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Lyme Disease: Symptoms and Treatment

In 2009, there were nearly 30,000 confirmed cases of Lyme disease in the United States, according to the Centers for Disease Control and Prevention. The disease is most common in the northeastern states. Humans acquire the disease when bitten by ticks (the deer tick) that carry a bacterium called Borrelia burgdorferi.

The difference between unfed and engorged female ticks.
Credit: Alexander Smith/University of Alberta

Symptoms

The most common symptom, regardless of where the tick bite occurs, is an erythema migrans lesion, or rash. Rash occurs in up to 90 percent of all cases, according to the American Lyme Disease Foundation. Individuals may notice a gradual spreading of the rash from a small point to an ever-widening circle. The rash typically forms within seven days after an individual is bitten and can persist for over a month. The rash area may feel warm, and it may not be itchy like a typical rash.

In addition to a rash, individuals may experience aches and pains accompanied by a fever. They may feel tired. Often these symptoms disappear leading an individual to think they are no longer sick.

Eventually, symptoms return but it may be weeks or years after the initial bite. When they do return, the symptoms are typically more severe. In addition to the above symptoms, individuals may also notice tingling in the arms and legs. Arthritis may develop.

Neurological problems can occur in late stages of the disease. These include memory loss and confusion.

 

Diagnosis & Tests

Because the symptoms of Lyme disease overlap with those of other disorders, it is possible to receive a false diagnosis. If a rash is absent, physicians will perform additional tests to confirm diagnosis.

An enzyme-linked immunosorbent assay test, also known as an ELISA test, is the standard test for Lyme disease. The test can determine whether the body's immune system has been exposed to the bacterium B. burgdorferi.

A positive ELISA test is followed up with a Western blot, which also shows whether the body has been trying to fight off B. burgdorferi.

A test called polymerase chain reaction, or PCR, may be used for individuals that appear to have late-stage symptoms of the disease. Fluid from joints or the spine is analyzed for the presence of genetic material from the bacterium.

Tests, however, are often not effective at diagnosing Lyme disease within a month of first infection. Therefore, presence of a tick bite as well as physical symptoms and geographical location should take precedence over test results in some cases.

Treatments & Medications

The earlier that an individual seeks treatment, the more likely they will recover fully, according to the American Lyme Disease Foundation.

For the most part, antibiotics are effective if administered as soon as possible. Examples of common antibiotics used to treat Lyme disease include doxycycline and amoxicillin. Antibiotics are usually given for up to three weeks.

Individuals in later stages of the disease may require several courses of intravenous antibiotics, but there is the possibility that symptoms will persist.

The Mayo Clinic warns that individuals should avoid an alternative treatment called Bismacine. When used for Lyme disease or injected into the body, it can lead to bismuth poisoning.

Complications

Without treatment, or if treatment is unsuccessful, Lyme disease can cause cardiovascular side effects such as an abnormal heartbeat.

Also, individuals may experience neurological side effects. Neuropathy — a condition of pain and numbness due to nerve damage — may develop in certain areas of the body. With long-term symptoms of the disease, people may experience "foggy thinking" and disorientation.

Some individuals may suffer from Lyme arthritis — arthritis caused by the bacterium. According to the Mayo Clinic, Lyme arthritis particularly affects the knee joints.

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