Stages Of Lyme Disease Symptoms Of Each Stage Of Lyme
Stage 1: Early Localized Lyme. In this stage of infection, patients might notice a Lyme rash, often in the shape of a very defined bulls eye. This stage occurs within 30 days after a bite from an infected black-legged tick. Other symptoms in this stage might be fever, chills, fatigue, headache, joint pain, and sore throat.
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.
Joint Pain And Swelling
About half of people with untreated Lyme get chronic arthritis. Joint pain and damage most commonly occur in the knee. But Lyme can also affect other joints, like the:
These joints may feel swollen and warm to the touch. Lyme arthritis is more common in older people with Lyme disease.
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How Do Doctors Diagnose Lyme Disease
In areas where the ticks that carry Lyme disease are found, when a patient comes to a doctor with probable erythema migrans , blood tests are performed to diagnose the condition, including the following:
- Step 1: Enzyme immunoassay or immunofluorescence assay — total Lyme titer or IgG and IgM titers
- Step 2: Western blot testing — only performed if step 1 test results are positive
Other tests that may be indicated include the following:
- Joint aspiration to see if there is another cause for fluid buildup on the joints
- Cerebrospinal fluid analysis in patients with meningitis
- Electrocardiogram to identify Lyme carditis or arrythmias
Stage : Early Localized Lyme Disease
Stage 1 or early localized Lyme disease occurs 128 days following a tick bite.
Some people with stage one Lyme disease do not experience any symptoms. If symptoms do occur, they may include the following:
- a skin rash that may or may not resemble a bulls-eye
- flu-like illness, including chills and a fever
- swollen lymph nodes
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Enhancing Healthcare Team Outcomes
The key to Lyme disease is prevention and this requires an interprofessional team approach. All healthcare workers including the nurse practitioner, pharmacist, and primary care provider should provide patient education on measures to prevent tick bites while hiking or working outdoors. In areas where ticks are common, cleaning up of the environment by removing the underbrush and spraying an insecticide may reduce the tick burden in the area. The outdoors person should be told to wear appropriate garments and be familiar with the skin features of the tick bite. The nurse should educate the patient on how to remove the tick from the skin and when to seek medical assistance. The pharmacist should educate the patient on medication compliance for those who have been confirmed to have acquired Lyme disease.
Nurses should educate parents how to inspect their children for ticks at the end of an outdoor event, in an endemic area. While there are many repellants on the market, it is best to avoid them as the risk of harm is greater than any benefit. If one is going to use a repellant, DEET is the one product that is safe, however, it is not 100% effective. finally, the pharmacist should educate the patient about the harms of taking prophylactic doxycycline a better strategy is to remove the tick as soon as it is visualized.
What Is Lyme Arthritis
Lyme arthritis occurs when Lyme disease bacteria enter joint tissue and cause inflammation. If left untreated, permanent damage to the joint can occur. Lyme arthritis accounts for approximately one out of every four Lyme disease cases reported to CDC. Because of reporting practices, this statistic may overstate the frequency of arthritis among patients seen in routine clinical practice.
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How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
Treatment For Erythema Migrans
People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease.
Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a persons age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions.
|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|
*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize unnecessary antibiotics that might result in adverse effects, including infectious diarrhea and antimicrobial resistance.
NOTE: For people intolerant of amoxicillin, doxycycline, and cefuroxime, the macrolide azithromycin may be used, although it is less effective. People treated with azithromycin should be closely monitored to ensure that symptoms resolve.
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What Should I Know About Lyme Disease
- Lyme disease is rarely fatal if treated early and is curable.
- Awareness about Lyme disease is the best way to prevent this disease.
- Using repellants, inspecting ticks and avoiding ticks are some of the effective ways to prevent disease occurrence.
- While going to woody areas, wear fully covered and light-colored clothes to avoid ticks.
- Pets can easily contract this disease, so it is necessary to make them wear a tick collar.
- For more protection, spray the chemical permethrin on clothes and camping sites.
- Some people have complained about lingering symptoms, even after undergoing recommended treatment for Lyme disease, known as post-treatment Lyme disease syndrome . The common complaints, which persist for six months or more are:
Lyme Disease And The Orthopaedic Implications Of Lyme Arthritis
Lyme disease is the most common tick-borne disease in the United States and Europe. Increased awareness of the clinical manifestations of the disease is needed to improve detection and treatment. In the acute and late stages, Lyme disease may be difficult to distinguish from other disease processes.
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Lyme Disease Symptoms : Johns Hopkins Lyme Disease Research
Late stage Lyme disease can result when treatment is unsuccessful or started too late due to unrecognized symptoms or misdiagnosis. The late disseminated stage occurs months or years after initial infection and can have a major impact on a patients health and quality of life. Late Lyme arthritis is a third stage Lyme disease manifestation that involves fluid accumulation
What Is Post Treatment Lyme Disease
Post Treatment Lyme Disease represents a research subset of patients who remain significantly ill 6 months or more following standard antibiotic therapy for Lyme disease. PTLD is characterized by a constellation of symptoms that includes severe fatigue, musculoskeletal pain, sleep disturbance, depression, and cognitive problems such as difficulty with short-term memory, speed of thinking, or multi-tasking. In the absence of a direct diagnostic biomarker blood test, PTLD has been difficult to define by physicians, and its existence has been controversial. However, our clinical research shows that meticulous patient evaluation when used alongside appropriate diagnostic testing can reliably identify patients with a history of previously treated Lyme disease who display the typical symptom patterns of PTLD.
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What Is The Prognosis Of Lyme Disease
Prognosis is excellent and most patients recover completely, especially if treated early with appropriate antibiotics. Sometimes a recurrent infection can occur with certain strains, but Lyme disease can be managed well with medication. Co-infection by other organisms transmitted by the same tick bite can occur.
Why Are Antibiotics The First Line Of Treatment For Lyme Disease
The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.
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Are There Alternative Treatments For Lyme Disease
There are a variety of alternative treatments aimed at patients who believe they may have Lyme disease. But the effectiveness of these treatments is not supported by scientific evidence, and in many cases they are potentially harmful.
Bismacine, also known as chromacine, is an alternative-medicine drug that some people use to treat their Lyme disease.
The Food and Drug Administration warns that people should not use this injectable product, which has reportedly caused hospitalization and at least one death. 70563-1.pdf” rel=”nofollow”> 6)
In addition, the FDA notes that bismacine contains high levels of bismuth, which can cause heart and kidney failure.
Other alternative treatments include oxygen therapy, light therapy, and a variety of nutritional or herbal supplements. But there is no evidence that these treatments are clinically effective in the treatment of Lyme disease.
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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Pearls And Other Issues
Based on the geographic distribution of the shared vector Ixodes scapularis, co-infections with Lyme disease and human granulocytic anaplasmosis and/or babesiosis can occur. Co-infected patients may be more severely ill at presentation, have a persistent fever longer than 48 hours after initiating antibiotic therapy for Lyme disease, or present with anemia, leukopenia, and/or thrombocytopenia. When co-infection is suspected or confirmed, treatment with an appropriate antimicrobial regimen for each infection is necessary for resolution of illness.
Early Disseminated 2nd Lyme Disease Stage
The second phase of Lyme disease typically lasts until the sixth month after the initial infection. As the disease progresses, the infected person will generally feel slightly sick for an extended period. They will have the sense they are unable to shake it off. This disease invades multiple bodily systems like the nervous system, immune system, and endocrine system. The infected person will become aware that something is wrong and potentially be overwhelmed or crippled by the attacks.
The early-stage symptoms will possibly begin to worsen or multiply. Studies show that bacterial spirochetes actively infect the central nervous system. A variety of neurological issues also start to manifest as the disease progresses to the final stage-chronic stage. The patient may suffer from memory lapses, mood swings, sleep disruption, learning impairment, or difficulty with decision-making. Their knees may develop arthritis or recurring episodes of swelling, redness, and fluid buildup.
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Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
Can Lyme Disease Be Cured
Even when treated in later stages, most patients will respond well to antibiotics, though there may be some chronic damage to the nervous system or joints.
The type of tick that carries Lyme disease feeds on deer and mice, and can only infect a human if it remains attached to a person for at least a day and a half.
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For Depression And Anxiety
Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.
A few noteworthy tips on anti-depressant agents:
- Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
- Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
- Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is i increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .
Top 3 Most Popular Alternative Lyme Disease Treatments
- Herbal protocols rated 68% effective
- Chelation or detox rated 63% effective
- Homeopathy rated 55% effective
Of these alternative treatment options, herbal protocols were rated the most effective by participants, but note that 22% rated this treatment method as having moderate or severe side effects. The treatment option with the most moderate or severe side effects was detox, at 29%. The least effective treatment option was rated to be stem cells.
As shown in the data above, herbal protocols are a common treatment choice, and there is some exciting new research in this field that may make it an even more popular option. Researchers have found that two plants Ghanaian quinine and Japanese knotweed have properties that might make them effective against the Lyme bacteria.
As with any medical intervention, alternative Lyme treatments can come with risks or negative side effects. It is crucial that you discuss these risks with your doctor before beginning any treatment regimen.
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Stage : Late Disseminated Lyme Disease
Stage 3 or late disseminated Lyme disease is the final stage of the disease. A person may enter this stage if they did not receive treatment for Lyme disease in the early stages, or if their symptoms persisted despite treatment. As such, doctors sometimes refer to this stage as chronic or post-treatment Lyme disease .
Stage 3 Lyme disease can occur after an infected tick bites a person.
A person with stage 3 Lyme disease may experience additional symptoms, including:
- severe joint pain and swelling, known as chronic Lyme arthritis
- heart palpitations or irregular heartbeat, due to Lyme carditis
- inflammation of the brain and spinal cord
- mental fogginess