Do You Always Have A Rash With Lyme Disease

How Is Lyme Disease Diagnosed

Your doctor will diagnose you based on your symptoms and whether youâve been exposed to a tick. They might also run a blood test. In the first few weeks of infection, the test may be negative because antibodies take a few weeks to show up.

Hopefully soon, there will be tests that can diagnose Lyme disease in the first few weeks after youâre exposed. The earlier you get treated, the less likely itâll get worse.

Ongoing Symptoms Of Lyme Disease

A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.

These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.

It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.

Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.

The doctor may be able to offer you further support if needed, such as:

• referral for a care needs assessment
• telling your employer, school or higher education institution that you require a gradual return to activities
• communicating with children and families’ social care

Page last reviewed: 05 July 2021 Next review due: 05 July 2024

Signs And Symptoms Of Lyme Disease

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Overview

Lyme disease is an underreported, under-researched, and often debilitating disease transmitted by spirochete bacteria. The spiral-shaped bacteria, Borrelia burgdorferi, are transmitted by blacklegged deer ticks. Lymes wide range of symptoms mimic those of many other ailments, making it difficult to diagnose .

The blacklegged ticks can also transmit other disease-causing bacteria, viruses, and parasites. These are known as coinfections . These ticks that transmit Lyme are increasing their geographical spread. As of 2016, they were found in about half the counties in 43 of 50 states in the United States .

Lyme is the fifth most reported of notifiable diseases in the United States, with an estimated 329,000 new cases found annually . Some studies estimate that there are as many as 1 million cases of Lyme in the United States every year .

Most people with Lyme who are treated right away with three weeks of antibiotics have a good prognosis.

But if youre not treated for weeks, months, or even years after infection, Lyme becomes more difficult to treat. Within days of the bite, the bacteria can move to your central nervous system, muscles and joints, eyes, and heart .

Here is a list of 13 common signs and symptoms of Lyme disease.

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How To Prevent Lyme Disease From Progressing

Learn the symptoms of early Lyme disease so that you can seek treatment promptly if you contract the infection. If you get timely treatment, you can avoid the potential complications of early disseminated Lyme disease and later stages.

The symptoms of early Lyme disease can occur between 3 and 30 days after an infected tick bites you. Look for:

• rash, such as:
• a red, expanding bulls-eye rash at the site of the tick bite
• a round or oval rash that can be as wide as 6 to 8 inches

The Blood Tests Can Have False Positives

The blood tests can trigger false positives, suggesting that you have the disease when you really dont. This can happen in up to one out of four tests.

This can lead to unnecessary treatment with antibiotics. These drugs are usually safe, but they sometimes cause side effects, such as nausea, vomiting, diarrhea, and increased sensitivity of the skin to sunlight. In rare cases, they can even cause dangerous allergic reactions.

Using too many antibiotics can also lead to the growth of drug-resistant bacteria. This means that bacteria in your body may get stronger and more difficult to treat with antibiotics in the future.

A false positive can also lead to more unneeded blood tests, urine tests, X-rays, and doctor visits.

If you have a false positive, you may not get treated for the real cause of your pain. For example, rheumatoid arthritis is a disease that causes joint pain. It can lead to permanent and severe joint damage if you do not start taking the right medicines as early as possible.

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What Do You Do If There’s A Tick Under Your Skin

Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.

You probably wonât get infected if you remove the tick within 36 to 48 hours.

How do you throw away a tick?

Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.

What To Do After Removing An Attached Tick That Has Bitten You

In general, the CDC does not recomment taking antibiotics prophylactically after tick bites to prevent tickborne diseases. However, in certain circumstances, a single dose of doxycycline after a tick bite may lower your risk of Lyme disease. Consider talking to your healthcare provider if you live in an area where Lyme disease is common to discuss prophylaxic doxycycline and other options.

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When Should You See A Doctor If You Think You Have Lyme

The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.

If you don’t have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.

Diagnosis And Treatment Of Lyme Disease

It is very important to diagnose and treat Lyme disease as early as possible. Use precautions to prevent tick bites by covering exposed skin when working or hiking in the outdoors during the warmer months. Check your skin for ticks after being outside and remove them, including the head with tweezers only. If you do receive a tick bite and think you have Lyme, see a doctor right away.

Diagnosis

Lyme disease can be very difficult to diagnose. Ticks on humans not only transmit Lyme disease, but other infections too. If you get bit and develop a Lyme disease rash, this is singlehandedly the best and most accurate way to diagnose Lyme. If you have the rash, the doctor will start treatment right away. If you receive a bite, but do not develop the rash the doctor can run the following tests:

• ELISA This is the most common test for Lyme disease and checks for antibodies to the bacteria, B. burgdorferi. It takes a while to become positive so the test cannot be performed for a few weeks after a bite.
• Western Blot This is usually a secondary test if the ELISA comes back positive. This test also checks for antibodies to the bacteria and needs to be done a few weeks after the bite.
• PCR If you have joint pain after a tick bite, the doctor can withdraw a sample of joint fluid and test it for the bacteria. It wont check for the infection in the bloodstream, but can also be used to check for infection in the spinal fluid.

Treatment

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How Is Erythema Migrans Treated

Because Lyme disease is caused by bacteria, it’s treated with antibiotics. The sooner you start antibiotics, the quicker and more complete your recovery will be.

Oral antibiotics. Early-stage Lyme disease is treated with oral antibiotics. Doxycycline is usually used to treat Lyme disease in adults and children over the age of 8. Amoxicillin or cefuroxime is usually used for younger children and pregnant or breastfeeding women. Oral antibiotics are usually given for 14 to 21 days, although a 10-to-14-day course may be just as effective.

Intravenous antibiotics. If Lyme disease involves your central nervous system, you may need IV antibiotics for 14 to 28 days. This will eliminate the infection, but it may take awhile for you to completely recover from your symptoms.

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.

*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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Outlook For Early Disseminated Lyme Disease

If you receive a diagnosis and treatment with antibiotics at this stage, you can expect to be cured of Lyme disease. Without treatment, complications can occur. Treatments are available for the complications.

In rare cases, you may experience a continuation of Lyme disease symptoms after antibiotic treatment. This is called post-treatment Lyme disease syndrome .

Some people who were treated for Lyme disease report muscle and joint pain, cognitive difficulties, sleep issues, or fatigue after their treatments were finished.

The cause of this is unknown. However, researchers believe it may be due to an autoimmune response in which your immune system attacks healthy tissues. It may also be linked to an ongoing infection with the bacteria that causes Lyme disease.

The practices below can reduce your likelihood of contracting Lyme disease and having it progress to the early disseminated stage.

Key Points To Remember

• Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
• Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
• Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
• Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
• Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

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Stage : Quickly Expanding Rash

After being bitten by a black-legged tick, a quickly growing rash can appear. This is the earliest stage of Lyme disease, known as stage 1.

Most people who develop a rash, get it within days or weeks of being bitten by a tick.

Where you see the rash: If you develop a rash, it appears near the tick bit you. For most people, that means the back, groin, armpit, or a lower leg. However, a tick can bite you anywhere.

What the rash can look like: You may see a spot or bump on the skin, which is the bite mark. Around or near the bite mark, a rash develops. Some people see the bulls-eye rash . You can also have one of the other rashes shown here.

Early rash caused by Lyme disease

Notice the bite mark in the center of this early rash, which will expand quickly.

Bull’s-eye rash on woman’s upper arm

This is another early sign of Lyme disease.

Lyme disease rash with lighter color on the outside

This rash has expanded, but you can still see the bite mark in the center.

Rash from Lyme disease has begun to clear

As the rash begins to clear, the redness fades.

If you develop a rash during this stage, you may notice that it:

• Feels smooth and warm to the touch

• Causes a burning sensation

• Itches or feels painful

• Has an outer edge that feels scaly or crusty

When the rash and symptoms begin: According to the Centers for Disease Control and Prevention , the rash begins 3 to 30 days after the tick bites you.

About 50% of people who have Lyme disease develop flu-like symptoms , which include:

What Is Lyme Disease

Lyme disease is a bacterial infection. You get it when the blacklegged tick, also known as a deer tick, bites you and stays attached for 36 to 48 hours. If you remove the tick within 48 hours, you probably wonât get infected.

When you do get infected, the bacteria travel through your bloodstream and affect various tissues in your body. If you donât treat Lyme disease early on, it can turn into an inflammatory condition that affects multiple systems, starting with your skin, joints, and nervous system and moving to organs later on.

The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when it bit you, and how long the tick was attached to you. Youâre most likely to get Lyme disease if you live in the Northeastern United States. The upper Midwest is also a hot spot. But the disease now affects people in all 50 states and the District of Columbia.

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What You Need To Know About Lyme Disease

• Lyme disease is an infection caused by the spiral-shaped bacteria Borrelia burgdorferi, which is most commonly transmitted by a tick bite.

• There are over 300,000 estimated new cases of Lyme disease in the United States each year.

• The symptoms of Lyme disease depend on the how long the infection has been present in the body. The first sign of Lyme disease is often an expanding round or oval red “bullseye” rash.

• If left untreated, people may develop neurological symptoms and heart problems, and have an approximately 60 percent chance of developing Lyme arthritis.

What Are The Treatments For Lyme Disease

Lyme disease is treated with antibiotics. The earlier you are treated, the better it gives you the best chance of fully recovering quickly.

After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome . Researchers don’t know why some people have PTLDS. There is no proven treatment for PTLDS long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel all better.

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What Are The Symptoms Of Lyme Disease

Symptoms can start anywhere from 3 to 30 days after the bite. They may look different depending on the stage of your infection. In some cases, you wonât notice any symptoms until months after the bite.

Early symptoms include:

All of those symptoms are also common in the flu. In most Lyme infections, one of the first symptoms youâll notice is a rash.

Without treatment, symptoms can get worse. They might include:

• Severe headache or neck stiffness
• Rashes on other areas of your body
• Arthritis with joint pain and swelling, particularly in your knees
• âDroopingâ on one or both sides of your face
• Inflammation in your brain and spinal cord
• Shooting pains, numbness, or tingling in your hands or feet

What does the rash look like?

Some Lyme rashes look like a bull’s-eye with circles around the middle. But most are round, red, and at least 2 inches across.

The rash slowly gets bigger over several days. It can grow to about 12 inches across. It may feel warm to the touch, but itâs usually not itchy or painful. It can show up on any part of your body.

How small are ticks?

Ticks come in three sizes, depending on their life stage. They can be the size of a grain of sand, a poppy seed, or an apple seed.

Lyme Disease Can Be Diagnosed By ‘bull’s Eye’ Rash Alone

Lyme disease can be diagnosed by the rash alone, new advice for the NHS says.

People with the “bull’s eye” circular rash do not need a blood test and should be treated immediately to avoid complications, the National Institute for Health and Care Excellence says.

Waiting for lab results is unnecessary and can cause delays in patients being prescribed the antibiotics they need.

Lyme disease is spread by tick bites and can be debilitating.

A blood tests can check for it but may not give a positive result until eight weeks after the patient is bitten.

Prof Gillian Leng, deputy chief executive and director of health and social care at the National Institute for Health and Care Excellence , said for most people with Lyme disease, a course of antibiotics would be an effective treatment, “so it is important we diagnose and treat people as soon as possible”.

“A person with Lyme disease may present with a wide range of symptoms, so we have clear advice for professionals about the use of lab tests for diagnosis and the most appropriate antibiotic treatments,” she said.

“If a characteristic bull’s eye rash is present, healthcare professionals should feel confident in diagnosing Lyme disease.”

Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there is not always an obvious rash. The rash can also appear in a number of different ways, as these images from the NICE guidance show.

Symptoms can also include:

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