Treatment Of Lyme Disease
Early diagnosis and proper antibiotic treatment of Lyme disease is important and can help prevent late Lyme disease. The following treatment regimens reflect CDCs interpretation of the most current data for four important manifestations of Lyme disease. These regimens are consistent with guidanceexternal icon published by the by the Infectious Disease Society of America, American Academy of Neurology, and American College of Rheumatology.
Some patients report persistent symptoms of pain, fatigue, or difficulty thinking even after treatment for Lyme disease. The state of the science relating to persistent symptoms associated with Lyme disease is limited, emerging, and unsettled.
Additional researchexternal icon is needed to better understand how to treat, manage, and support people with persistent symptoms associated with Lyme disease. In light of these research gaps, recommendations for treatment of persistent symptoms in people previously treated for Lyme disease are not provided here.
If you are interested in information on chronic Lyme diseaseexternal icon, see NIHs website.
Links with this icon indicate that you are leaving the CDC website.
Other Causes Of Lyme Disease Symptoms
Sometimes people think they have the symptoms of Lyme disease, but it is a different disease caused by ticks. Diseases caused by tick bites that are known in Australia are:
- Queensland tick typhus
- Q fever
- mammalian meat allergy
Sometimes there is no known diagnosis for symptoms such as fatigue, disordered thinking, disturbances of the senses, joint pain and headaches. These symptoms are real and can be very debilitating. In this case, you doctor will work with you to manage the symptoms and improve your quality of life.
When To See Your Gp
You should contact your GP or dial NHS 111 promptly if you feel unwell with any of the symptoms described above after being bitten by a tick or after spending time in areas where ticks may live.
Take this leaflet with you if you are unsure what to say and remember to let your GP know if youve recently had a tick bite or spent time in areas where ticks may live.
Diagnosing Lyme disease can be difficult as many of the symptoms are similar to other conditions. A spreading erythema migrans rash appearing some days after a known tick bite is characteristic and should be treated with antibiotics.
If you dont have this rash but do have other symptoms of Lyme disease, blood tests can be carried out that look for antibodies against the borrelia bacteria.
Blood tests can be negative in the early stages of the infection as the antibodies take some time to reach levels that can be detected.
You may need to be re-tested if Lyme disease is still suspected 4 to 6 weeks after a first negative test result.
If you have long-lasting symptoms, you may be referred to a specialist in microbiology, infectious diseases, rheumatology, or neurology as appropriate for further investigation and management.
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How Is Lyme Disease Treated
Lyme disease is treated with antibiotics. In most cases, people bitten by a tick are given antibiotics only if they are sick or have a rash. If you are bitten by a tick but dont get sick or get a rash, you dont need antibiotics.
Early-stage Lyme disease responds very well to treatment. In most cases, taking an antibiotic for 2 to 4 weeks kills the bacteria and clears up the infection. Your doctor will tell you how long to take the antibiotic. Its important to take all the medicine your doctor prescribes. This will prevent the spread of Lyme disease to your joints, nervous system, or heart. If you have problems with the medicine, do not quit taking it. Call your doctor and talk to them about your side effects.
Late-stage Lyme disease is also treated with antibiotics. It may be necessary to give the antibiotics intravenously at this stage. Medicine that reduces swelling and pain can ease arthritis associated with late-stage Lyme disease. If necessary, excess fluid can be drained from any affected joints.
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.
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Stage : Small Oval Rashes Or A Reddish Lump
When a tick that causes Lyme disease bites you, it infects you with bacteria. Without treatment, the bacteria can spread to other areas of your body. Stage 2 begins when the bacteria spread to other parts of your body.
During this stage, you may see small, oval rashes on your skin. Some people develop a bluish-red lump.
Where you see these signs: Because the infection has spread, small rashes can appear anywhere on your skin, except for your palms and soles. Most rashes appear on the arms, legs, and face.
Some people develop a lump, which your doctor may refer to as borrelial lymphocytoma. In children, this lump tends to appear on an earlobe. Adults often see a raised growth form around a nipple.
Borrelial lymphocytoma on a childs ear
This can appear in stage 2 of Lyme disease.
What you may see on your skin: The rashes that appear during stage 2 differ from the rash that can appear in stage 1. In stage 2, the rashes stay the same size rather than grow larger.
When the rashes, lump, and symptoms begin: About 30 to 45 days after the tick bites you, you may notice rashes or a lump. These can also take longer to appear, sometimes six months or more.
Some people develop symptoms, which make them feel ill, including:
Shortness of breath and dizzy spells
Bells palsy, which causes one half of the face to droop
Heart problems, such as chest pains or an irregular heartbeat
What Do I Do If I Find A Tick On My Skin
Dont panic. Use fine-tipped tweezers to grasp the tick as close to the skins surface as possible. Pull up with steady, even pressure. Be careful not to squeeze or twist the tick body. Sometimes parts of the tick remain in the skin. You can leave them alone or carefully remove them the same way you would a splinter. Do not use heat , petroleum jelly, or other methods to try to make the tick back out on its own. These methods are not effective.
Wash the area where the tick was attached thoroughly with soap and water. Keep an eye on the area for a few weeks and note any changes. Call your doctor if you develop a rash around the area where the tick was attached. Be sure to tell your doctor that you were bitten by a tick and when it happened.
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Early Symptoms Of Lyme Disease
Early symptoms will typically develop 1 to 4 weeks after being bitten, however, they can appear anytime between 3 to 30 days after exposure.
Many people with early-stage Lyme disease develop a distinctive circular red rash usually, but not always, at the site of the tick bite.
The rash is often described as looking like a bulls-eye on a dart board and is known as erythema migrans. The affected area of skin will be red and the edges may feel slightly raised.
The size of the rash can vary significantly and it may expand over several days or weeks. Typically, its around 15cm across but it can be much larger or smaller than this.
Some people may develop several rashes on different parts of their body. However, around one in every 3 people with Lyme disease do not report seeing a rash.
As well as a rash, people with early Lyme disease may experience any of the following:
- flu-like symptoms such as fever and sweats, chills, fatigue, neck pain or stiffness, headaches, joint or muscle pains
- paralysis of the facial muscles, typically only on one side of the face
- nerve pains, which may be shooting, sharp or prickly and which follow the course of the nerve
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.
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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How Do I Know If I Have Lyme Disease
Lyme disease is an illness caused by a tick bite–specifically, the bite of the black legged tick or deer tick. Some of these ticks carry a bacteria called Borrelia burgdorferi. The tick transfers the bacteria to a persons bloodstream through the bite. The tick must be attached for at least 24 hours before this can happen.
Over time, untreated Lyme disease can cause serious problems with the heart, joints, nervous system, and memory. Youre most likely to get infected during spring and summer. So before you rush outside to enjoy the warmth of the sun, take some time to review Lyme disease symptoms and when you should see your health care provider.
Lyme Disease: What to Look For
If you become ill within a few weeks of a known tick bite, see your health care provider right away. And even when you arent sure if youve been bitten by a tick–but have the symptoms of Lyme disease and have been in the great outdoors–you should check in with your provider. Immature deer ticks cause most infections they are very tiny and many people are bitten without being aware of it.
Shortly after infection, Lyme disease can cause:
- Muscle and joint pain
- Swollen lymph nodes
- A bulls-eye-shaped rash at the site of the bite, which can appear within a few days or up to a month after the bite
How Is Lyme Disease Diagnosed?
Building Knowledge, Enhancing Care
Stage : Changing Skin
In stage 3, few signs of Lyme disease appear on the skin. Most problems occur in the heart and nervous system, and these can be serious.
Where you see signs on your skin: If you were in Europe when bit by a tick, you may see changes to your skin in this late stage. These changes usually appear on a hand or foot. Some people develop this change on both of their hands or feet. It can also occur on a knee, elbow, or elsewhere.
What the skin looks like: The skin begins to swell, and you may notice some redness. These signs are caused by having a bacterial infection for a long time. The affected skin may also feel sore.
In time, the skin starts to harden and shrink, causing deep lines to form. If you have hair in the area, it tends to fall out. The sweat glands can die, and the skin often becomes so thin that it tears easily. The medical name for this condition is acrodermatitischronical atrophicans.
In stage 3, you may also see tumors on your skin. It is believed that the long-term infection and swelling in the lymph nodes can lead to a cancer known as cutaneous B-cell lymphoma.
Skin starts to harden and shrink, causing deep lines to form
The medical name for this condition is acrodermatitis chronical atrophicans. Swelling, hardened skin, and deep lines on the foot of someone who has had Lyme disease for years.
When you see signs of changing skin and symptoms: These tend to occur months or years after you are bitten by a tick.
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What Abnormal Results Mean
A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. But, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.
For many people, the ELISA test remains positive, even after they have been treated for Lyme disease and no longer have symptoms.
A positive ELISA test may also occur with certain diseases not related to Lyme disease, such as rheumatoid arthritis.
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 Lyme Disease Be Prevented
To prevent Lyme disease, you should lower your risk of getting a tick bite:
- Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
- Use an insect repellent with DEET
- Treat your clothing and gear with a repellant containing 0.5% permethrin
- Wear light-colored protective clothing, so you can easily see any ticks that get on you
- Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
- Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
- Take a shower and wash and dry your clothes at high temperatures after being outdoors
Centers for Disease Control and Prevention
Regression And Other Symptoms In Children
Children are the largest population of Lyme patients.
The CDC study of reported Lyme cases from 19922006 found that the incidence of new cases was highest among 5- to 14-year-olds . About one quarter of reported Lyme cases in the United States involve children under 14 years old .
Children can have all the signs and symptoms of Lyme that adults have, but they may have trouble telling you exactly what they feel or where it hurts.
You may notice a decline in school performance, or your childs mood swings may become problematic.
Your childs social and speech skills or motor coordination may regress. Or your child may lose their appetite.
Children are more likely than adults to have arthritis as an initial symptom 01267-2/fulltext#sec0040″ rel=”nofollow”> 25).
In a 2012 Nova Scotian study of children with Lyme, 65 percent developed Lyme arthritis . The knee was the most commonly affected joint.
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How Is Lyme Disease Diagnosed And Treated
Lyme disease is usually diagnosed when a person develops a bull’s-eye rash, flu-like symptoms , or both. These symptoms usually start a few days or weeks after the person is bitten by an infected tick.
A two-step blood test can verify the presence of Lyme disease antibodies, although it does take a few weeks for those antibodies to develop. And despite what some physicians and advocacy groups claim, a blood test is the only way Lyme disease can be confirmed, Larry Zemel, MD, Professor of Pediatrics at the University of Connecticut School of Medicine told Health. “Some healthcare providers say they can diagnose Lyme even when patients test negative repeatedly, but that has not been borne out by any scientific study,” said Dr. Zemel.
When people are diagnosed with Lyme disease in its early stages, a 10- to 20-day course of oral antibioticsusually with a drug called doxycyclinewill clear the infection and help them feel better fairly quickly. “This cures the vast majority of people, and they have a 100% recovery with no lasting effects,” said Dr. Zemel.
If Lyme disease isn’t diagnosed right away, it can cause more serious symptoms like arthritis and memory problems. These people may need a full month of oral antibiotics, said Dr. Zemel. About 20% of these patients will need IV antibiotics , and they may also need other medications to treat symptoms like pain and muscle stiffness.