Lyme Disease
Symptoms
Lyme disease may progress in stages from mild symptoms to serious, long-term disabilities if left untreated. There are three stages of Lyme disease: early localized, early disseminated, and late persistent.
Stage 1: Early localized infection (1 to 4 weeks)
From 1 to 4 weeks after being infected with bacteria that cause Lyme disease, up to 80% of people develop an expanding, circular red skin rash (called erythema migrans). 3
For people who live in areas where Lyme disease most often occurs—in the United States along the Atlantic coast, the Midwest, and parts of Oregon and California—the circular rash is usually a sure sign of Lyme disease, especially when it appears during the summer months.
In up to 50% of people who have Lyme disease, the expanding circular rash is accompanied by flulike symptoms such as: 6
Fatigue or lack of energy, which is the most common symptom.
Headache and stiff neck.
Fever and chills.
Muscle and joint pain.
Swollen lymph nodes.
As many as 25% have only flulike symptoms (no rash) or have no symptoms at all. 2
Stage 2: Early disseminated infection (1 to 4 months)
If Lyme disease is not detected and treated while early symptoms are present, or if you do not have early symptoms that trigger the need for treatment, the infection may spread to the skin, joints, nervous system, and heart within weeks to months after the initial infection.
Symptoms at this stage may include: 7, 4
Persistent fatigue.
Additional skin rashes in several places on your body that develop as the infection spreads.
Pain, weakness, or numbness in the arms or legs.
Inability to control the muscles of the face (paralysis of the facial nerves).
Recurring headaches or fainting.
Poor memory and reduced ability to concentrate.
Conjunctivitis (pinkeye) or sometimes damage to deep tissue in the eyes.
Occasional rapid heartbeats (palpitations) or, in rare cases, serious heart problems. 7
Stage 3: Late persistent infections
If Lyme disease is not promptly or effectively treated, damage to the joints, nerves, and brain may develop months or years after you become infected (late Lyme disease). Symptoms at this stage may include: 6, 2
Swelling and pain (inflammation) in the joints, especially in the knees.
Numbness and tingling in the hands, feet, or back.
Severe fatigue.
Partial facial nerve paralysis (Bell's palsy), which usually occurs within the first few months after the tick bite. 8
Neurologic changes, including problems with memory, mood, or sleep and sometimes problems speaking.
Chronic Lyme arthritis, which causes recurring episodes of swelling, redness, and fluid buildup in one or more joints that last up to 6 months at a time.
Heart, nervous system, and joint symptoms may be the first signs of Lyme disease in people who did not have a rash or other symptoms of early infection.
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Treatment Overview
Lyme disease is treated with antibiotics such as doxycycline or amoxicillin. Antibiotic treatment for early Lyme disease is effective, and symptoms usually go away within 3 weeks of treatment. 10
The earlier antibiotic treatment is started after infection, the more quick and complete the recovery. 11 Research indicates that if you are given a single dose of the antibiotic doxycycline within 72 hours after being bitten by an infected tick, your chances of developing Lyme disease may be reduced by up to 87%. 12 This treatment may be especially effective for those who live in high-risk areas.
If Lyme disease is not diagnosed and treated until later problems arise, it may take you a long time to get better or you may require additional treatment.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are usually helpful for arthritislike symptoms associated with late Lyme disease.
Around 50% of people with untreated Lyme disease will eventually develop a condition called chronic Lyme arthritis, which is repeated episodes of swelling, redness, and fluid buildup in one or more joints that last up to 6 months at a time. While only 10% to 20% of chronic Lyme arthritis resolves on its own without additional treatment, it usually is effectively treated with antibiotics, such as cefotaxime, doxycycline, or penicillin. 13 However, joints that have been badly damaged by Lyme arthritis may take a long time to get better or antibiotics may not improve symptoms. If chronic Lyme arthritis persists despite antibiotic treatment, surgery to remove the lining of the affected joint (synovectomy) may be considered.
For late nervous system problems (such as tingling and numbness or conditions such as meningitis), a number of examinations and tests may be done to rule out other causes before more aggressive or long-term antibiotic treatment is started. Up to 90% of those with partial facial paralysis (Bell's palsy) as a result of Lyme disease will improve on their own without additional treatment. 13
In rare instances, serious heart problems, such as severe irregular heartbeat, can occur when Lyme disease goes untreated or is not treated effectively. However, a problem such as irregular heartbeat usually begins to correct itself even before antibiotic treatment is started. 13 Serious heart problems (such as pericarditis and heart failure) are extremely rare, especially in people who did not have heart problems before getting Lyme disease.
In the past, medications were used to try to prevent Lyme disease. A Lyme disease vaccination was developed for use in high-risk areas; however, the vaccine was removed from the market due to uncertainty over its effectiveness and lack of demand and is no longer available.
What To Think About
Previously, health professionals recommended using the antibiotic doxycycline for about 20 days to cure early Lyme disease. However, a recent study suggests that 10 days of doxycycline is as effective as 20 days to cure early, uncomplicated Lyme disease. 14
Doxycycline is not generally used to treat children with Lyme disease. The antibiotic amoxicillin is the preferred treatment for children. If a child can't take amoxicillin for some reason (such as an allergy), the antibiotic cefuroxime axetil can be used instead. 15
Misdiagnosis of Lyme disease is common, especially if you do not have the characteristic circular red rash. In addition, anxiety and awareness of Lyme disease has resulted in frequent use of antibiotic treatment for people who really do not need it. In general, antibiotics are not usually needed unless it is clear you have Lyme disease.
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Medications
Antibiotics, such as doxycycline or amoxicillin, are highly effective in treating Lyme disease. 13 Doxycycline prevents the development of Lyme disease in up to 87% of those treated with this medication within 72 hours of being bitten by an infected tick in a high-risk area. 17
The goals of treatment are to eliminate the infection and prevent complications of Lyme disease, such as problems involving the skin, joints, nervous system, or heart.
The type of antibiotic prescribed, the amount, and whether the medication is taken orally, as an injection, or through a vein (intravenous or IV) depends on the severity of your symptoms and how long you've had Lyme disease. Oral antibiotics are prescribed for early Lyme disease. Either oral or intravenous antibiotics may be used to treat late Lyme disease symptoms.
Intravenous (IV) antibiotics are the treatment of choice if your nervous system is affected by late Lyme disease and you have severe headaches, neck pain, weakness or numbness in the arms or legs, or problems with thinking or memory. IV antibiotics are also used if the Lyme disease bacteria or antibodies against the bacteria have been identified in your spinal fluid.
Oral antibiotics are usually prescribed first for chronic Lyme arthritis (recurring swelling and joint pain), but IV antibiotics may be tried if the oral antibiotics do not work.
Medication Choices
Antibiotics, such as doxycycline, amoxicillin, cefotaxime, or penicillin, are used to treat Lyme disease.
Recent research indicates that using doxycycline for 10 days is as effective for early Lyme disease as taking it for 20 days. 14 Also, if doxycycline is given within 72 hours after you are bitten by an infected tick, it may prevent Lyme disease from developing.
A vaccine was formerly available for prevention of Lyme disease for those in high-risk areas, but it was recently removed from the market due to uncertainty over its effectiveness and lack of demand and is no longer available.
What To Think About
Different antibiotics may be used to treat children and adults. Doxycycline is often prescribed for adults, while amoxicillin is usually preferred for treating children with Lyme disease. 15
The decision to take medications for Lyme disease may be based on one or more of these factors:
You have symptoms of Lyme disease, especially the characteristic red, circular rash, and a history of exposure to ticks in geographic regions where Lyme disease is known to occur.
Blood tests reveal antibodies to the Lyme disease bacteria in your blood, spinal fluid, or joint fluid.
You are a pregnant or breast-feeding and are bitten by a tick.
In rare instances, Lyme disease symptoms may persist even after antibiotic treatment has cured the infection. There are a number of possible reasons why symptoms may take longer to improve:
Some symptoms simply take longer to resolve.
Tissue or nerve damage caused by untreated Lyme disease may be severe or even irreversible.
You may not actually have Lyme disease or may have another illness at the same time with symptoms that do not respond to antibiotic treatment. Lyme disease may trigger fibromyalgia or chronic fatigue syndrome, or you may be misdiagnosed as having Lyme disease when you really have a chronic fatigue condition.
The initial course of antibiotics almost always cures the infection. If symptoms continue, an additional treatment with antibiotics may be needed.
2007-10-21 07:30:44
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answer #1
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answered by Anonymous
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Your description of the original bite looks more like a spider bite. I'm not sure what your "weird rash" is like; that's the important part. You could have had an allergic reaction (to the bite or something else) or gotten an infection in the original bite by scratching it.
Ticks have to hang on and suck your blood for quite a while, a few hours to a day or two (yuck!). They don't just bite and move on like mosquitoes. Unless the bite was somewhere you wouldn't notice a tick for a while, it probably isn't a tick.
However, bites can get infected, particularly if you scratch (and it's possible to scratch enough in your sleep). If your "rash" looks like red streaks coming out from the bite and the area is hot, that could be a serious infection you'd need to treat ASAP, insurance or not. If it's just itchy, try anti-itch creams or even mentholated products. If your clothes rub on it or you don't want to scratch it in your sleep, try covering it with a bandaid.
Lyme disease isn't transmissible person-to-person, so even if you had it, you couldn't give it to your husband. He's being silly.
I get all kinds of itchy dime-sized bites that fail to impress my doctor when I show them off during visits for other reasons.
2007-10-21 07:50:27
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answer #2
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answered by Kathryn H 4
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