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Lyme disease

Last reviewed: April 7, 2024

Lyme disease stands as the most prevalent vector-borne illness in the United States. It stems from infection by the bacteria Borrelia burgdorferi or, in rare cases, Borrelia mayonii. This ailment is conveyed to humans through bites from infected black-legged ticks. Typical symptoms include headaches, fatigue, fever, and a distinctive skin rash called erythema migrans. Left untreated, the infection can disseminate to the heart, joints, and nervous system.

Lyme disease diagnosis commonly relies on symptomatology, physical examination such as the presence of rash, and potential exposure to infected ticks. Accurate diagnosis is achieved through laboratory tests utilizing validated techniques. Typically, treatment with antibiotics leads to complete recovery within a few weeks. Prevention strategies involve applying pesticides, using insect repellents, prompt tick removal, and minimizing tick habitats. It’s worth noting that the ticks responsible for transmitting Lyme disease may also transmit other tick-borne illnesses.

Signs and symptoms

Lyme disease, if left untreated, can produce wide-ranging signs and symptoms, based on the stage of infection. The symptoms can include rash, fever, arthritis, and facial paralysis.

If Lyme disease goes untreated, it can manifest a variety of symptoms that vary depending on the stage of infection. These symptoms may include rash, fever, arthritis, and facial paralysis.

Early signs and symptoms of Lyme disease may include fatigue:

Later signs and symptoms:

Transmission

Ticks carrying the bacterium B. burgdorferi can attach themselves to any body region, often preferring concealed areas like the armpits, scalp, and groin. An infected tick takes at least 36 hours to transmit the bacterium into the body.

Many Lyme disease cases stem from bites by nymph ticks, which are immature and difficult to detect due to their small size. Nymph ticks typically feed during the warmer months of summer and spring. While adult ticks can also transmit the bacteria, they are more easily spotted and removed before they can cause infection.

Risk factors

Living or vacationing in specific regions can heighten the risk of contracting Lyme disease, as can certain professions and outdoor activities. Common risk factors for Lyme disease include:

Prevention

Avoiding areas where deer ticks thrive, particularly densely wooded regions with tall grass is the most effective means of preventing Lyme disease. Additionally, simple precautions can significantly reduce the risk:

Diagnosis

A healthcare professional will conduct a physical examination to identify any symptoms or rashes indicative of Lyme disease.

Testing may not be conducted during early and localized infection.

Several weeks after initial infection, blood tests become valuable as antibodies appear in the bloodstream. The healthcare provider may recommend the following tests:

Treatment

Lyme disease is typically treated using antibiotics, with earlier initiation of treatment leading to smoother recovery.

Oral antibiotics are the primary treatment for early-stage Lyme disease. Doxycycline is commonly prescribed for adults and children over eight years old, while amoxicillin or cefuroxime is recommended for younger children, adults, and pregnant or breastfeeding women.

Treatment durations typically range from 10 to 21 days, with shorter courses proving equally effective in some cases.

In cases where the disease spreads to the central nervous system, intravenous antibiotics may be administered for 14 to 28 days. While effective in eliminating infection, complete recovery may take time.

It’s important to note that intravenous antibiotics can lead to various side effects, including mild to severe diarrhea, decreased white blood cell count, or infection with antibiotic-resistant organisms unrelated to Lyme disease.

Some individuals may experience lingering symptoms after treatment, known as post-treatment Lyme disease syndrome (PTLDS). The cause of these symptoms is not fully understood, and further research is needed to explore potential autoimmune responses.

While some experts speculate that certain individuals may be predisposed to autoimmune reactions following Lyme disease, additional investigation is required to clarify this relationship.

Work cited

Last reviewed and updated by on Apr 7, 2024

Dr. Jessica is a registered nurse and educator with 20 years of experience in critical care emergency nursing, specializing in patient care, education, and evidence-based practice. She holds multiple certifications and serves as a Patient Safety Coordinator.

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