Stage : Late Disseminated Lyme Disease
Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.
This stage is characterized by:
- arthritis of one or more large joints
- brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations and sleep disturbance
- numbness in the arms, legs, hands, or feet
Be Ready For Trial And Error
Lyme-related joint pain takes time to both diagnose and treat. In the meantime, there are many things you can do to decrease inflammation and pain. As every Lyme patient is different, try not to get too frustrated if what works for someone else doesnt work for you. Be patient as you experiment with diet, herbs, exercise, alignment, and releasing tight fascia. You will find tools that help you. Reach out and surround yourself with people who understand you and are on your side. We are all healing together.
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.
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
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How And Why Does Arthritis Present In Lyme Disease
The reason people get symptoms of arthritis when they contract Lyme disease has to do with how the bacteria B. burgdorferi functions in your body. Bacterium protects itself with walls made of proteins and sugars. These are called peptidoglycan. The peptidoglycan helps bacteria divide and grow and spread.
However, with B. burgdorferi, it cannot do this. The proteins and sugars are primarily useless to the bacteria associated with Lyme disease. So, because it cant be used, B. burgdorferi dumps the peptidoglycan wherever it can in your body.
Most of the time, this dumping goes into your joints. Both sugars and proteins like these can cause inflammation. And this can happen even when the bacteria have been killed off. In this study, it was found that patients whose symptoms did not improve even after taking antibiotics, still had peptidoglycan in the fluids in their joints.
What Are The Side Effects Of Lyme Disease Treatments
Antibiotics, like all medications, have the potential for side effects. Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria. In the first 24 to 48 hours, dead bacterial products stimulate the immune system to release inflammatory cytokines and chemokines that can cause increased fever and achiness. This should be transient and last no more than a day or two after the initiation of antibiotics.
The most common side effect of the penicillin antibiotics is diarrhea, and occasionally even serious cases caused by the bacteria Clostridium difficile. This bacterial overgrowth condition occurs because antibiotics kill the good bacteria in our gut. It can be helpful to use probiotics to restore the good bacteria and microbiome balance.
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.
How Can Lyme Disease Be Prevented
Unfortunately, there is currently no vaccine for Lyme disease. But you can avoid Lyme disease by avoiding tick bites, checking for ticks, and removing ticks promptly, before they become lodged in the skin. Some tips:
Avoid tick playgrounds: Ticks like low-level shrubs and grasses, particularly at the edges of wooded areas. If youre hiking, try to stay in the center of the trail and avoid bushwhacking. Walk on cleared paths or pavement through wooded areas and fields when possible.
Dress appropriately: Long pants with legs tucked into socks and closed-toed shoes will help keep ticks away from skin. Light-colored clothing helps make ticks visible.
Insect repellant: Products that contain DEET repel ticks but do not kill them and are not 100 percent effective. Use a brand of insect repellent that is designated as child-safe if your child is 1 year or older. For infants, check with your pediatrician about what brands are safe to use. You can also treat clothing with a product that contains permethrin, which is known to kill ticks on contact.
Shower after outdoor activities are done for the day. It may take four to six hours for ticks to attach firmly to skin. Showering will help remove unattached ticks.
- all parts of the body that bend: behind the knees, between fingers and toes, underarms and groin
- other areas where ticks are commonly found: belly button, in and behind the ears, neck, hairline, and top of the head
- anywhere clothing presses on the skin
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Prevention Of Lyme Arthritis
Preventive measures to avoid or minimize tick bites are important and may include landscaping measures, removal of deer from specific areas, wearing appropriate clothing such as pants tucked into socks, and tick repellants. In areas where ticks are common, its important to check your child frequently and remove any ticks. Ticks may remain on your childs skin for hours before attaching themselves, so checking for ticks after coming inside may help remove them before they attach.
Treatment Of Early Manifestations
Table 1 Antibiotic therapy for early Borrelia burgdorferi infection
Late skin disease
Late skin manifestations are usually caused by B. garinii and B. afzelii, and are thus seen predominantly in Europe and not in the USA. Acrodermatitis chronica atrophicans is caused by B. afzelii and is characterised as a blue/red-coloured atrophic skin lesion predominantly at the extremities . Antibiotic therapy for at least 4 weeks has been recommended .
Post-Lyme disease syndrome
Despite the resolution of Lyme borreliosis manifestations after antibiotic treatment in the majority of patients, a minority of patients present fatigue, musculoskeletal pain, concentration or short-term memory problems. These generally mild and self-limiting symptoms have been termed post-Lyme disease symptoms. If the symptoms last longer than 6 months they have been called post-Lyme disease syndrome.
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Stage : Early Localized Disease
Symptoms of Lyme disease usually start 1 to 2 weeks after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.
The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but it isnt painful and doesnt itch. This rash will gradually fade in most people.
The formal name for this rash is erythema migrans. Erythema migrans is said to be characteristic of Lyme disease. However, many people dont have this symptom.
Some people have a rash thats solid red, while people with dark complexions may have a rash that resembles a bruise.
The rash can occur with or without systemic viral or flu-like symptoms.
Other symptoms commonly seen in this stage of Lyme disease include:
The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But it’s 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. They’re 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 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.
What’s The Best Way To Prevent A Tick Bite
Ticks can’t fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:
- Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
- Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
- For even more protection, use the chemical permethrin on clothing and camping gear.
- Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
- Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.
How do you know if you’ve been bitten?
Since ticks are so small, you’ve got to have pretty good eyes to see them.
If you have a small, red bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, itâs not a problem. Remember, a tick bite doesnât necessarily mean you have Lyme disease.
If you notice a rash in the shape of a bull’s-eye, you might have a tick bite. Talk to your doctor about treatment.
If you have an allergic reaction to ticks, you’ll notice a bite right away.
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Can Lyme Arthritis Go Away
Lyme arthritis can be permanent or temporary. It all depends on how and when the patient seeks treatment. If treatment is prompt and rids the body of the bacteria quickly, the symptoms of Lyme arthritis will go away and there will likely be no permanent damage left to the joint.
In other instances, treatment can be put off. This could be for a variety of reasons. If someone is unaware that they could have contracted Lyme disease, its likely that their arthritic symptoms will first be examined as something else. This delay in the proper treatment could lead to bacteria permanently damaging the joints and tissue, and thus creating a long-lasting form of Lyme disease accompanied by arthritic symptoms.
What If A Tick Bites My Dog
The more ticks in your region, the likelier it is that your furry pal will bring them home.
Your dog is much more likely to be bitten by a tick than you are. And where Lyme disease is common, up to 25% of dogs have had it at some point.
About 10% of dogs with Lyme disease will get sick. 7-21 days after a tick bite, your dog might seem like theyâre walking on eggshells. They also might have a fever and enlarged lymph nodes. Plus, they might seem tired. Dogs also get antibiotics for Lyme.
What if my dog brings ticks into my home?
Use a tick control product on your pet to prevent Lyme disease. Also, have your dog vaccinated against Lyme.
Check your dogâs whole body each day for bumps. If you notice a swollen area, see if thereâs a tick there. If you find a tick, wear gloves while you use tweezers to separate it from your dog. Then, put it in soapy water or alcohol, or flush it down the toilet.
Use alcohol to clean the spot on your dog where the tick was attached. Keep an eye on that spot, and also on your dog to make sure theyâre behaving normally. If you notice any changes, check with your vet.
John Aucott, MD, assistant professor of medicine, Johns Hopkins University School of Medicine director, Johns Hopkins Lyme Disease Clinical Research Center.
Morbidity and Mortality Weekly Report: âVital Signs: Trends in Reported Vectorborne Disease Cases — United States and Territories, 2004-2016.â
American College of Rheumatology.
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When Lyme Disease Isnt Caught And Treated Early It Can Cause Late
If youre from a certain area, you know at least a little about Lyme disease. Its the reason your parents made you cover up any time youd be remotely close to a wooded area and checked you religiously for ticks upon your return home.
Lyme disease is an infectious disease spread by certain ticks in certain parts of the United States and Europe. Early on, it can cause flu-like symptoms and a telltale bulls-eye rash. But if Lyme disease isnt caught and treated with antibiotics promptly, the infection can eventually spread through the body. The most common late-stage symptoms include joint swelling and pain, a condition known as Lyme arthritis.
Historically, about 60 percent of people with undiagnosed, untreated Lyme disease would develop Lyme arthritis, according to a study in the journal Arthritis & Rheumatology.
Lyme arthritis, however, shouldnt be confused with chronic Lyme. As its name implies, chronic Lyme is a condition that doesnt go away with one course of antibiotics. Its controversial in the medical world, partly because some patients are diagnosed with chronic Lyme when lab tests dont show evidence of an infection. Some doctors insist that chronic Lyme patients symptoms fade when they stay on antibiotics others argue that its a different disease entirely and that long-term antibiotics will only create more side effects.
Late-stage Lyme, on the other hand, is curable Lyme disease thats progressed and lead to complications such as arthritis.
Lyme Arthritis Diagnosis And Treatment
Because Lyme arthritis can mimic other types of arthritis, and because Lyme disease is often misdiagnosed, working with a Lyme specialist is imperative to getting the right treatment. Diagnosis will include a two-part blood test. As soon as you notice symptoms, tell your doctor you want to be tested.
While the only two available tests for Lyme disease are not considered reliable, documentation of your symptoms will also be used to make a diagnosis. The best way to help assist your doctor is by thoroughly logging symptoms and all the minor details in between that may deem useful to your doctor.
Treatment weighs heavily on what you tell your doctor, you want to give the most complete description possible. The good news is that Lyme arthritis is highly treatable and there are a variety of methods doctors can use to ease symptoms, as well as eliminate the disease from the body. The first step most doctors use is a regimen of antibiotics.
At the same time, patients are given anti-inflammatory medicines to reduce swelling, which can reduce pain. Some doctors prefer to administer steroid injections into the joint. To compliment Lyme arthritis treatments, your diet and lifestyle will play significant roles. The changes you can make, like eliminating sugar, can aid in reducing inflammation in your joints.
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What Are The Symptoms
The main feature of Lyme arthritis is obvious swelling of one or a few joints. While the knees are affected most often, other large joints such as the shoulder, ankle, elbow, jaw, wrist, and hip can also be involved. The joint may feel warm to the touch or cause pain during movement. Joint swelling can come and go or move between joints, and it may be difficult to detect in the shoulder, hip, or jaw. Lyme arthritis typically develops within one to a few months after infection.