What Are The Symptoms Of Late Stage Lyme Disease
Up to 15-40% of late-stage Lyme patients develop neurological disorders, which are responsible for many common symptoms of chronic Lyme disease. Experts dont know for sure why some people experience persistent symptoms, even with treatment.
As a result, sometimes people who are infected with Lyme disease are incorrectly diagnosed with other ailments such as fibromyalgia, rheumatoid arthritis, and multiple sclerosis . These chronic conditions arent the only illnesses that can be mistaken for Lyme disease. We explore 3 Lyme-like conditions that might not immediately come to mind.
Ruling Out Other Diseases
Many other infections and medical conditions can produce fever, headache, muscle aches, and fatigue, including a very wide variety of common, generally benign viral illnesses. They can also produce some of the neurologic or cardiac features characteristic of early Lyme disease. The same tick that causes Lyme disease can also transmit other infections.
Co-Infections Transmitted by the Ixodes Tick
Babesiosis, Rocky Mountain Spotted Fever , and human granulocytic anaplasmosis are transmitted by the same tick that carries Lyme disease. People may be co-infected with one or more of these infections, all of which can cause flu-like symptoms. If these symptoms persist and there is no rash, it is less likely that Lyme disease is present.
Other Tick-Borne Infections
A number of other tick-borne diseases may resemble Lyme disease. The most important of these is southern tick-associated rash illness , which is caused by the bite of the Lone star tick, usually in southern and Southeastern parts of the United States. It causes a rash very similar to Lyme disease. The bacterium responsible for STARI remains unknown, but may be B. lonestari.
Allergic Reactions and Insect Bites
Autoimmune Diseases And Lyme Disease: Misdiagnosis Or Complication Of Lyme
As mentioned above, there are documented correlations between Lyme and autoimmune diseases. The evidence shows that Lyme disease may trigger an autoimmune disease, or it may mimic an autoimmune disease.
What does this mean for patients and physicians? It comes down to the importance of getting an accurate and timely diagnosis if you suspect Lyme or another tick-borne disease. The longer Lyme disease goes untreated, the stronger the chance that it will spread to multiple body systems and possibly trigger an autoimmune response.
Because Lyme disease symptoms mimic symptoms of so many other conditions, including autoimmune diseases, it is notoriously tricky to diagnose. One of the most common Lyme disease misdiagnoses is the autoimmune disease rheumatoid arthritis , characterized by chronic joint pain.
If a patient with Lyme is diagnosed with RA without the Lyme being detected and treated, not only can the arthritic symptoms of Lyme persist and worsen, but the Lyme can also go on to affect more systems, causing neurological and psychiatric symptoms, heart problems, and more. In rare cases, untreated Lyme can even be fatal.
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Frequently Asked Questions About Lyme Disease
ILADEF is devoted to training doctors and other medical professionals in the diagnosis and treatment of Lyme. ILADEF, and our sister organization ILADS, also believes that increasing the public’s awareness of Lyme and its effects is one of the most important steps we can take to reducing the incidence of Lyme and other tick-borne diseases.
The information below is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If you suspect the presence of a tick-borne illness, you should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases. Our provider search can help you find doctors in your area.
Disease Reporting And Case Definitions
The Centers for Disease Control and Prevention maintains a list of nationally notifiable diseases . RSMo 192.139, Communicable Disease Reporting, Guidelines for Department, stipulates that communicable disease reporting requirements established by the Missouri Department of Health and Senior Services shall be in accordance with guidelines, funding requirements, or recommendations established by CDC. DHSS has incorporated CDC-mandated diseases as well as selected other diseases for which there are established diagnostic tests into 19 CSR 20-20.020, Reporting Communicable, Environmental and Occupational Diseases . Local public health agencies and/or DHSS are notified by physicians, laboratories, and other reporters when diseases/conditions listed in 19 CSR 20-20.020 are confirmed or suspected. DHSS, in turn, reports cases to CDC.
The usefulness of public health surveillance data depends on its uniformity, simplicity, and timeliness. CDCs case definitions establish uniform criteria for disease reporting and should not be used as the sole criteria for establishing clinical diagnoses, determining the standard of care necessary for a particular patient, setting guidelines for quality assurance, or providing standards for reimbursement. Use of additional clinical, epidemiologic, and laboratory data may enable a physician to diagnose a disease even though the formal surveillance case definition may not be met.
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How Is Lyme Disease Diagnosed
Lyme disease is difficult to diagnose because symptoms are not consistent and may mimic other conditions. The primary symptom is a rash, but it may not be present in up to 20% of cases.
Diagnosis for Lyme disease must be made by a healthcare provider experienced in recognizing Lyme disease. Diagnosis is usually based on symptoms and a history of a tick bite. Testing is generally done to confirm the diagnosis and rule out other conditions. This may need blood and other lab tests.
Research is underway to develop and improve methods for diagnosing Lyme disease.
The symptoms of Lyme disease may look like other medical conditions or problems. Always talk with your healthcare provider for a diagnosis.
No Sure Way To Predict
Predicting the number of Lyme disease or other tickborne infections, including how an upcoming season will compare with previous years, is complicated. Ticks that spread germs to people can have up to 2- to 3-year lifecycles, and many factors can affect their numbers, including temperature, rainfall, humidity, and the availability of hosts for the ticks to feed on, such as mice, deer and other animals. In any given year, the number of ticks in an area will be different from region to region, state to state, and even county to county.
Numbers of reported tickborne disease cases are also affected by healthcare provider awareness and by testing and reporting practices.
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Treating Early Stage Lyme Disease
The early stages of Lyme disease usually include the bull’s-eye rash and flu-like symptoms of chills and fever, fatigue, muscle pain, and headache. In rare cases, people develop an abnormal heartbeat .
All of these conditions are treated with 14 to 28 days antibiotics courses. The exact number of days depends on the drug used and the person’s response to it. Antibiotics for treating Lyme disease generally include:
- Doxycycline. This antibiotic is effective against both Lyme disease and human granulocytic anaplasmosis . It is the standard antibiotic for anyone over 8 years old, except for pregnant women. It is a form of tetracycline and can discolor teeth and inhibit bone growth in young children. It can also cause birth defects if used during pregnancy.
- Amoxicillin. This type of penicillin is probably the best antibiotic for pregnant women. Some people are allergic to penicillin and strains of Lyme bacteria are emerging that are resistant to it.
- Cefuroxime . This cephalosporin antibiotic is an alternative treatment for young children and for adults with penicillin allergy.
- Intravenous ceftriaxone or cefotaxime. Intravenous infusions of one of these cephalosporin antibiotics may be warranted if there are signs of infection in the central nervous system or heart.
Other types of antibiotics, such as macrolides like azithromycin and clarithromycin, are not recommended for first-line therapy.
Antibiotic Side Effects
Molecular Fingerprint Similarities In Covid
A recently released study that is still in pre-print looked at molecular patterns of ME/CFS and compared the results to some chronic infections and autoimmune diseases. Blood and immune cells from the ME/CFS patients and control groups were analyzed with RNA sequencing to develop molecular signatures. The researchers developed mathematical models where they identified 904 âkey driver genesâ in ME/CFS.
Surprisingly, molecular patterns in ME/CFS were similar to patterns in Lyme disease and COVID-19 and not the autoimmune conditions tested. This suggests a âcommon underlying biology that shares immune and metabolic dysregulation.â
The findings from this complex study may explain why people that develop Long COVID may have a similar clinical path as those with ME/CFS and Lyme disease.
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Other Infections Carried By The Ixodes Tick
Human granulocytic anaplasmosis and babesiosis are also transmitted by the deer tick Ixodes scapularis. Although HGA, babesiosis, and Lyme disease are caused by the same kind of tick, these infections are entirely different diseases.
Deer ticks can also transmit deer tick virus, a disease caused by the Powassan virus. In very rare cases, Powassan virus may cause serious brain infection .
New tick-borne diseases, carried by Ixodes ticks as well as other tick species, continue to emerge.
What Are The Signs & Symptoms Of Lyme Disease
Lyme disease can affect different body systems, such as the nervous system, joints, skin, and heart. The symptoms of Lyme disease are often described as happening in three stages. Not everyone with Lyme has all of these, though:
The rash sometimes has a “bull’s-eye” appearance, with a central red spot surrounded by clear skin that is ringed by an expanding red rash. It also can appear as an growing ring of solid redness. It’s usually flat and painless, but sometimes can be warm to the touch, itchy, scaly, burning, or prickling. The rash may look and feel very different from one person to the next. It can be harder to see on people with darker skin tones, where it can look like a bruise. It gets bigger for a few days to weeks, then goes away on its own. A person also may have flu-like symptoms such as fever, tiredness, headache, and muscle aches.
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The Disease That Looks Like Lyme
English: Erythematous rash in the pattern of a bulls-eye from Lyme disease
The blacklegged tick , the primary vector for Lyme disease in the central and… eastern United States.
A newly identified disease spread by deer ticks may be among one of the new summer illnesses to be on the lookout for if you spend time outside in the Northeast and upper Midwest. The disease is referred to as Borriela miyamotoi.
However, many healthcare providers may not be familiar with or have experience treating patients with this newly identified spirochete.
First discovered and isolated by Japanese scientists in 1995, Borriela miyamotoi was detected in the common deer tick in Connecticut in 2001, and has now been noted in all areas of the US where Lyme disease is endemic.
The first human cases of B. miyamotoi were actually described by researchers from Yale in 2011 in Russian patients. According to correspondence published in NEJM in January of 2013, researchers from Yale described 18 patients ultimately diagnosed with this spirochete. And in July, 2013, an additional clinical report of two patients suspected of having human granulocytic anaplasmosis who were later diagnosed with this spirochete has drawn growing attention to this entity.
This new illness resembles Lyme disease or HGA however, it has unique characteristics which potentially could make it more problematic to identify and diagnose.
Autoimmune Disease Vs Systemic Autoinflammatory Disease : Understanding The Immune System
Autoimmune diseases are not the only type of immune system disorder associated with immune system overactivity. A newer, less recognized category is that of systemic autoinflammatory diseases, or SAIDs. Though they share many symptoms, they actually arise from two different immune systems: the innate immune system and the adaptive immune system.
Autoimmune diseases are disorders of the adaptive immune system, which works by creating specialized antibodies to attack specific antigens. The cells involved in these processes are B-cells or T-cells. Vaccines work by utilizing the adaptive immune system, introducing pathogens to the body so that it will create the specific antibodies needed to fight off that pathogen. This system is also engaged to fight off bacterial infections like Lyme and other tick-borne diseases.
The other immune system is what is known as the innate immune system. This is the immune system affected by SAIDs. The innate immune system is the immune system youre born with, consisting of all the physical barriers , defense mechanisms , and general immune responses that protect the body from illness. One of the primary forms of general immune responses is inflammation the process of sending immune cells to the site, which will swell as the immune cells go about attacking harmful agents.
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Lyme Disease Could Be The Real Cause Of Arthritic Symptoms In Children And Adults
The misdiagnosis of arthritic symptoms is actually what first catapulted Lyme disease into the public spotlight more than 40 years ago. A group of adults and children in Lyme, Connecticut, were experiencing various symptoms initially attributed to rheumatoid a
rthritis and juvenile rheumatoid arthritis , respectively. The cause of the symptoms was later linked to tick bites and ultimately Borrelia burgdorferi, the bacterium that causes Lyme disease.
Today, arthritis is still one of the most common misdiagnoses of Lyme disease, especially if patients dont recall being bitten by a tick or dont alert doctors to the fact that they or their children have been in regions where Lyme disease is prevalent. Similar to symptoms of both RA and JRA, Lyme disease can cause joint pain, fatigue, and fever. Patients with Lyme disease, however, may also have additional symptomssuch as headache, chills, sore muscles, and swollen lymph nodes. The presence of a rash can also help distinguish Lyme disease from RA or JRA, but, again, the absence of a rash should not rule out a Lyme disease diagnosis.
The Cycle Of Infection
The blacklegged tick has a 2-year life cycle during which it goes through 3 stages of development:
- Egg. Adult females lay eggs during the spring of year 1. Eggs are deposited usually on the ground in the area where the female detached from its host.
- Larva Stage. In spring and summer of year 1, 6-legged larvae hatch from eggs. They take their first meal from a mouse, bird, or other small animal. This is when larvae can first acquire the B. burgdorferi spirochete but they do not transmit it at this stage. After feeding, the larvae fall off their hosts and molt into nymphs, which become dormant for the fall and winter of year 1.
- Nymph Stage. In the spring and summer of year 2, the 8-legged nymph ticks wake up and begin to feed on wild animals , domestic animals , or humans. Peak activity is usually from late May through July, although this can vary depending on climate. Most cases of Lyme disease are transmitted by nymphs.
- Adult Stage. In the fall of year 2, the nymphs become 8-legged adults. Only the adult female takes a blood meal. Adult female ticks may also transmit Lyme disease. For their third and final meal, female ticks seek a larger animal. After feeding, they mate with males, drop off the host, lay eggs, and then die. White-tailed deer are the main hosts for adult ticks. Female ticks feed on deer, while male ticks attach themselves to deer to wait for the females.
Keep in mind that:
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Does A Tick Bite Cause Immediate Danger
If a tick is only on you two or three hours, it probably won’t even get a chance to attach and start feeding, says Dr. Moscovitz.
Once a tick attaches, it starts feeding and stays on you for about 12 or 18 hours and then falls off when its full.
A tick has to be attached for a long timemore than 10 hoursto transmit bacteria. A tick that looks flat and small probably hasn’t eaten, notes Dr. Moscovitz.
What Should You Do If You Find A Tick
Don’t touch the tick with your bare hand.
Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your skin as possible.
Pull up slowly and steadily without twisting until it lets go. Don’t squeeze the tick, and don’t use petroleum jelly, solvents, knives, or a lit match to kill the tick.
Save the tick. Place it in a plastic container or bag so it can be tested for disease, if needed.
Wash the bite area well with soap and water and put an antiseptic lotion or cream on the site.
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How Are Lyme And Covid
Lyme disease and COVID-19 are both zoonotic diseases, meaning they originated in animals and then spread to humans. The primary reservoir for the Lyme bacteria is mice, and the primary reservoir for COVID-19 virus is believed to be bats.
Both diseases are spreading uncontrolled across the globe. Ticks are the main vector for Lyme, and humans are the main source of transmission for COVID-19.
Lyme and COVID-19 cause many symptoms, ranging from mild to life-threatening.
The majority of Lyme and COVID-19 cases begin with flu-like symptoms including fever, chills, sweats, muscle aches, fatigue, nausea and joint pain. Some with Lyme will get a rash and most with COVID-19 will get shortness of breath, sore throat, a cough, loss of sense of taste or smell, and/or a runny nose.
When diagnosed and treated early, both Lyme and COVID-19 have a better chance of full recovery. Left untreated, Lyme and COVID-19 can spread to multiple organs and systems of the body causing relapsing and chronic symptoms, and in some cases, death.