What Criteria Do Doctors Use To Choose Different Antibiotics
Partly, doctors rely on what medicines have been shown in published studies to be effective for Lyme disease. For neurologic Lyme disease, the best tested antibiotic is IV ceftriaxone . For early Lyme disease, the best tested antibiotics include oral doxycycline, cefuroxime and amoxacillin. Physicians however often use other antibiotics well. For example, because one mouse study and several in vitro studies indicate that the agent of Lyme disease can penetrate and lodge inside cells, some doctors prefer to use medications that have good intracellular penetration ). Other factors that go into the decision include whether the patient is allergic to a particular family of antibiotics or whether the patient can tolerate oral medications intolerance might suggest the use of intramuscular penicillin whereas if a person is allergic to penicillins or cephalosporins a doctor would want to avoid long-acting intramuscular penicillin-family medicines.
To our knowledge, having had a Lyme disease infection that has been treated does not have a negative impact on the ability to become pregnant.
I Was Wondering If Lyme Disease Affects Vision
Lyme disease can affect eye sight in a number of ways. If the extraocular muscles are involved as in a cranial nerve palsy, then the muscle weakness may result in double vision. Patients may report that their visual acuity appears to be less or that they have lost color vision or can’t see the full visual field. If there is central involvement of the visual pathways, then some patients may experience a marked sensory hyperacusis such as prominent painful light sensitivity or rarely visual trails. In very rare cases, an unattenuated increase of intracranial pressure from neurologic Lyme disease may result in blindness. Of course, any visual problems should be checked by an ophthalmologist or a neuro-ophthalmologist who can then perform a thorough differential diagnosis to rule out other conditions.
What Does A Dog With Lyme Disease Look Like
Many animals can have Lyme disease and show no signs. In dogs, the most common signs include fever, loss of appetite, painful or swollen joints, lameness that comes and goes, swollen lymph nodes, and lethargy. If Lyme disease is left untreated it can lead to damage in the kidneys, nervous system, and heart.
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Can An Animal Get Infected Despite Being Vaccinated
Yes. This has been observed that some animals can still get infected after Lyme vaccination. This can be due to a low immune response of the respective animal and/or a very high exposure rate or Lyme prevalence in the area where the animal lives. A yearly check of the OspA titer is recommended for a vaccinated animal to ensure that the animal responded with high OspA antibodies to vaccination. Please indicate the name of the vaccine and when it has been last applied on the accession form.
Are There Any Diseases That Can Be Misdiagnosed As Lyme Disease
Lots of diseases could be misdiagnosed as Lyme disease. This of course makes sense when you know that Lyme disease itself may manifest as a multisystemic disorder that can mimic other diseases. This means that just as the Lyme disease might be “missed” in some cases, some individuals may be misdiagnosed as having Lyme disease when in fact they have another disease. Erring on either side of this diagnostic divide can be dangerous. Given that the main symptoms that afflict patients with Lyme disease are fatigue and pain and given that these are non-specific symptoms seen in a wide ranges of diseases, including cancer, hematologic, and endocrine disorders, one has to make sure to rule out other reasonable causes of fatigue and pain before making the diagnosis of Lyme disease. It is also important to realize that a patient can have two independent diseases – Lyme disease and another emergent condition. For example, concurrent depression,sleep apnea or hypothyroidism may exacerbate fatigue in a patient with actual Lyme disease.
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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 .
Summary:
Joint pain that comes and goes, or moves from joint to joint, could be a sign of Lyme.
Which Areas Are More Likely To Have It
The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. Cases in California and Florida are on the rise. After a drop between 2017 and 2018, the numbers jumped a little bit in 2019.
But most Lyme cases in 2019 were in 15 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New
Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin. Washington, DC, is also a hotspot.
In 2019, Pennsylvania had the most Lyme infections, with 6,763. New York was next, with 2,847 cases.
In the Southern U.S., where itâs hotter, ticks stay under leaves so they don’t dry out. This means people donât get Lyme from Southern ticks very often because they don’t usually come out to bite.
Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.
Whoâs likeliest to get Lyme disease?
Boys up to age 15 and men between the ages of 40 and 60 are the most likely to get Lyme disease. Thatâs because they tend to play outside and go camping, hunting, and hiking.
Why are there more ticks now than there used to be?
There are several reasons why Lyme is spreading. Some of these are:
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Can Lymes Disease Make You Crazy
Neuropsychiatric symptoms are prominent. Lyme patients tend to have trouble with mood regulation, cognition, energy, sensory processing, and/or sleep. This can manifest into paranoia, hallucinations, mania, and/or obsessive-compulsive behaviors. Memory loss and concentration issues mirror other psychological disorders.
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 : 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:
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Shortness of breath and dizzy spells
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Bells palsy, which causes one half of the face to droop
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Heart problems, such as chest pains or an irregular heartbeat
Are There Any Risks To Lyme Disease Tests
There is very little risk to having a blood test or a lumbar puncture.
With a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
With a CSF test, you may feel a little pinch or pressure when the needle is inserted. After the test, you may feel some pain or tenderness in your back where the needle was inserted.
You may also have some bleeding at the site or get a headache. The headache may last for several hours or up to a week or more, but your provider may suggest treatment to help relieve the pain.
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How To Avoid Tick Bites
To reduce the chance of being bitten:
- cover your skin while walking outdoors and tuck your trousers into your socks
- use insect repellent on your clothes and skin products containing DEET are best
- stay on clear paths whenever possible
- wear light-coloured clothing so ticks are easier to see and brush off
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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.
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Tick Check And Tick Removal
Tick Check
In most cases, ticks begin transmitting the Lyme disease spirochete only after 36 to 48 hours of attachment, however the precise minimum time is not known. Removing a tick within 24 to 48 hours can reduce your chance of contracting Lyme disease. The following tips are important for self-inspection:
- Nymph ticks are very small and may resemble poppy seeds, freckles, or scabs. Adult ticks may resemble raisins.
- People spending time in tick-infested locations should inspect themselves several times a day, including at bedtime.
- Check non-exposed areas, such as the back of the knee, as well as exposed areas. Someone else should check the scalp, back of the neck, and other difficult to reach areas. Parents should check children.
- After coming from outdoors, take a shower. It may help wash off unattached ticks, gives you an opportunity for a complete tick check, and will remove any remaining DEET.
- Check clothing as well as skin. A tick on clothes can be hidden in folds or creases.
Tick Removal
If an attached tick is discovered, there is no reason to panic. A very small percentage of ticks are actually infected , and not everyone who is bitten by a tick will get Lyme disease.
Do not put a hot match to the tick or try to smother it with petroleum jelly, nail polish, or other substances. This only prolongs exposure time and may cause the tick to eject the Lyme spirochete into the body.
The following is the safest and most effective way to remove an attached tick:
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.
Its not clear why this happens to some people and not others. This means theres 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
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If My Animal Is Positive On The Assay Should He/she Be Treated For Lyme Disease
If your animal is displaying clinical signs of Lyme disease and is positive on the Lyme Multiplex assay, it is advisable to discuss treatment options with your veterinarian. If your animal appears healthy, discuss the risks and benefits of treatment and develop a monitoring plan with your veterinarian.
The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But its still important to be aware of ticks and to safely remove them as soon as possible, just in case.
Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.
Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. Theyre found all over the UK.
Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.
Once a tick bites into the skin, it feeds on blood for a few days before dropping off.
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What To Do If You Have A Blacklegged Tick Bite
Remove the tick by pulling it directly out with fine-tipped tweezers. Lift upward with slow and even pressure. Dont twist when removing it. Dont crush it or put soap or other substances on it. Dont apply heat to it.
Place the tick in a resealable container. See if you can identify what kind of a tick it is.
Immediately after removing the tick, wash your skin well with soap and water or with rubbing alcohol.
Not all ticks carry Lyme. The Lyme bacteria is transmitted only by blacklegged ticks in their nymph or adult stage.
Save the tick to show your doctor. The doctor will want to determine if its a blacklegged tick and if theres evidence of feeding. Ticks enlarge as they feed. Your risk of getting Lyme from an infected tick increases with the length of time that the tick fed on your blood.
Summary:
Pull the tick out with tweezers and save it in a resealable container for identification.
How Do I Remove A Tick From My Dog
Check your pet immediately after it has been in a tick-infected area. The deer tick is a small tick and only about pinhead size in juvenile stage, but is a little more obvious in the adult phase and after feeding. If you find a tick moving on your pet, the tick has not fed. Remove the tick promptly and place it in rubbing alcohol or crush it between two solid surfaces. If you find a tick attached to your pet, grasp the tick with fine tweezers or your finger nails near the dog’s skin and firmly pull it straight out. There are also tools available called Tick Twister® or Tick Key® which can be useful. However, take care to use them cautiously as twisting or jerking the tick may cause the mouth parts to break off and remain in the skin. See your veterinarian if you are unsure or unable to remove the tick from your dog.
Make sure you protect your fingers from exposure by using a tissue or a disposable glove.You may need another person to help restrain your dog. Removing the tick quickly is important since the disease does not appear to be transmitted until the tick has fed for approximately 12 hours. If you crush the tick, do not get the tick’s contents, including blood, on your skin.
Note: The bacterium that causes Lyme disease can pass through a wound or cut in your skin.
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Diagnosis Of Lyme Disease
Diagnosis is currently based on clinical findings supported by several types of laboratory tests. One type of test seeks to isolate the actual organism from the EM skin lesion, blood, joints, and cerebrospinal fluid. Other types of tests attempt to detect antibodies formed by the patients immune system against the organism. Currently, serology tests are poorly standardized and physicians must interpret them with caution. They are insensitive during the first several weeks of infection and may remain negative in people treated early with antibiotics. Test sensitivity increases when patients progress to later stages of the disease, but a small proportion of Lyme disease patients never develop a positive blood test result. Another complicating factor is that there can be a cross-reaction in the blood test, giving a false positive result for Lyme disease in persons who really have conditions such as syphilis, Rocky Mountain spotted fever, human immunodeficiency virus infection, infectious mononucleosis, lupus or rheumatoid arthritis. Although present diagnostics are not perfect, great strides have been made in the past twenty years. More sensitive and specific tests for Lyme disease are being developed.