Using Erythema Migrans To Diagnose Lyme Disease
Many cases of Lyme disease are initially misdiagnosed. The early symptoms of Lyme disease are common symptoms that occur with many illnesses. Although not all people with Lyme disease have erythema migrans, recognizing it when it is present is an important part of early diagnosis and treatment.
When erythema migrans is present, it can be the basis of a diagnosis by itself since early blood tests are not always reliable. You should understand that the bullseye pattern is only present in a minority of cases. Most often, the lesion is a solid red or blue-red oval or circle. The lesion expands over several days and may have blisters in the center, though this is not common.
If no rash is present or it goes unnoticed, and you don’t remember being bitten by a tick, it can be difficult to diagnose Lyme disease. Testing early in the disease process will likely show a false negative, as your body hasn’t had time to develop a response that can be measured. Once your body does develop a response, you may get a positive test for years, even after Lyme disease has been properly treated.
Lyme Disease And Vertigo
According to researchers, vertigo, as a symptom of Lyme disease, links to damage in the inner ear.
The inner ear contains important parts of the vestibular system, a sensory system that provides the brain with information about motion, balance, and equilibrium.
The researchers conclude that these symptoms suggest that Lyme disease is present in the inner ear.
This nerve consists of both the vestibular and cochlear nerves, which are responsible for maintaining balance and eye movements, and hearing, respectively.
As a result of dysfunction in the inner ear and vestibulocochlear nerve, a person can experience vertigo.
Although vertigo is itself a symptom, it can cause other symptoms, or may commonly occur with other symptoms.
A person with vertigo may have the sense that the space around them, or their head, is , even while they are still.
Other symptoms which may co-occur can include:
What’s The Treatment For Later
There are a few options to treat the joint pain and swelling associated with Lyme disease. Pain-relievers and anti-inflammatories â such as ibuprofen â can help relieve symptoms. An in-office procedure called arthrocentesis can be used to withdraw fluid from swollen joints. Rarely, arthritis persists after antibiotic treatment. Some scientists believe that chronic joint inflammation can be triggered by the infection even after the successful elimination of Lyme bacteria.
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Larger Or Additional Rashes
As the Lyme disease infection spreads throughout the body, your rash might start to expand even more. You might also develop new, smaller rashes nearby. Like the early rash, these might be bullseye-shaped. But they can also just look splotchy or blob-like, according to the CDC. They might even take on a slightly bluish tint in the middle.
Signs And Symptoms Of Lyme Disease
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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 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.
Who’s At Risk Of Lyme Disease
The risk of getting Lyme disease is higher:
- for people who spend time in woodland or moorland areas
- from March to October because more people take part in outdoor activities
It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.
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Each Year Nearly Half A Million People In The United States Are Diagnosed And Treated For Lyme Disease Also Known As Lyme Borreliosis Caused By A Bacterium Carried By Deer Ticks And Transmitted To Humans Through Their Bite
In a new study, US and Danish researchers report that patients hospitalised with Lyme disease had a 28 per cent higher rate of mental disorders and were twice as likely to have attempted suicide post-infection, compared to individuals without the diagnosis.
The study, a collaboration of Columbia University and the Copenhagen Research Centre for Mental Health, is believed to be the first large, population-based study examining the relationship between Lyme disease and psychiatric outcomes.
The research appears in the July 28 online edition of the American Journal of Psychiatry.
“It is time to move beyond thinking of Lyme disease as a simple illness that only causes a rash,” said Brian Fallon, MD, MPH, a psychiatrist with the New York State Psychiatric Institute and Columbia University who is the lead author of the paper, adding, “In addition to the risk of severe cardiac, rheumatologic, and neurologic problems, Lyme disease can cause severe mental health problems as well.”
Dr. Fallon, one of the foremost researchers of the neuropsychiatric effects of Lyme disease, is director of the Lyme and Tick-borne Diseases Research Center at Columbia. The team of investigators on the study includes Michael Benros MD, PhD, principal investigator Trine Madsen, PhD, co-first author and Annette Erlangsen, PhD, all psychiatric epidemiologists at the Research Centre for Mental Health.
Signs And Symptoms Of Untreated Lyme Disease
Seek medical attention if you observe any of these symptoms and have had a tick bite, live in an area known for Lyme disease, or have recently traveled to an area where Lyme disease occurs.
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.
The appearance of the erythema migrans rash can vary widely.
- Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
- Erythema migrans rash :
- Occurs in approximately 70 to 80 percent of infected persons
- Begins at the site of a tick bite after a delay of 3 to 30 days
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or bulls-eye appearance
- May appear on any area of the body
- Does not always appear as a classic erythema migrans rash
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heart beat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
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How Is Lyme Disease Diagnosed
A healthcare provider will diagnose Lyme disease based on symptoms, physical findings and whether or not you’ve been in an area populated by infected ticks.
Many people dont remember or know that theyve been bitten by a tick. This is because the tick is tiny, and its bite is usually painless.
Your provider will confirm the diagnosis using a blood test. If your first blood test is negative for Lyme disease, you won’t need another test. If the first test is positive or equivocal, your provider will conduct the test again. You have to have two positive results to be diagnosed with Lyme disease.
Stages Of Lyme Disease
I spoke with Dr. Lockman who explained more about this worrisome illness. There are two stages of Lyme:
In his suburban Philadelphia practice, Dr. Lockman says he sees quite a few children in the early, localized stage, and a short course of antibiotics is enough to knock it out of their systems.
Lockman listed some of the possible complications of later stage disseminated Lyme. These include arthritis, with swollen joints. The heart can also be affected . Neurologic symptoms may include Bells palsy , meningitis, and cognitive problems. There can also be eye changes and liver and spleen inflammation. For disseminated Lyme, IV antibiotics are sometimes required for a longer time period. Although, Lockman added, there is a good bit of controversy in the medical profession about the patterns of later stage Lyme disease.
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What Are The First Signs And Symptoms Of Lyme Disease
In the first early localized stage of Lyme disease the skin at the site of the tick bite becomes infected with Borrelia burgdorferi bacteria which can cause an expanding round or oval red skin lesion called erythema migrans. This may or may not be associated with flu-like symptoms within days to a month after the tick bite such as achiness, chills, fever, sweats, fatigue, malaise, headache, stiff neck, muscle soreness, joint pain, swollen lymph nodes, and sore throat. The combination of the skin lesion and flu-like symptoms are the primary manifestations of acute stage Lyme disease. Acute Lyme disease is not associated with typical cold-like symptoms of runny nose, prominent cough, or prominent diarrhea.
When To See Your Doctor About Lyme Disease Symptoms
Its best to seek medical attention sooner rather than later. The longer Lyme disease goes untreated, the more likely you are to develop severe complications like intense joint pain, heart problems, or cognitive issues.
Lyme disease treatment: Your doctor should refer you to an infectious disease specialist, who can evaluate your symptoms and decide whether you need testing, Dr. Yancey says. If you test positive, youll be given antibiotics to fight the infection.
False-negatives: If your test comes back clean, but youre convinced that Lyme disease is the culprit, ask to be retested. False negatives are common early on since it takes a few weeks for your immune system to build up antibodies to the bacteria.
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What Are The Symptoms And Signs Of Lyme Disease
There are three distinct phases of Lyme disease. Each phase involves different parts of the body.
- 1. Early localized disease causes skin rashes and redness.
- 2. Early disseminated disease affects the nervous system and heart. People in this stage may have palsies that exhibit paralysis and tremors. A rare but potentially life-threatening bacterial infection called meningitis may occur in this stage. Meningitis affects the tissue surrounding the brain and spinal cord .
- 3. Late disease involves arthritis and neurological issues. During this stage damage to nerves of sensation and movement can occur.
Telehealth Rash Consultation Services
Tick bite and Lyme disease rash consultation* is available by telemedicine appointment at the Johns Hopkins Lyme Disease Research Center. A telehealth visit requires the ability to digitally photograph the patients skin rash for the evaluation and to meet certain State insurance parameters.
* Only available currently to patients in Maryland, Pennsylvania, Virginia, and Delaware.
If you are experiencing flu-like symptoms, please seek the advice of a healthcare practitioner.
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Severe Pain Numbness Or Tingling In Your Joints And Muscles
Around 60% of patients will develop joint pain or even arthritis as their Lyme disease progresses, according to a Johns Hopkins University School of Medicine study. Usually, it starts in the joints closest to where you were bitten and can spread from there, especially to areas like the knees. The pain isnt usually constant, though. Experts dont fully understand why, but the symptoms can wax and wane over a period of weeks or months, Sellati says.
Over time, the disease can attack the cartilage in the joints and lead to tissue damage, says Linda Yancey, M.D., an infectious disease specialist with Memorial Hermann Katy Hospital in Katy, TX.
Like many of the other problems caused by Lyme disease, this one is also triggered by inflammation. The damage to tissues, bone, and cartilage is caused by the production of pro-inflammatory proteins, the same protein responsible for damage caused by rheumatoid arthritis, Sellati says.
What Happens At Your Appointment
The GP will ask about your symptoms and consider any rash or recent tick bites you know about.
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.
2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.
You may need to be retested if you still have Lyme disease symptoms after a negative result.
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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.
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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Where Is Lyme Disease Found
There are currently 330,000 cases of Lyme disease annually in the U.S. Eighty-five percent of these cases have been found in just 14 states, mostly in the Northeast , though cases also appear in California, Oregon, and Washington state. My sonsleeping outdoors in southeastern Pennsylvaniawas a prime candidate for a Lyme-carrying deer tick bite.
The tick carrying Lyme disease has increased its range in North America due to reforestation the explosion of the whitetail deer population, explains Dr. Patrick Gaffney of the College of Earth, Ocean and Environmentat the University of Delaware.
Lyme Disease And The Cdc
In order for the Centers for Disease Control to recognize a Lyme case for surveillance purposes, there must be objective findings, such as positive blood tests, Bells palsy or joint swelling . The chart below reflects the CDC-reviewed surveillance case manifestations from 2001 to 2010.
This situation contributes to what many experts view as severe undercounting of Lyme disease by the CDC.
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