show that chronic fatigue syndrome can be mistakenly attributed to Lyme disease rather than considering sympathetic neural hyperalgesia edema syndrome.[ncbi.nlm.nih.gov]
  • We concluded that women with endometriosis are more likely to have chronic fatigue syndrome, systemic lupus erythematous, Sjögren's syndrome, rheumatoid arthritis, multiple sclerosis, and other autoimmune inflammatory and endocrine diseases.[ncbi.nlm.nih.gov]
  • Your doctor may want to treat you in ways similar to patients who have fibromyalgia or chronic fatigue syndrome. This does not mean that your doctor is dismissing your pain or saying that you have these conditions.[web.archive.org]
Dyspnea
  • The patient presented with dyspnea and pain behind the sternum, which had been occurring for several months, mainly during fast walking upstairs. The patient reported having no symptoms when he was motionless.[doi.org]
  • […] within one to two months after infection (range of less than one week to seven months). 17 – 19 Lyme carditis is a less common complication of systemic disease, occurring in approximately 4 to 10 percent of patients. 19 It may present as chest pain, dyspnea[web.archive.org]
  • Hospitalization and continuous monitoring, with consideration for temporary pacing, are advisable for patients with any of the following: Associated symptoms (eg, syncope, dyspnea, or chest pain) Second-degree or third-degree AV block First-degree heart[emedicine.medscape.com]
Gagging
  • A 26-kDa Borrelia glycosaminoglycan-binding (GAG-binding) protein, Bgp, binds to the GAG side chains of heparan sulfate on endothelial cells, and to both heparan sulfate and dermatan sulfate on neuronal cells ( 49 , 50 ).[doi.org]
  • GGG AAT AGG TCT AAT ATT AGC CT) and OspA7 (TGT GGT TTG ACC TAG ATC GTC AG); and primer set 1110/1428 (detects a 328-bp portion [positions 1110 to 1438] of the OspB gene), consisting of OspB-1110 (AAA CGC TAA ACA AGA CCT TCC TG) and OspB-1411 (AGC TTT GAG[doi.org]
Skin Lesion
  • Four patients who had received tick bites while visiting forests in Mexico had skin lesions that met the case definition of erythema migrans, or borrelial lymphocytoma.[ncbi.nlm.nih.gov]
  • We report a probable case of Lyme disease in a woman, living in Jagůaré slum (São Paulo), who showed characteristics skin lesions of erythema chronicum migrans, with fever, weakness, headache, muscular pain, cough, arthralgia and sensitive radicular neuropathy[ncbi.nlm.nih.gov]
  • Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection,[ncbi.nlm.nih.gov]
  • In the United States, Lyme disease commonly begins in summer with a characteristic skin lesion, erythema migrans, accompanied by flu-like or meningitis-like symptoms.[ncbi.nlm.nih.gov]
Erythema Annulare
  • Erythema annulare centrifugum . Erythema multiforme . Granuloma annulare . Contact dermatitis or discoid eczema .[patient.info]
Diplopia
  • A 71-year-old woman with headache, malaise, fever, and diplopia. Initial coronal postcontrast T1 MR imaging ( A and B ) with enhancing bilateral third and fifth cranial nerves.[doi.org]
Ptosis
  • RESULTS: A 16-year-old girl, with a 4-year history of recurrent left eye photophobia, intense redness, and superior eyelid edema, presented with lid erythema, ptosis, superficial venous tortuosity, conjunctival hyperemia, corneal thinning with precipitates[ncbi.nlm.nih.gov]
Arthritis
  • It was subsequently identified as a new clinical entity originally called Lyme arthritis based on the observation that arthritis was a major clinical feature.[ncbi.nlm.nih.gov]
  • A 45-year-old man presented for evaluation for suspected Lyme arthritis.[doi.org]
  • Arthritis caused by Lyme disease manifests differently than other causes of arthritis and must be distinguished from arthralgias (pain, but not swelling, in joints).[web.archive.org]
  • Arthritis and Lyme Disease Lyme disease is a bacterial infection transmitted by a tick.[web.archive.org]
  • BACKGROUND: A 71-year-old woman presented to a rheumatologist with what she believed to be a 2-year history of Lyme disease, progressing from erythema migrans to Lyme arthritis.[ncbi.nlm.nih.gov]
Arthralgia
  • In a second case, a 40-year-old male, with a previously known microscopic hematuria, presented with rash, arthralgias, new proteinuria and gross hematuria following a tick bite. Biopsy revealed focal proliferative IgA nephropathy.[ncbi.nlm.nih.gov]
  • We report a probable case of Lyme disease in a woman, living in Jagůaré slum (São Paulo), who showed characteristics skin lesions of erythema chronicum migrans, with fever, weakness, headache, muscular pain, cough, arthralgia and sensitive radicular neuropathy[ncbi.nlm.nih.gov]
  • Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans.[ncbi.nlm.nih.gov]
  • Six of these seven persons suffered from intermittent migratory arthralgias or myalgias, and one from acrodermatitis chronica atrophicans.[ncbi.nlm.nih.gov]
  • A 26-year-old woman with a summer home on Long Island, New York, had a low-grade fever, malaise, arthralgias, headache, and neck pain one week after removing a tick from her thigh.[doi.org]
Myalgia
  • Most patients with NAGU exhibit nonspecific symptoms such as myalgias and fever, suggesting an infectious agent, but the majority have no identifiable pathogen.[ncbi.nlm.nih.gov]
  • Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans.[ncbi.nlm.nih.gov]
  • Six of these seven persons suffered from intermittent migratory arthralgias or myalgias, and one from acrodermatitis chronica atrophicans.[ncbi.nlm.nih.gov]
  • A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias.[ncbi.nlm.nih.gov]
  • Each of the 3 stages of the disease is associated with specific clinical features: early localized infection, with erythema migrans, fever, malaise, fatigue, headache, myalgias, and arthralgias; early disseminated infection (occurring days to weeks later[ncbi.nlm.nih.gov]
Knee Pain
  • The sixth patient presented with knee pain and swelling. Motile spirochaetes were seen in blood samples from one patient and cultured from blood samples from two patients.[ncbi.nlm.nih.gov]
  • Knee pain may be a symptom of advanced Lyme disease. Image Source: Image reprinted with permission from eMedicine.com, 2008. (left), CDC / James Gathany (right) Text Reference: "Lyme Disease." Centers for Disease Control and Prevention.[emedicinehealth.com]
  • Intra-articular steroid injection may be useful as a temporizing procedure in patients with persistent knee pain but this runs the risk of masking persistent infection.[web.archive.org]
Back Pain
  • Meningoradiculitis due to borreliosis presenting as low back pain only. Neuroradiology 1998 ; 40 : 126 –27 Ljostad U, Okstad S, Topstad T, et al. Acute peripheral facial palsy in adults. J Neurol 2005 ; 252 : 672 –76 Lesser RL.[doi.org]
  • Omid Salaami and Dennis Michael Manning , Woman with lower back pain, SIADH and a twist of Lyme , BMJ Case Reports , 10.1136/bcr-2018-225801 , (bcr-2018-225801) , (2018) .[doi.org]
Headache
  • Special attention should be paid to patients with headaches who have traveled to endemic areas.[ncbi.nlm.nih.gov]
  • Abstract A 46-year-old man presented with recurrent left hemiparesis and headache.[ncbi.nlm.nih.gov]
  • We report a probable case of Lyme disease in a woman, living in Jagůaré slum (São Paulo), who showed characteristics skin lesions of erythema chronicum migrans, with fever, weakness, headache, muscular pain, cough, arthralgia and sensitive radicular neuropathy[ncbi.nlm.nih.gov]
  • He presented with daily pulsatile frontotemporal headache, pallor, photophobia and phonophobia. His neurological examination revealed papilledema with no nuchal rigidity.[ncbi.nlm.nih.gov]
  • However, with all three antibiotic agents nearly half of the patients had minor late symptoms such as headache, musculoskeletal pain, and lethargy. These complications correlated significantly with the initial severity of illness.[doi.org]
Confusion
  • BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse[ncbi.nlm.nih.gov]
  • Third-stage parenchymal involvement causes a multitude of nonspecific CNS manifestations that can be confused with conditions such as multiple sclerosis, brain tumor, and psychiatric derangements.[ncbi.nlm.nih.gov]
  • Samples were obtained from 16 patients with CNS Borrelia burgdorferi infection, eight patients with Lyme encephalopathy (confusion without intra-CNS inflammation), and 45 controls.[ncbi.nlm.nih.gov]
  • This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern[ncbi.nlm.nih.gov]
  • (getting or feeling lost) Feeling as if you are losing your mind Over-emotional reactions, crying easily Too much sleep, or insomnia Difficulty falling or staying asleep Narcolepsy, sleep apnea Panic attacks, anxiety Memory loss (short or long term) Confusion[ticktalkireland.org]
Peripheral Neuropathy
  • neuropathy, and painful radiculoneuropathy.[ncbi.nlm.nih.gov]
  • The clinical presentation can be highly varied, including early manifestations that are limited to erythema migrans and ranging to disseminated infection with arthritis, carditis, cranial nerve palsy, peripheral neuropathy, meningitis, or other manifestations[ncbi.nlm.nih.gov]
  • KEYWORDS: Borrelia burgdorferi; Lyme disease; Neuroborreliosis; Neuropathy; Peripheral neuropathy[ncbi.nlm.nih.gov]
  • neuropathy or partial paralysis Pressure in the head Numbness in body, tingling, pinpricks Poor balance, dizziness, difficulty walking Increased motion sickness Lightheadedness, wooziness Mood swings, irritability, bi-polar disorder Unusual depression[ticktalkireland.org]
Neck Stiffness
  • stiffness during their acute illness (87% compared with 13%; odds ratio, 2.4 [CI, 1.0 to 5.5]; P 0.045); however, the performance of the two groups on neurocognitive tests did not significantly differ.[doi.org]
  • Persons with previous Lyme disease who had persistent symptoms after receiving treatment (n 67) were more likely than those who had completely recovered to have had fever, headache, photosensitivity, or neck stiffness during their acute illness (87% compared[ncbi.nlm.nih.gov]
  • stiffness due to meningitis (inflammation of the spinal cord) Pain and swelling in the large joints (such as knees) Shooting pains that may interfere with sleep Heart palpitations and dizziness due to changes in heartbeat Many of these symptoms will[web.archive.org]
  • Over the course of several weeks, there may be heart and nervous system issues, Bell’s palsy (loss of muscle tone on one or both sides of the face), severe headache, neck stiffness due to inflammation of the spinal cord (meningitis), pain and swelling[arthritis.org]
  • If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations among others.[disabled-world.com]
Stroke
  • KEYWORDS: LYME DISEASE; STROKE[ncbi.nlm.nih.gov]
  • Michael J Schneck, MD Associate Professor, Departments of Neurology and Neurosurgery, Stritch School of Medicine, Loyola University; Associate Director, Stroke Program, Director, Neurology Intensive Care Program, Medical Director, Neurosciences ICU, Loyola[emedicine.medscape.com]
  • Unexplained cerebral vasculitis and stroke: keep Lyme neuroborreliosis in mind. Lancet Neurol 2007 ; 6 : 756 –57, author reply 757 Hammers-Berggren S, Grondahl A, Karlsson M, et al. Screening for neuroborreliosis in patients with stroke.[doi.org]
  • He carried diagnoses of hypertension, history of stroke and mild to moderate dementia. The wife noted him to be hallucinating three to four days prior to presentation.[doi.org]
  • Cerebral angiopathy and recurrent strokes following Borrelia burgdorferi infection. J. Neurol. Neurosurg. Psychiatry 50 : 1703–1704. Google Scholar Veendendall-Hilbers, J. A., Perquin, W. V. M., Hoogland, P. H., and Doornbos, L. (1988).[doi.org]

Workup

Signs and symptoms of Lyme disease often mimic other disease conditions and therefore the disease is sometimes also referred to as “The great imitator”. The following are the diagnostic procedures employed to detect Lyme disease:

  • ELISA test is carried out to detect the antibodies to the bacterium. However, this test can sometimes provide false positive results and is also not useful in the initial stages of the disease [9].
  • Western blot test is done for confirming the presence of Lyme disease.
  • The polymerase chain reaction (PCR) test involves testing of the bacterial DNA from the fluid that is obtained from the joint of the affected individual.
Borrelia Burgdorferi
  • Gilmore , Invasion of human neuronal and glial cells by an infectious strain of Borrelia burgdorferi , Microbes and Infection , 8 , 14-15 , (2832) , (2006) . Geeta Ramesh and Mario T.[doi.org]
  • Immunoglobulin G Immunoglobulin M Lipoproteins OspC protein Recombinant Proteins VlsE protein, Borrelia burgdorferi[ncbi.nlm.nih.gov]
  • Lyme disease is caused by a bacterial infection with a spirochete from the species complex Borrelia burgdorferi sensu lato, and is most often acquired from the bite of an infected Ixodes tick.[commons.wikimedia.org]
  • burgdorferi/chemistry Borrelia burgdorferi/genetics Borrelia burgdorferi/immunology* Crystallography, X-Ray Epitopes/chemistry* Humans Lipoproteins/chemistry* Lipoproteins/genetics Lipoproteins/metabolism Lyme Disease/immunology* Mice Models, Molecular[ncbi.nlm.nih.gov]
  • Bannwarth syndrome Lyme Disease Borrelia burgdorferi Infection Borrelia Statements Identifiers Sitelinks Wikipedia (59 entries) edit Wikibooks (0 entries) edit Wikiquote (0 entries) edit Wikisource (0 entries) edit Wikiversity (0 entries) edit Wiktionary[wikidata.org]
Third Degree Atrioventricular Block
  • atrioventricular block, 28 percent had some form of second- or first-degree atrioventricular block, and 23 percent had no conduction abnormalities. 18 Other less common manifestations include myopericarditis, bundle branch block, and heart failure. 17[aafp.org]
  • Differential Diagnoses Bell Palsy Chronic Fatigue Syndrome (CFS) Fibromyalgia Insect Bites Juvenile Idiopathic Arthritis Myocarditis Pediatric Contact Dermatitis Systemic Lupus Erythematosus (SLE) Third-Degree Atrioventricular Block (Complete Heart Block[emedicine.medscape.com]
  • atrioventricular block for 1,222 (0.8%) cases.[cdc.gov]
First-Degree Atrioventricular Block
  • A 16-year-old girl with serologic evidence of Borrelia burgdorferi infection and transient first-degree atrioventricular block underwent cardiac magnetic resonance imaging, which demonstrated myocardial hyperemia, edema, and delayed gadolinium enhancement[ncbi.nlm.nih.gov]
  • atrioventricular block and PR interval greater than 30 milliseconds, as well as for patients with second- or third-degree atrioventricular block Patients with an isolated facial nerve palsy (i.e., normal cerebrospinal fluid examination) can be treated[aafp.org]
HLA-DR2
  • This condition is more prevalent among individuals with HLA-DR2, HLA-DR3, or HLA-DR4 allotypes.[emedicine.medscape.com]
  • Association of chronic Lyme arthritis with HLA-DR4 and HLA-DR2 alleles. N Engl J Med. 1990;323:219-223. [published correction appears in N Engl J Med . 1991;324:129]. Google Scholar 42. Gross DM, Forsthuber T, Tary-Lehmann M. et al.[doi.org]
  • Association of chronic Lyme arthritis with HLA-DR4 and HLA-DR2 alleles. N Engl J Med 1990 ;323: 219 - 223 9. Kalish RA, Leong JM, Steere AC.[doi.org]

Treatment

Lyme disease can be successfully treated when the disease has been diagnosed in the initial stages. Antibiotics are the only way by which the disease can be treated. These are administered either orally or through the intravenous route depending on the condition of the patient. For oral antibiotics, the course duration is as long as 14 – 21 days depending on the severity of the condition [10] [11]. When administered through the intravenous route, the course duration is about 14 – 28 days. However, some studies have postulated that antibiotics given for 10 – 14 days are equally effective.

Prognosis

The prognosis of Lyme disease is usually favorable as the condition can be successfully treated with prompt initiation of strong antibiotic regime. Failure to initiate early treatment can pave way for several unpleasant complications to set in [7].

Etiology

Lyme disease occurs due to tick bites that are infected by the bacteria known as Borrelia burgdorferi. The disease manifests itself in 2 stages namely the initial stage and the late or the chronic stage [3]. For an infection to occur, the bacterium must gain entry into the human body which is achieved through infected ixodid ticks. The ticks appear so small that it is almost impossible to spot them with naked eye. Once the bacterium gains entry, it spreads through the blood affecting various body organs and systems.

Epidemiology

Lyme disease commonly affects individuals of North America and Europe. In the year 2013, it was ranked as the 5th most common nationally identifiable disease. It has been estimated that each year in the United States, as high as 30,000 cases of the disease are reported. In the year 2011 alone, the disease struck about 33,097 individuals of the United States [4].

Sex distribution
Age distribution

Pathophysiology

For an individual to develop Lyme disease, he or she should have been bitten by ixodid ticks infected by bacterium Borrelia burgdorferi. Once the bacterium gains entry into the body it spreads through the blood stream giving rise to unpleasant symptoms. For an infection to occur, the tick must be attached to the skin for about 25 – 36 hours [5]. It is therefore necessary to remove the tick as soon as possible in order to prevent transmission of the disease [6].

Prevention

Following certain simple steps can help you prevent from Lyme disease. In countries where Lyme disease is a common occurrence, individuals should avoid wandering in areas where ixodid (deer) ticks are common. These include bushy areas with long grass and wooded areas. Individual are advised to wear long pants when exploring such areas. It is also necessary to use insect repellents. When bitten by deer tick, it is necessary to remove the tick as soon as possible to prevent the infection. Individuals are also advised to check their pets for ticks. Whenever they notice tick bites, it should immediately be removed with the help of tweezers.

Summary

Lyme disease is caused by the bacterium Borrelia burgdorferi. It is transmitted to humans when they are bitten by ixodid ticks. Lyme disease greatly affects the body organs such as the joints, muscles, hearts, neurological system and gastrointestinal system [2]. Individuals affected with this disease often present with arthritis, fever, rashes, conjunctivitis and many other debilitating conditions. Lyme disease is treated with a strong antibiotic course that works towards elimination of the bacterium from the body. The disease can be successfully treated if treatment is initiated in the early stages.

Patient Information

Definition

Lyme disease is a kind of bacterial infection caused by infected ticks. The bacterium that causes the disease is called as Borrelia burgdorferi. It is the most common form of vector illness in the United States. It has been estimated that about 30,000 cases of Lyme disease are detected each year in the US.

Cause

Infected deer tick is the sole cause of Lyme disease. In this, the bacterium gains entry into the human system through the tick bite and spreads through the blood affecting other body organs and system.

Symptoms

Symptoms of Lyme disease include development of rash which is small and red colored in the initial stages. As the disease progresses, the rash extends in bull’s eye pattern. Other symptoms include joint pain, neurological problems, fever, fatigue, headache and muscle aches.

Diagnosis

Diagnosis of Lyme disease gets difficult as the symptoms often mimic other disease conditions. Many a time physical examination of the rash is enough to confirm the diagnosis. However additional tests such as ELISA test, Western blot test and polymerase chain reaction test may also be necessary to confirm the disease condition.

Treatment

A strong antibiotic course for 14 – 21 days would be enough to successfully treat the condition.

References

Article

  1. Feder HM Jr. Lyme disease in children. Infect Dis Clin North Am. Jun 2008;22(2):315-26, vii. 
  2. Steere AC. Lyme disease. N Engl J Med 2001; 345:115.
  3. Oschmann P, Dorndorf W, Hornig C, et al. Stages and syndromes of neuroborreliosis. J Neurol 1998; 245:262.
  4. Centers for Disease Control (CDC). Lyme disease--United States, 1987 and 1988. MMWR Morb Mortal Wkly Rep 1989; 38:668.
  5. Sood SK, Salzman MB, Johnson BJ, Happ CM, Feig K, Carmody L, et al. Duration of tick attachment as a predictor of the risk of Lyme disease in an area in which Lyme disease is endemic. J Infect Dis. Apr 1997;175(4):996-9. 
  6. Kalish RA, Kaplan RF, Taylor E, et al. Evaluation of study patients with Lyme disease, 10-20-year follow-up. J Infect Dis 2001; 183:453.
  7. Seltzer EG, Gerber MA, Cartter ML, Freudigman K, Shapiro ED. Long-term outcomes of persons with Lyme disease. JAMA. Feb 2 2000;283(5):609-16
  8. Steere AC, Bartenhagen NH, Craft JE, et al. The early clinical manifestations of Lyme disease. Ann Intern Med 1983; 99:76.
  9. Ang CW, Notermans DW, Hommes M, Simoons-Smit AM, Herremans T. Large differences between test strategies for the detection of anti-Borrelia antibodies are revealed by comparing eight ELISAs and five immunoblots. Eur J Clin Microbiol Infect Dis. Aug 2011;30(8):1027-32. 
  10. Steere AC, Angelis SM. Therapy for Lyme arthritis: strategies for the treatment of antibiotic-refractory arthritis. Arthritis Rheum. Oct 2006;54(10):3079-86Steere AC, Sikand VK. The presenting manifestations of Lyme disease and the outcomes of treatment. N Engl J Med. Jun 12 2003;348(24):2472-4.

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Last updated: 2017-08-09 17:33