Symptoms Of Lyme Disease
A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.
The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.
The rash can have a darker or lighter area in the centre and might gradually spread. It’s not usually hot or itchy.
The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.
Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:
- a high temperature, or feeling hot and shivery
- tiredness and loss of energy
Some people with Lyme disease develop more severe symptoms months or years later.
This is more likely if treatment is delayed.
These more severe symptoms may include:
- pain and swelling in joints
- nerve problems such as pain or numbness
- heart problems
- trouble with memory or concentration
Questions To Ask Your Doctor
- I found a tick embedded in my skin, but I cant get it out. What should I do?
- Ive been bitten by a tick. Do I need to be seen?
- Do I need a blood test to confirm Lyme disease?
- Which antibiotic is best for me?
- How long will I have to take the antibiotic?
- What tick or insect repellent should I use for me or my child?
- How long will the symptoms last?
- What should I do if I still dont feel well a long time after I was bitten?
Diagnosis Testing And Treatment
You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.
Several weeks after infection, FDA cleared tests have very good sensitivity.
It is possible for someone who was infected with Lyme disease to test negative because:
If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.
* Silver HM. Lyme disease during pregnancy. Infect Dis Clin North Am. 1997 Mar 11:93-7.
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Antimicrobials That Kill Growing Phase Spirochetes
- Amoxicillin 500 mg 1 to 2 pills 3 times a day. Alternatively as an alternative to IV antibiotics take 3 to 4 pills 3 times a day.
- Amoxicillin/Clavulanic Acid 875 mg/125 mg 1 pill 2 times a day
- Bicillin LA 2.4 million units IM 3 times a week with one day between each injection
- Ceftriaxone 2 gm IV 2 times a day for 4 days in a row then off for 3 days of each 7 days
- Cefotaxime 2 gm IV every 8 hours
- Cefuroxime 500 mg 1 pill 2 times a day
- Cefdinir 300 mg 1 pill 2 times a day
Additional IV Antibiotics
Vancomycin, imipenem, and ertapenem are possible alternatives if someone is allergic to Ceftriaxone or Cefotaxime.
Intracellular and Extracellular
- Clarithromycin 500 mg 2 pills 2 times a day
- Azithromycin 500 mg 1 time a day or 500 mg IV 1 time a day
- Doxycycline 100 mg 1 or 2 pills 2 times a day or 200 to 400 mg mg IV 1 time a day
- Minocycline 100 mg 1 pill 2 times a day
Treatment For Erythema Migrans
People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease.
Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a persons age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions.
|30 mg/kg per day orally, divided into 2 doses||500 mg per dose|
*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize unnecessary antibiotics that might result in adverse effects, including infectious diarrhea and antimicrobial resistance.
NOTE:For people intolerant of amoxicillin, doxycycline, and cefuroxime, the macrolide azithromycin may be used, although it is less effective. People treated with azithromycin should be closely monitored to ensure that symptoms resolve.
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Herbal & Prescription Lyme Disease Antibiotics
In this article, you will learn how to build a Lyme disease herbal or prescription antibiotic treatment. Later, in this guide I provide nine sample herbal and prescription antibiotic treatment plans, including the dosing regimens I find effective.
The focus of this article is on Lyme germ treatment. For information about treating Lyme disease coinfections see
Before I describe these plans, you should be aware that chronic Lyme disease recovery requires more than antibiotics. I cannot emphasize this point strongly enough. Treating Borrelia, the Lyme germ, with antibiotics is complicated because limited research shows which treatment regimens work best. As a result, many Lyme-Literate Medical Doctors , like me, prescribe antibiotics based on theory, in addition to our collective observation, which is that combinations of antimicrobials work better than single agents alone. It is critical that a Lyme disease treatment regimen addresses the first ten steps outlined in my Lyme disease treatment guidelines, The Ross Lyme Support Protocol. These steps are designed to revive health and to boost the immune system. Even a year or more into treatment, when a person is feeling better, these steps are essential to speed recovery by supporting the immune system.
Essential Oils For Lyme Disease
It is believed that many essential oils have antimicrobial activities, and some people with persistent Lyme disease symptoms have turned to essential oils to help reduce symptoms of the disease.
Researchers tested 34 essential oils against B. burgdorferi in the lab and found cinnamon bark, clove bud, citronella, wintergreen, and oregano show strong activity against the bacterium that causes Lyme disease, even more effectively than daptomycin, the gold standard antibiotic many people with Lyme disease are prescribed.
These results indicate that essential oils show promise as treatments for persistent Lyme disease, but clinical trials are needed in order to show their effectiveness in humans.
When used properly, most essential oils are safe and free of adverse side effects. However, it is important to use them carefully. They can irritate the skin if not properly diluted, and some should not be taken internally.
Purchase high-quality essential oils that go through testing to ensure the product is safe to use. Follow the usage and dilution instructions on the label carefully. Talk with your healthcare professional before using essential oils to avoid drug interactions with any medications you are taking.
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Trial Design And Study Characteristics
Table summarizes the study design of the four randomized, double-blind, placebo-controlled trials included for analysis. All four trials were conducted in areas where Lyme disease is endemic and all trials enrolled patients with an Ixodes scapularis tick bite within the preceding 72 h. In all four trials, the blinding of patients was performed by giving them identical-appearing tablets, capsules or liquid suspensions. The success of patient blinding was assessed in only one study. In all four trials, physicians were reported to be blinded to the treatment allocation. However, no trial reported how physician blinding was assessed. Two trials assessed patient compliance: the first measured patient compliance by assessing the antimicrobial activity of patient urine and the other asked subjects to swallow the single-dose regimen under direct observation by study personnel.
All of the four clinical trials used the development of erythema migrans or symptoms of extracutaneous Lyme disease as their primary outcome for statistical analysis. All trials measured serum antibodies against B. burgdorferiat presentation and upon follow-up. Only two trials, confirmed equivocal or positive results with immunoblot assays.
Dosage, duration and types of antibiotics tested varied among trials. In three trials, a 10 day course of treatment was administered. In the other trial, subjects were given two 100 mg capsules of doxycycline as a single dose.
What Does Current Guidance Say On This Issue
NICE guidance on Lyme disease states that those without focal symptoms should receive 100mg oral doxycycline twice a day or 200mg once per day for 21 days. The first alternative to this is oral amoxicillin, 1g three times per day for 21 days and the second alternative is oral azithromycin, 500mg daily for 17 days.
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What Is The Outlook For Someone With Lyme Disease
Most of the people who get Lyme disease and are treated early will be fine.
Even after proper treatment, some patients may experience lingering fatigue, achiness or headaches. This does not signify ongoing infection and will not respond to additional antibiotics. The majority of people in this group will have symptoms resolve over the next one to six months.
Chronic Lyme Syndrome
Chronic Lyme syndrome is a term used by some that includes the symptoms of Post-Lyme syndrome outlined above. This is a controversial topic with no accepted etiology and no proven cause or association.
How Ticks Spread Lyme Disease
Ticks are small biting arachnids that feed on blood by attaching their mouthparts to people and animals. Ticks get infected with borrelia burgdorferi when they feed on mice, squirrels, birds and other small animals that carry the bacterium — and it can spread to humans through an infected tick bite. People and pets can pick up ticks by brushing against vegetation like grass, shrubs and leaf litter.
Blacklegged ticks are very small. Before feeding, adult females are approximately 3-5 mm in length and red and dark brown in colour. Females are a little larger than males and when they’re full of blood, they can be as big as a grape. Males never expand in size because they do not engorge on blood. Larvae and nymphs are smaller still and, when unfed, are lighter in colour than adult ticks.
The greatest risk of getting Lyme disease is during the spring and summer months. Ticks might also be active in the winter, if the winter is mild with little snow.
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How To Prevent Lyme Disease After A Tick Bite
If you spend a considerable amount of time outdoors, youre likely familiar with the steps you should take to avoid being bitten by a tick. Treating clothing and equipment with permethrin, tucking your pant legs into your socks, and applying a chemical repellent with DEET or picaridin can all help prevent tick bites.
But what if youve already been bitten by a tick? Is there anything you can do to reduce your risk of contracting Lyme disease? PhysicianOne Urgent Care has compiled the following tips:
Many people assume that theyll need to undergo blood testing immediately after being bitten by a tick to determine whether they contracted Lyme disease. However, blood tests will not begin to come back positive for Lyme disease until approximately two to six weeks after the time of infection.
How Is It Treated
The main treatment for Lyme disease is antibiotics. These medicines usually cure Lyme disease within 3 weeks of starting treatment.
Its important to get treatment for Lyme disease as soon as you can. If it goes untreated, Lyme disease can lead to problems with your skin, joints, nervous system, and heart. These can occur weeks, months, or even years after your tick bite. The problems often get better with antibiotics, but in rare cases they can last the rest of your life.
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Several Antibiotics Appear Effective Against Early
This is a plain English summary of an original research article
Most cases of Lyme disease, which is an infection carried by ticks, can be easily managed if treated early using antibiotics, with choice of antibiotic agent having little bearing on success.
This network meta-analysis suggests that when symptoms of the disease are confined to a localised skin infection, treatment failures are relatively infrequent, only 2% at 12 months. Effective antibiotics include penicillin V, doxycycline, azithromycin, cefuroxime, amoxicillin and ceftriaxone plus doxycycline.
The research has significant limitations, but choice, dose and duration of antibiotics appear to have little impact on outcomes. This research does not suggest that guidelines need to be reviewed.
How To Prevent Post
While you may not be able to prevent post-treatment Lyme disease syndrome, you can take precautions to prevent coming into direct contact with infected ticks. The following practices can reduce your likelihood of getting Lyme disease and developing persistent symptoms.
If a tick bites you, contact your doctor. You should be observed for 30 days for signs of Lyme disease. You should also learn the signs of early Lyme disease and seek prompt treatment if you think youre infected. Early antibiotic intervention may reduce your risk of developing chronic symptoms.
The signs of early Lyme disease can occur from 3 to 30 days after a bite from an infected tick. Look for:
- a red, expanding bulls-eye rash at the site of the tick bite
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Antibiotics Alone Are Unlikely To Get You Well
This is the second time I am making this point because it is very important. It is essential to your recovery that, at a minimum, your treatment address the steps outlined in my Lyme disease treatment guidelines: The Ross Lyme Support Protocol. Even a year or more into your treatment, these ten steps are essential to resuscitate and support the immune system.
What Are The Symptoms Of Lyme Disease
Lyme disease may evolve through several phases or stages which can overlap, causing symptoms that may involve the skin, joints, heart or nervous system.
Early Lyme disease typically causes a reddish rash or skin lesion known as erythema migrans . The rash starts as a small red spot at the site of the tick bite 1 to 4 weeks after the bite. It expands over a period of days or weeks, forming a circular, triangular, or oval-shaped rash. The rash may look like a bulls eye because it appears as a red ring that surrounds a clear center area. The rash can range in size from that of a dime to the entire width of a person’s back. As infection spreads, several rashes can appear at different sites on the body.
If the infection goes untreated, you may develop multiple areas of rash, paralysis of facial muscles , heart block or areas of numbness or abnormal sensation .
Untreated late Lyme disease, which occurs months to a year after the initial infection, is most commonly associated with recurring episodes of swollen joints typically of large joints such as the knee. Additionally some patients may develop difficulty concentrating, which is called brain fog .
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Clinical Questions And Evidence Review
An initial list of relevant clinical questions for these guidelines was created by the whole panel for review and discussion. The final set of clinical questions was approved by the entire committee. All outcomes of interest were identified a priori and explicitly rated for their relative importance for decision making. Each clinical question was assigned to a pair of panelists.
Evidence summaries for each question were prepared by the technical team from Tufts Medical Center. The risk of bias was assessed by the technical review team using the Cochrane risk of bias tool for randomized controlled trials , the Newcastle-Ottawa scale for nonrandomized studies and QUADAS-2 tool for diagnostic test accuracy studies . The certainty in the evidence was initially determined for each critical and important outcome, and then for each recommendation using the GRADE approach for rating the confidence in the evidence . Evidence profile tables and quality of evidence were reviewed by the guideline methodologists . The summaries of evidence were discussed and reviewed by all committee members and edited as appropriate. The final evidence summaries were presented to the whole panel for deliberation and drafting of recommendations. Literature search strategies, PRISMA flow diagrams detailing the search results, data extraction and evidence profiles tables, and additional data, such as meta-analysis results when appropriate, can be found in the supplementary materials .
Summary Of Study Characteristics
Additional details regarding the strengths and limitations of included publications are provided in .
Systematic Review with Meta-Analysis
The review is unclear regarding whether study selection was conducted in duplicate if the reviewers did not conduct study selection in duplicate then this could introduce bias into the review, with reduced quality and confidence in its results. Grey literature was not searched and content experts were not consulted, which may have omitted relevant data and introduced publication bias. This omission is of particular importance since publication bias was not assessed. The sources of funding for each included trial were not discussed and risk of bias from the selection of the reported result from multiple measurements or analyses was not assessed. These review characteristics may increase bias in: study selection search strategy risk of bias assessments and their impact on the meta-analysis, interpretation of results, and discussion sources of funding and conflicts of interest, which therefore decrease the confidence in the results of the systematic review.
Outcome measurement may have been influenced by knowledge of received intervention since the outcome assessors were aware of the intervention received by study participants and may therefore decrease confidence in the results of the study.
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