Treatment Of Lyme Disease
Although all stages of Lyme disease respond to antibiotics, early treatment is more likely to prevent complications.
Antibiotics such as doxycycline, amoxicillin, or cefuroxime, taken by mouth for 2 to 3 weeks, are effective during the early stages of the disease. If early disease is localized, people may need treatment for only 10 days. If people cannot take any of these drugs, azithromycin is sometimes used but is less effective. Usually, doxycycline is not given to children under 8 years old or to pregnant or breastfeeding women.
Antibiotics can also help relieve many of the symptoms of Lyme disease.
For arthritis due to Lyme disease, antibiotics such as amoxicillin, cefuroxime, or doxycycline are given by mouth for 28 days, or ceftriaxone is given intravenously for 28 days.
Antibiotics eradicate the bacteria and, in most people, relieve arthritis. However, arthritis sometimes lasts even after all the bacteria are gone because inflammation continues. Even after successful antibiotic treatment, some people still have other symptoms such as fatigue, headache, and mental problems.
Nonsteroidal anti-inflammatory drugs , such as aspirin or ibuprofen, may relieve the pain of swollen joints. Fluid that collects in affected joints may be drained. Using crutches may help.
How Is Bartonella Transmitted
It is accepted that ticks transmit the bacteria that cause Lyme disease. However, it was not until 2008 when an article was published in a medical journal that brought awareness to tick transmission of Bartonella.
Other vectors that infect humans with Bartonella are sandflies, lice, and fleas. It is estimated 6-12 million children between the ages of 3 and 11 get head lice each year, but this number is grossly underestimated since lice is not a reportable infection. Mosquitoes have been implicated as a vector of Bartonella. There is a case report in the medical literature that indicates spider bites transmitted Bartonella to multiple members of a family that went on to develop neurological symptoms.
With this many vectors that transmit Bartonella, it is easy to see why Bartonellosis should be a global health concern.
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.
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How Do They Test For Lyme Disease
Lyme disease is best tested using two different blood testing methods. These are:
- The Enzyme-linked Immunosorbent Assay test: In a nutshell, this test will look for signs that your body is trying to fight off Lyme disease by producing antibodies. However, the ELISA test may come back negative even when a person is infected by the Borrelia burgdorferi bacteria. False-negatives can occur during the early stages of the disease, where the infected persons body has not produced enough antibodies to fight off the B. burgdorferi bacteria. For this reason, reliable diagnosis is not usually based only on the ELISA test results.
- Western Blot test: Heres a simple way to explain the western blot test without getting into all the nitty-gritty details of what it does and how it does it. Put simply, it separates the blood proteins and detects antibodies to the bacteria causing the Lyme disease. Usually, when an ELISA test comes back positive, a western blot test is performed to confirm the diagnosis.
Ideally, the CDC recommends standard two-tier testing to confirm the veracity of the Lyme disease test accuracy. Together, the ELISA and western blot tests are 99.9% accurate.
Pregnancy And Pediatric Case Assessment
It is documented that trans-placental transmission of the spirochetes from the mother to the fetus is possible, and Borrelia starts crossing the placenta during the first month, unlike Treponema, which passes through the placenta barrier starting from the 5th month. A case of congenital Lyme with multiple annular erythema at birth has been reported in a child whose mother reported having an erythema migrans during pregnancy. Culture of skin biopsy from the childs skin lesion was positive for Borrelia garinii and rapid recovery was achieved after antibiotic therapy . A study on seven pregnant European women with EM and Borrelia isolated from blood indicated that the course and outcome of early LB was uneventful when pregnant women were treated with intravenous ceftriaxone, and that the outcome of their pregnancies was good . Therefore, in case of pregnancy, antibiotic prophylaxis treatment may be appropriate in the case of tick bites in endemic areas.
Below is a description of the symptoms of LB in children with potential exposure to tick bites, who have been diagnosed with EM or positive serological results or clinical manifestations compatible with LB.
Patients with non-specific symptoms are classified as probably not affected by Lyme disease. These patients should be considered positive only if, after 1 month, serology tests demonstrate serum conversion.
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What Do The Results Mean
The Centers for Disease Control and Prevention recommends a two-test process of your sample:
- If your first test result is negative for Lyme disease, you don’t need any more testing.
- If your first result is positive for Lyme disease, your blood will get a second test.
- If both results are positive for Lyme disease and you also have symptoms of infection, you probably have Lyme disease.
Positive results don’t always mean a Lyme disease diagnosis. In some cases, you can have a positive result but not have an infection. Positive results may also mean you have an autoimmune disease, such as lupus or rheumatoid arthritis.
If your lumbar puncture results are positive, it may mean you have Lyme disease, but you might need more tests to confirm a diagnosis.
If your health care provider thinks you have Lyme disease, he or she will prescribe antibiotic treatment. Most people who are treated with antibiotics in the early stage of disease will make a complete recovery.
Prevention Of Lyme Disease
People should take precautions to avoid being bitten by a tick. If people may have been exposed to ticks, they should check their whole body very carefully after each possible exposure and remove any ticks they find. Checking is effective because ticks must usually be attached for more than a day and a half to transmit Lyme disease.
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Bartonella Contributes To Small Vessel Disease
Bartonella has a preference for the cells that line blood vessels called endothelial cells. Bacteria inside of the vessel wall create inflammation and fibrin deposition, causing narrowing of the vessel where blood flows. Blood vessel constriction reduces blood flow and oxygen delivery to organs and tissues. Decreased oxygen causes damage to tissue and leads to loss of function to cells contributing to symptoms. Tissue that receives blood from small vessels like capillaries is most at risk.
The central nervous system especially the brain is susceptible to decreased oxygen delivery. The white matter of the brain does not have collateral circulation, so neurological symptoms manifest early in an infection with Bartonella. Symptoms such as cognitive impairment, disconnection syndrome, poor executive function , decreased working memory, delayed processing speed, and mood swings are associated with small vessel disease caused by Bartonella.
Advantages Of The Equine Lyme Multiplex Assay
The Equine Lyme Multiplex Assay is available only at the Animal Health Diagnostic Center at Cornell University. It combines the results obtained by previous ELISA and Western blot testing and exceeds the information obtained by tests that are based on a single antigen of B. burgdorferi such as C6. The Lyme Multiplex Assay provides information whether the horse got infected with B. burgdorferi and when the infection occurred. The test results are fully quantitative and appropriate to follow-up on treatment success or response to vaccination. The advantages of the Lyme Multiplex Assay compared to other Lyme tests are:
The Lyme Multiplex Assay result provides advanced information beyond any of the currently available Lyme disease testing methods. Lyme Multiplex Assay testing allows a better definition of the horses current infection status and assists in determining treatment options and prognosis. The infection status can also be determined most vaccinated horses. Interpretation varies slightly depending on the vaccine used.
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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
Lyme Disease Can Be Found Throughout The Uk And Around The World The Number Of Cases Has Been Steadily Increasing
Recent draft guidelines from NICE say: Infected ticks are found throughout the UK and Ireland particularly high-risk areas are the South of England and Scottish Highlands, but infection can occur in many areas.
If you have reason to suspect that you may be suffering the effects of Lyme Disease, please complete the online screening form below. An advisor will review your information and get back to you.
Could I have Lyme Disease?
Lyme Disease can be roughly categorised into three stages. The symptoms shown below are just a selection, and indeed the categories may overlap.
Tingling sensation in the hands and feet
Numbness of the skin
Heart rhythm disturbances, heart palpitations
Later disease symptoms may include:
Arthritis of the large joints: knees, hips, etc.
Brain disorders and disturbance, including: memory loss, mood disturbances and sleep interruption
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Symptoms Of Lyme Disease
A circular or oval shape rash around a tick bite can be an early symptom of Lyme disease in some people.
The rash can appear up to 3 months after being bitten by an infected tick, but usually appears within 1 to 4 weeks. It can last for several weeks.
The rash can have a darker or lighter area in the centre and might gradually spread. It’s not usually hot or itchy.
The rash may be flat, or slightly raised, and look pink, red, or purple when it appears on white skin. It can be harder to see the rash on brown and black skin and it may look like a bruise.
Some people also get flu-like symptoms a few days or weeks after they were bitten by an infected tick, such as:
- a high temperature, or feeling hot and shivery
- tiredness and loss of energy
Some people with Lyme disease develop more severe symptoms months or years later.
This is more likely if treatment is delayed.
These more severe symptoms may include:
- pain and swelling in joints
- nerve problems such as pain or numbness
- heart problems
- trouble with memory or concentration
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.
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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When Should I Get Checked For Lyme Disease
Generally, it is best to get tested for Lyme disease if you live where ticks are common or have recently visited such areas. Most certainly, you should get tested if you suspect that a tick has bitten you. It is important to talk to your doctor if you think you have any of the following early Lyme disease symptoms:
- A rash resembling a bulls eye on the spot where youve been bitten
Other symptoms dont show up immediately. Sometimes, it takes up to a few weeks or months after the tick bite to notice the following:
- Swelling on the joints or severe joint pain
- Tingling in the feet and hands
- Shortness of breath
While it is okay get checked early, Lyme disease test results numbers are more authentic a few weeks after youve been bitten by a carrier-tick. Your body would have developed antibodies within that period, and that can make it easier to detect the disease.
So When Do You Need Blood Tests For Lyme Disease
In some cases, you can have Lyme disease without the rash. Or you may not see the rash before it goes away on its own.
In these cases, your doctor should ask you about your medical history and do a thorough physical exam. Your doctor should look for these signs that you might have Lyme disease:
- You were in an area with ticks and Lyme disease.
- You also have fever or redness, warmth, and swelling in one or a few joints at a time usually the knees, shoulders, or wrists.
Other symptoms can occur later on. Talk to your doctor about testing and treatment choices.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
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What To Think About
- It may be hard to tell if you have Lyme disease. False-positive and false-negative Lyme disease test results are common. Many people do not make antibodies to Lyme disease bacteria for up to 8 weeks after being infected.
- Doctors often do not rely on test results alone when recommending treatment for a person who may have Lyme disease. Treatment is often based on a person’s symptoms, the time of year, having a tick bite, and other risk factors for Lyme disease.
Patient History And Review Of Systems
The patient was a very thin, 170-cm -tall, 14-year-old girl diagnosed with Lyme disease after receiving a tick bite while playing outdoors on a warm winter day in February in New England. She reported finding and removing the tick. The site of the bite became sore and developed the characteristic erythema migrans rash. Two days after finding the tick, the patient was seen by a nurse practitioner at her primary care physician’s office. The nurse practitioner recognized the rash, ordered blood work, and prescribed 1 month of doxycycline. The initial test returned a negative result, and the antibiotics were discontinued.
At the initial assessment, the patient and her mother reported that since the infection she had not been attending school, participating in her church youth group, playing sports, or doing light chores. She also had episodes of falling down stairs due to her knees buckling. She stated that falling episodes had diminished at the time of her physical therapy evaluation. Prior to the Lyme infection, her past medical history was unremarkable. The patient’s goals for physical therapy were to run, participate in sports, pick up things without hurting, and go to the youth group.
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Muscle Testing As An Additional Therapy For Lyme Disease Patients
If you are struggling with Lyme disease symptoms and not seeing good health returning, you may want to look into muscle testing.
Simply put, muscle testing a method of assessing your body and organs strengths and weaknesses. Based in Chinese medicinal practices, your body is energy and reacts and interacts with the energy of everything around it. As a result, your body and organs can become weakened over time when coming in contact with negative energy sources. However, through muscle testing, your practitioner can help determine which organs are strong or weak as well as compounds your body reacts to positively or negatively. From there, you can streamline your supplement intake, eliminate harmful compounds, and take more definitive action against Lyme.
A holistic practitioner familiar with muscle testing is one person you can find to do this on you. Remember this is in addition to other strategies to help you heal and should be done under the close supervision of the practitioner. This is not a method for eradicating Lyme, but rather a strategy to help promote your body a better state of wellness.
When being tested, you will be lying down or sitting up. The practitioner will have you raise one arm to channel the energy through your body to various organs. He or she will then touch other organs starting from the top of your head and moving to your torso and other pressure points in your legs. If you arm moves, the organ is weak. If it stays up, the organ is strong.
Diagnosis Testing And Treatment
You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.
Several weeks after infection, FDA cleared tests have very good sensitivity.
It is possible for someone who was infected with Lyme disease to test negative because:
If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.
- Report being bitten by a tick, or
- Live in, or have recently visited, a tick-infested area.
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