Signs of Lyme Disease

Description

Caused by the bacteria Borrelia burgdorferi. Deer ticks, also called backlogged ticks, can carry the bacteria, and the disease is acquired after being bitten by an infected tick. Some patients don't remember the tick bite. There are three stages to the infection. See the symptoms section for a description. If untreated the disease can be very serious involving the heart, brain, joints and nerves. The CDC states 94% of all Lyme disease cases occurred in the following states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Hampshire, New York, Pennsylvania, Virginia, and Wisconsin.

Symptoms

In Stage 1: the classic bulls-eye rash (erythema migrans) at the site of the bite, headache, fever, myalgias. Stage 2: spreading of the rash, muscle pain, joint pain, heart palpitations, dizziness, Bell's palsy (facial muscle weakness), severe headache, confusion, stiff neck, meningitis, memory loss, depression. Stage 3: intermittent joint pain, joint swelling, chronic numbness, memory loss.

Tests

A history and physical exam will be performed. A blood test will be done to detect antibodies to the bacteria. The most common one used is the ELISA for Lyme disease. A western blot test is done to confirm ELISA results. Other tests to determine the damage done by the disease may be done.

Standard Workup

CBC
Chem 12
UA
X-Ray
EKG
CT Scan

Treatment

Most people who are bitten by a tick do not get Lyme disease. Antibiotics (doxycycline, amoxicillin, or cefuroxime axetil) are used to treat Lyme disease. The specific antibiotic used depends on the stage of the disease and the symptoms. Severe cases require intravenous antibiotics. Pain medications such as acetaminophen (Tylenol), and nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn) are sometimes prescribed to relieve joint stiffness.