Lyme disease infection is caused by the bacterium Borrelia burgdorferi, carried by deer ticks. An infected tick transmits the bacteria to humans by biting the skin. If untreated, the bacteria is capable of traveling through the bloodstream, settling in various body tissue, and causing a number of acute and persistent symptoms, ranging from mild to severe.
These factors increase your chance of developing Lyme disease. Tell your doctor if you have any of these risk factors:
The symptoms of Lyme disease are varied and can range from mild to severe. The majority of infected individuals first notice a red rash known as erythema migrans (EM). The rash starts as a small red spot at the site of the tick bite and expands over a period of days or weeks, forming a circular or oval-shaped rash. Sometimes, the rash resembles a bull's eye, a red ring surrounding a clear area with a red center. The size of the rash can range from dime-sized to the entire width of a person's back.
The diagnosis of Lyme disease is usually based on the presence of symptoms and the history of a tick bite. Many people with typical symptoms do not have Lyme disease, even if they have spent time outdoors. If you think you have the symptoms and believe you may have been exposed to a tick, see your doctor right away.
After four weeks, people with Lyme disease usually have antibodies against B. burgdorferi in their blood. A blood test, called an ELISA, can test for the antibodies. When an ELISA is positive, the results should be confirmed with a second blood test called a Western blot.
However, a negative test does not completely exclude the disease, and a positive test alone does not confirm the diagnosis. Blood tests are used to support a diagnosis that is also based on symptoms and risk factors.
Lyme disease responds well to antibiotics. Antibiotics, including doxycycline (Vibramycin, Adoxa, and others) and amoxicillin (Amoxil, Dispermox, Trimox), are usually effective. (Note: Young children and pregnant women should not take doxycycline.)
You will need to take antibiotics for 10 days to four weeks. Some symptoms may continue after treatment. For persistent or severe cases that do not respond to oral antibiotics, intravenous (IV) antibiotic treatments (usually ceftriaxone ) may be given.
Chronic arthritis may require anti-inflammatory medication or joint injection with steroids.
To help prevent Lyme disease, try the following:
Taking antibiotics, including a single dose of doxycycline, within 72 hours after a known tick bite has been shown to reduce the risk of contracting Lyme disease.
The risk of catching Lyme disease after a single tick bite is low, and many experts do not necessarily recommend preventive antibiotic treatment even in parts of the country with relatively high Lyme disease risk.
RESOURCES:
American Lyme Disease Foundation
http://www.aldf.com/
Centers for Disease Control and Prevention
http://www.cdc.gov/
CANADIAN RESOURCES:
Communicable Disease Control
http://www.gov.mb.ca/
Public Health Agency of Canada
http://www.phac-aspc.gc.ca/
References:
Diaz JH. The diagnosis, management, and prevention of common ectoparasitic infections. J La State Med Soc . 2006;158:90-98.
Loewen PS, Marra CA, Marra F. Systematic review of the treatment of early Lyme disease. Drugs . 1999;57:157-173.
Lyme disease. American Lyme Disease Foundation website. Available at: http://www.aldf.com . Updated July 2009. Accessed July 20, 2009.
Lyme Disease Foundation website. Available at: http://www.lyme.org/ . Accessed July 20, 2009.
Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single dose doxycycline for the prevention of Lyme disease after an Ixodes Scapularis tick bite. N Engl J Med . 2001;345:79-84.
National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/ . Accessed July 20, 2009.
Weiner HR. Lyme disease: questions and discussion. Compr Ther . 2006;32:17-19.
5/28/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Warshafsky S, Lee DH, Francois LK, Nowakowski J, Nadelman RB, Wormser GP. Efficacy of antibiotic prophylaxis for the prevention of Lyme disease: an updated systematic review and meta-analysis. J Antimicrob Chemother. 2010;65(6):1137-1144.
Last reviewed October 2009 by David L. Horn, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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