How Is Lyme Disease Diagnosed
It can be hard for doctors to diagnose Lyme disease because:
- The tick bites and rash might not be noticed.
- Many early symptoms seem like the flu or other illnesses.
- Blood tests can only help diagnose Lyme disease later in the illness, several weeks after it started.
Doctors can diagnose early Lyme disease if they see a tick bite or the telltale rash, especially if the person lives in an area where Lyme disease is common.
To diagnose late Lyme disease, doctors:
- Ask about symptoms.
- Do blood tests that look for signs of Lyme disease.
Depending on the symptoms, doctors might order other tests, such as a spinal tap, which looks at the fluid around the brain and spinal cord.
How To Remove Ticks
Tick bites aren’t always painful. You may not notice a tick unless you see it on your skin. Check your skin and your children’s or pets’ skin after being outdoors.
To remove a tick:
The risk of getting ill is low. You don’t need to do anything else unless you become unwell.
When Should I Call My Doctor
- Canât get the tick totally out
- Have any flu-like symptoms, with or without a rash
- See red streaks, or yellow fluid oozing from the bite, meaning the bite is infected
Some people have more serious reactions to the bite itself. Go to the emergency room if you have:
- Anaphylaxis. This is a life-threatening reaction that needs medical care right away.
- Tick paralysis. If you have this, you will be unable to move. Paralysis usually goes away within 24 hours of removing the tick.
- You canât move your arms, legs, or part of your face.
- Itâs hard to breathe.
- Your heart feels like itâs fluttering, skipping beats, or beating too hard or too fast.
- You have a severe headache.
- You feel weakness in your arms or legs.
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How Is Lyme Disease Treated
Antibiotics, usually doxycycline or amoxicillin, are effective treatments for Lyme disease. How long your treatment lasts depends on the stage of infection. In general, its true that the sooner youre treated, the quicker and more complete the recovery.
Pregnant people should receive treatment for Lyme disease as well. There is, however, no evidence that a fetus can get the infection from its parent. Theres also no strong evidence that miscarriages are more likely after Lyme disease.
What should I do if a tick bites me?
If a tick bites you, the best way to remove it is by taking the following steps:
- Tug gently but firmly with blunt tweezers near the “head” of the tick at the level of your skin until it releases its hold on your skin.
- Avoid crushing the tick’s body or handling the tick with bare fingers because you could expose yourself to the bacteria in the tick.
- Wash the bite area thoroughly with soap and water.
- Don’t use kerosene, petroleum jelly or hot cigarette butts to remove the tick.
- Don’t squeeze the tick’s body with your fingers or tweezers.
Who Is At Risk For Lyme Disease
Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks.
Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.
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How To Prevent Lyme Disease
The deer ticks that carry the bacteria that transmit Lyme disease are most prevalent in New England, the mid-Atlantic states, and the upper Midwest of the United States. They live in moist and woody environments. If you’re going to be in an area like this, use an insect repellent that contains DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. You should also:
- Check your body for ticks after being outside.
- Check your clothing and pets for ticks.
- Place clothes in a dryer on high heat to kill ticks.
- Remove attached ticks with tweezers as soon as you notice them.
- Watch for symptoms of Lyme disease after you remove a tick.
- Contact your healthcare provider if you develop a fever or rash, even if you don’t remember being bitten.
- Treat your animals using veterinarian-prescribed tick prevention products to keep them from bringing ticks into your house.
- Discourage deer from coming into your yard by removing plants that attract them and putting up fences.
- Create a tick-safe zone in your yard by using chemical control agents and keeping the area clean of yard debris.
Atypical Lyme Rashes And Less
In some cases, the Lyme disease rash doesnt look like a bulls eye at all. It can be blistered , cause a bluish swelling , be uniform in color instead of banded, be oval or triangular in shape, or just look like a large red area . You can see a picture of atypical Lyme disease on a black man here.
There are also many instances of Lyme rashes which are considered to be bulls-eye shaped, but dont have the white band inside. The message? Dont expect a Lyme rash to look like a perfect bulls eye. If you suspect Lyme, contact your doctor!
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Itch After A Tick Bite
One of the symptoms after a tick bite is developing an itch. The tick bite itself is usually not felt, but the remaining bump might itch . It might feel similar to a mosquito bite. The spot usually looks like a red spot with a dark red dot in the middle, where the tick used to be.
After a tick bite, such a spot or bump is quite normal. This doesnt immediately indicate Lyme disease, but is a consequence of skin irritation after the bite. However, a red rash is a characteristic symptom of Lyme disease. Even so, this doesnt occur until a few days or weeks after a tick bite, and will grow slowly.
How Is It Treated
Lyme disease is usually cured by 14 days of oral antibiotics if it is diagnosed during stage I. If it is not diagnosed until stage II or III, a month of antibiotics may be necessary, and the antibiotic will probably be given by injection into a muscle or vein.
Antibiotics should be given to any child who develops a rash characteristic of Lyme disease within 1 month of having a deer tick bite or within 1 month of being in a high-risk area. Remember that most deer tick bites do not pass on Lyme disease.
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Cultures And Molecular Testing
The skin lesion on Case 4 was sampled using a 3-mm skin biopsy punch, and skin biopsies were inserted directly into vials of BarbourStoennerKelly II medium, and sent by courier to the Division of Medical Microbiology, Department of Pathology, University of British Columbia, Vancouver, British Columbia. Upon their arrival, the culture tubes were incubated at 34 °C, and checked weekly for spirochetal activity. In order to avoid culture contamination, polymerase chain reaction amplification was conducted in a separate filtered laboratory. PCR testing identifies the genes of Bbsl, namely OspA, 16S rRNA, and HSP60. The OspA ), OspB , OspC , P39 , flagellin , P22 , and P93 bands were profiled using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These isolates were further analyzed for plasmid profiles pulsed-field gel electrophoresis separation of macro-restriction digests and of total DNA were applied.
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Seek Medical Care Early To Prevent Lyme Disease From Progressing
Its easy to get bit by a tick and not know it. Most people dont feel a tick on their skin or the bite. Checking your skin for ticks after spending time outdoors can help you find a tick and remove it.
Removing a tick can prevent Lyme disease. A tick must be attached to your skin for at least 36 hours to infect you with the bacteria that cause Lyme disease.
Its not always possible to find a tick, so its important to pay close attention to your skin. If you notice any signs of Lyme disease or develop a rash, get medical care right away. Ticks can cause other serious diseases, such as Rocky Mountain spotted fever.
Related AAD resources
ImagesImage 1: Centers for Disease Control and Prevention, Public Health Image Library, Last accessed May 11, 2017.
Images 2, 3, and 7: Used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol. 2011 64:619-36.
Images 4 and 5: Getty Images
Image 6: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
ReferencesBhate C and Schwartz RA.
Lyme disease: Part I. Advances and perspectives. J Am Acad Dermatol. 2011 64:619-36.
Lyme disease: Part II. Management and prevention. J Am Acad Dermatol 2011 64:639-53.
Centers for Disease Control and Prevention:
Signs and symptoms of untreated Lyme disease. Page last updated October 26, 2016. Last accessed May 2, 2018.
Lyme disease: transmission. Page lasted updated March 4, 2015. Last accessed May 2, 2018.
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Chronic Lyme Disease Rash
Various photos of Lyme rashes and skin conditions that are not Lyme related. How to distinguish a Lyme disease rash from look-alikes. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
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When Should I See My Healthcare Provider
If you feel sick after having spent time in areas where ticks might live, you should make an appointment with your healthcare provider.
If you received a Lyme disease diagnosis and you dont feel well after taking all of your antibiotics, contact your provider. This is especially true if you have symptoms like a stiff neck or mental confusion.
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Can Lyme Disease Completely Be Cured
Taking oral antibiotics typically cures Lyme disease after two to four weeks. You may need to get antibiotics through the vein for four more weeks. However, theres no reason to think that Lyme disease stays in you forever after treatment.
A note from Cleveland Clinic
If youre going to spend time in an area that might have ticks, take measures to avoid being bitten. This includes wearing long-sleeved shirts and pants to make it harder for ticks to bite. If you feel sick after being in an area that probably has ticks, make an appointment with your healthcare provider. If your provider prescribes antibiotics, make sure you take all of them as instructed.
Last reviewed by a Cleveland Clinic medical professional on 08/16/2022.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy
History Of Lyme Disease
The history of the disease can be traced back to 1975 in United States, where the symptoms of rheumatoid arthritis started being seen in large number of cases in Lyme, Connecticut area. This gave it the name for which it is well known today. Owing to the uncurbed deer population, the number of deer ticks in the region started to increase. More and more cases of tick bites became prevalent in these parts. The lone star or deer tick causing the disease came closer to human residences where people were apparently bitten while mowing their lawns, hiking in wooded, grassy regions or through their family pets.
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What Is The Outlook For Someone With Lyme Disease
Most of the people who get Lyme disease and receive treatment early will be fine. Treatment can cure Lyme disease but you might still have some long-term effects. Untreated Lyme disease may contribute to other serious problems but its rarely fatal.
Post-treatment Lyme disease syndrome
Even after proper treatment, some people may experience lingering fatigue, achiness or headaches. This is known as post-treatment Lyme disease syndrome or PTLDS. The symptoms dont mean that you still have an infection. PTLDS probably wont respond to additional antibiotics. The majority of people in this group will have symptoms that resolve at some point over the next six months.
Chronic Lyme disease
Chronic Lyme disease is a term used by some for a condition in a person who had Lyme disease and the symptoms of PTLDS. Some people consider chronic Lyme disease to be the same as PTLDS. However, some people receive a chronic Lyme disease diagnosis without a Lyme disease diagnosis. Sometimes, extended treatment with antibiotics helps.
This term may be why some people think a Lyme disease infection can occur without being bitten by a tick. There isn’t enough proof that mosquitoes can transmit Lyme disease. Many researchers dislike using the term chronic Lyme disease.
Achy Stiff Or Swollen Joints
Joint pain and stiffness, often intermittent, are early Lyme symptoms. Your joints may be inflamed, warm to the touch, painful, and swollen. You may have stiffness and limited range of motion in some joints .
Pain may move around. Sometimes your knees may hurt, whereas other times its your neck or your heels. You may also have bursitis . Bursae are the thin cushions between bone and surrounding tissue.
The pain may be severe, and it may be transitory. More than one joint may be affected. Most often the large joints are involved .
People often attribute joint problems to age, genetics, or sports. Lyme should be added to that list, as these statistics indicate:
- One study estimates that 80 percent of people with untreated Lyme have muscle and joint symptoms .
- Fifty percent of people with untreated Lyme have intermittent episodes of arthritis .
- Two-thirds of people have their first episode of joint pain within six months of the infection .
- Use of anti-inflammatory drugs may mask the actual number of people with joint swelling .
Joint pain that comes and goes, or moves from joint to joint, could be a sign of Lyme.
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Can A Bullseye Rash Not Be Lyme Disease
The bullseye rash is one of the classic telltale signs of Lyme disease, but not everyone who contracts the disease will develop the characteristic rash. In fact, up to 30 percent of patients do not show the characteristic rash. Because Lyme is such an imitator of other illnesses, its not uncommon for people to have the bullseye rash without ever experiencing the other symptoms associated with the disease.
The ticks that carry Lyme disease are tiny and are difficult to detect. The bite of a tick is not painful, and it may not be noticed for weeks or months after the bite. Ticks can be found throughout the UK and many other parts of Europe and North America, but they are particularly common in areas with overgrown plants and deep vegetation. Theyre commonly found in forests and moorland areas, but they can also be found in gardens.
A woman who presented with flu-like symptoms and a bullseye rash was diagnosed with early Lyme disease. After being treated with doxycycline, the rash cleared up within a week. She later reported experiencing generalized joint pain and irritation behind her knee. Cellulitis was the primary diagnosis, but it is not the only rash that can confuse clinicians.
Can Lyme Disease Rash Itch
If you develop a Lyme disease rash, you probably won’t be scratching your skin until it’s raw. Still, Lyme disease rashes can be slightly itchy, even mildly painful, said Dr. Aucott, but they don’t itch like a case of poison ivy.
Lyme rashes often feel warm to the touch as well. Your healthcare provider may perform what’s called a “crossover test” to gauge whether the area feels warmer than the rest of your skin, said Dr. Johnson. Here’s what that involves: Let’s say the rash is behind one knee. You place one hand on the rash and your other hand in the same area of the unaffected knee, wait a few seconds, and then switch hands. If there’s a difference in temperature, you’ll notice it.
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Does Lyme Disease Bullseye Rash Itch
Does lyme disease bullseye rash itchDoes lyme disease bullseye rash itch Atypical Lyme Rashes and Less-Distinct Bulls-Eyes. In some cases, the Lyme disease rash doesnt look like a bulls eye at all. It can be blistered , cause a bluish swelling , be uniform in color instead of banded, be oval or triangular in shape, or just look like a large red area .).
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Treatment Of Lyme Disease
- Lyme disease in pregnant women and children younger than eight years is treated with oral antibiotics.
- Oral antibiotics such as doxycycline may be given to patients older than 8 years old.
- Severe cases of Lyme disease are treated with intravenous administration of antibiotics
- Pain killers may be prescribed to alleviate joint pain and other body aches.
This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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