Key Points For Healthcare Providers
Antibiotic Treatment Of Lyme Carditis
Table 1. Mild
|100 mg, twice per day orally||N/A|
|500 mg, three times per day orally||N/A|
|500 mg, twice per day orally||N/A|
|4.4 mg/kg per day orally, divided into 2 doses||100 mg per dose|
|50 mg/kg per day orally, divided into 3 doses||500 mg per dose|
|30 mg/kg per day orally, divided into 2 doses||500 mg per dose||14-21||3|
Table 2. Severe *
|2 grams intravenously, once a day*||N/A|
|5075 mg/kg intravenously, once a day*||2 grams per day||1421||3 5 12|
*After resolution of symptoms and high-grade AV block, consider transitioning to oral antibiotics to complete treatment course .
Tissue sample from a patient who died of Lyme carditis. Image taken using Warthin-Starry stain at 158X.
The heart on the top shows how an electrical signal flows from the atrioventricular node to the chambers in the lower half of the heart, called the ventricles.
The heart on the bottom shows a case of third degree heart block. In this illustration, the electrical signal from the AV node to the ventricle is completely blocked. When this happens, the electrical signal of the atria does not transmit to the ventricles , which causes the ventricles to beat at their own, slower rate.
How Do I Remove A Tick
You should know how to remove a tick just in case one lands on you or a friend. To be safe, remove the tick as soon as possible.
If you find a tick:
- Use tweezers to grasp the tick firmly at its head or mouth, next to your skin.
- Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in your skin, don’t worry. It will eventually come out. But call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
- Swab the bite site with alcohol.
Note: Don’t use petroleum jelly or a lit match to kill a tick. They won’t get the tick off your skin quickly enough, and may just cause it to burrow deeper into your skin.
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What Are The Stages Of Lyme Infection
There are three stages:
- Early localized Lyme: Flu-like symptoms like fever, chills, headache, swollen lymph nodes, sore throat, and a rash that looks like a bulls-eye or is round and red and at least 2 inches long
- Early disseminated Lyme: Flu-like symptoms like pain, weakness, or numbness in your arms and legs, changes in your vision, heart palpitations and chest pain, a rash , and a type of facial paralysis known as Bellâs palsy
- Late disseminated Lyme: This can happen weeks, months, or years after the tick bite. Symptoms might include arthritis, severe fatigue and headaches, dizziness, trouble sleeping, and confusion.
About 10% of people treated for Lyme infection donât shake the disease. They may go on to have three core symptoms: joint or muscle pain, fatigue, and short-term memory loss or confusion. This is called post-treatment Lyme disease syndrome. It can be hard to diagnose because it has the same symptoms as other diseases. Plus, there isnt a blood test to confirm it.
Experts arenât sure why Lyme symptoms donât always go away. One theory is that your body keeps fighting the infection even after the bacteria are gone, like an autoimmune disorder.
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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As I Continue To Treat My Lyme Disease I Finally Feel Okay Not Being Okay
I want to turn this adversity into my power. I was always afraid to overshare on social media, so I kept a lot to myself, but I think Lyme is a gift that I was given to both spread awareness to others and to truly learn my own strength. If you catch it early, it’s a lot easier to treat, and you don’t have to spend eight years of your life wondering WTF is wrong with you, like I did. I want to encourage anyone who may be experiencing symptoms similar to mine to please go get tested.
I ran around nonstop for so long. I was always traveling, running to meetings and events, and trying to fit everything I possibly could into a day. I almost feel as if I was running away from finding out what was truly wrong with me. Nowadays, I often don’t have the energy, strength, or mental health to write the book Im working on or fully inspire people the way I want to. But accepting that you’re sick doesn’t make you a slackerit is just an obstacle that is here to make you stronger. If you are out there living with a chronic illness, take a moment and give yourself a big hug. You are a badass. You are loved. You are strong. You will get through this. And I will too.
Who Is At Risk
Many occupations may be at risk, including forestry, farming, veterinarians, construction, landscaping, ground keepers, park or wildlife management, and anyone who either works outside or has contact with animals that may carry ticks
Similarly, any person who spends a lot time outdoors , especially in grassy or wooded areas may also be at risk.
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Dr Ellie Cannon: I’ve Felt Dizzy For Over Three Years Is It Lyme Disease
17:00 EST, 19 February 2022 | Updated:
I have had severe balance problems for more than three years. Ive read that it could be due to Lyme disease. Is that true?
Lyme disease is a bacterial infection caused by a bite from an infected tick, an insect in the spider family that normally lives on animals.
Usually, patients remember being bitten. Its uncommon in the UK only 3,000 people in England and Wales are affected every year.
It is true it can cause neurological problems, including dizziness and feeling off-balance, but its rare for such symptoms to be the only complaint.
However balance problems are incredibly common, and feeling off-balance all the time can be debilitating, affecting every aspect of ones daily routine.
It can be hard to find an answer, but often the problem lies with the area of the inner ear responsible for balance, called the labyrinth.
Lyme disease is a bacterial infection caused by a bite from an infected tick , an insect in the spider family that normally lives on animals
It is true it can cause neurological problems, including dizziness and feeling off-balance, but its rare for such symptoms to be the only complaint
The most common conditions are benign paroxysmal positional vertigo , chronic labyrinthitis, Menieres disease or vestibular neuronitis.
All of these problems affect specific balance mechanisms in the inner ear. In neuronitis, for instance, its the nerves that are malfunctioning.
But some dietary choices can make it worse.
What Is Lyme Carditis
Lyme carditis occurs when Lyme disease bacteria enter the tissues of the heart. This can interfere with the normal movement of electrical signals from the hearts upper to lower chambers, a process that coordinates the beating of the heart. The result is something physicians call heart block, which can vary in degree and change rapidly. Lyme carditis occurs in approximately one out of every hundred Lyme disease cases reported to CDC.
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How Is It Treated
Facial palsy is treated with oral antibiotics and Lyme meningitis/radiculoneuritis can either be treated with oral or intravenous antibiotics, depending on severity . Most people with Lyme disease respond well to antibiotics and fully recover. Varying degrees of permanent nervous system damage may develop in people who do not receive treatment in the early stages of illness and who develop late-stage Lyme disease.
How Do I Know If I Have A Tick Bite
Many people who develop the disease do not remember seeing ticks or being bitten. Tick bites commonly occur from May to September in North America, although blacklegged ticks can be active most of the year. Ticks sometimes move around on the body but they usually attach themselves to the skin and stay in one place. Before feeding, ticks look like small, brown scabs or freckles. After feeding, ticks may swell considerably, and could be as big as a raisin or a small grape.
Follow the link for more information about blacklegged ticks from the Government of Canada.
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How Is Lyme Disease Transmitted
Ticks usually live in woods or tall grasslands in Canada, the United States, Europe, and Asia. Ticks can become infected with Borrelia burgdorferi by feeding on infected wild animals, and then can spread the bacteria when they feed on blood from the host. Ticks cannot fly – they hang onto small bushes or tall grasses and are usually found close to the ground. They wait for an animal or person to pass near them and when the animal or person makes contact, the ticks attach themselves to the skin to feed.
In North America, Lyme disease is transmitted mainly by two species of ticks:
- Blacklegged tick , Ixodes scapularis.
- Western blacklegged tick, Ixodes pacificus.
The Public Health Agency of Canada states that there no evidence that Lyme disease can spread from person-to-person. Pets, especially dogs, can get Lyme disease, but there is no evidence that pets can spread the infection directly to humans. They may, however, carry infected ticks into the home or yard which may increase the chance of transmission.
Neurological Symptoms From Late
If Lyme disease or associated infections are not adequately treated or go untreated, the persistence of the bacteria, and the inflammation from the immune response, can affect nerve function leading to a myriad of neurological symptoms. One study indicated it took an average of a year and a half following a tick bite for symptoms to manifest in the peripheral nervous system and two years to the onset of symptoms in the central nervous system . The significant length of time from bacterial exposure to onset of symptoms creates a challenge in associating Lyme disease as the cause of chronic neurological symptoms.
Neuropathy is a general term for disease of the nerves.
Polyneuropathy refers to multiple nerves involved in the pathology. In late-stage Lyme disease, polyneuropathy typically manifests as numbness, tingling or burning and can include any nerve but most commonly begins in the hands/arms and feet/legs. Less frequently, chronic neuropathy can lead to radicular pain.
Encephalopathy refers to generalized brain dysfunction
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How Can Lyme Disease Be Prevented
In areas where ticks are found, people should know about the risk of Lyme disease and should take precautions to protect themselves. Be aware of the signs and symptoms of Lyme disease so it can be detected and treated promptly. PHAC states that removing ticks within 24 to 36 hours after the tick bite usually prevents infection.
PHAC has also prepared a Lyme disease tool kit which provides material to raise awareness and educate.
Late Stage Lyme Disease: Symptoms And Treatment
There are three stages of Lyme disease. If you are experiencing the symptoms in the late stage, that means you have already passed through the first two stages of early localized and early disseminated Lyme disease.
During the early localized phase, you may have had a rash associated with the bite given by the infected tick. Symptoms following the bite may have included chills, fever, headaches, fatigue, stiff neck, muscle soreness, and possibly swollen lymph nodes.
If you did not receive the right treatment at the onset, you quickly moved into the next stage. During the early disseminated phase, the Lyme infection started spreading through your body.
Symptoms in the second stage include all of the signs from the early localized stage, only worse. You may also experience vision problems, pain or weakness in your limbs, heart palpitations, and facial paralysis such as bells palsy.
If left untreated, stage two will turn into late stage Lyme disease.
If you are in stage three, or the late disseminated stage, you have been struggling with symptoms for a long while and without treatment specific to Lyme disease.
The symptoms of late stage Lyme disease are genuine and can interfere with daily functioning.
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Conditions With Headache As A Symptom
The list of diseases with headache as a symptom is lengthy and includes head injuries, sinusitis, the flu, stress, and high blood pressure. Also, someone may have allergies to foods, thyroid disease, pregnancy, and numerous other potential conditions. You can see how easy it is for doctors to misdiagnose the source of the headache.
Unless you see a tick or rash or both on your body, you and your doctor may not know to consider Lyme as a possible source.
What Are The Symptoms Of Lyme Disease
Early symptoms of Lyme disease start between 3 to 30 days after an infected tick bites you. The symptoms can include:
- A red rash called erythema migrans . Most people with Lyme disease get this rash. It gets bigger over several days and may feel warm. It is usually not painful or itchy. As it starts to get better, parts of it may fade. Sometimes this makes the rash look like a bulls-eye.
- Muscle and joint aches
- Swollen lymph nodes
If the infection is not treated, it can spread to your joints, heart, and nervous system. The symptoms may include:
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of your body
- Facial palsy, which is a weakness in your facial muscles. It can cause drooping on one or both sides of your face.
- Arthritis with severe joint pain and swelling, especially in your knees and other large joints
- Pain that comes and goes in your tendons, muscles, joints, and bones
- Heart palpitations, which are feelings that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast
- Shooting pains, numbness, or tingling in the hands or feet
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Lyme Disease Symptoms Also Occur In Other Diseases
Many Lyme symptoms, such as fatigue, cognitive impairment, joint pain, poor sleep, mood problems, muscle pain, and neurological presentations also occur in other diseases. Hence, the symptoms of Lyme disease significantly overlap those of chronic fatigue, fibromyalgia, rheumatoid arthritis, multiple sclerosis, Parkinsons disease, ALS, depression and Alzheimers disease. Many Lyme patients report being misdiagnosed with a different condition before being properly diagnosed with Lyme disease.
Can Lyme Disease Be Prevented
There’s no sure way to avoid getting Lyme disease. But you can minimize your risk. Be aware of ticks when you’re in high-risk areas. If you work outdoors or spend time gardening, fishing, hunting, or camping, take precautions:
- Wear closed shoes or boots, long-sleeved shirts, and long pants. Tuck your pant legs into your shoes or boots to prevent ticks from crawling up your legs.
- Use an insect repellent containing 10% to 30% DEET .
- Wear light-colored clothing to help you see ticks more easily.
- Keep long hair pulled back or wear a hat for protection.
- Don’t sit on the ground outside.
- Check yourself for ticks regularly both indoors and outdoors. Wash your clothes and hair after leaving tick-infested areas.
If you use an insect repellent containing DEET, follow the directions on the product’s label and don’t overapply it. Place DEET on shirt collars and sleeves and pant cuffs, and only use it directly on exposed areas of skin. Be sure to wash it off when you go back indoors.
No vaccine for Lyme disease is currently on the market in the United States.
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