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Treatment For Late Disseminated Lyme Disease

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Outlook For Early Disseminated Lyme Disease

Lyme Disease Prognosis – Johns Hopkins – (5 of 5)

If you receive a diagnosis and treatment with antibiotics at this stage, you can expect to be cured of Lyme disease. Without treatment, complications can occur. Treatments are available for the complications.

In rare cases, you may experience a continuation of Lyme disease symptoms after antibiotic treatment. This is called post-treatment Lyme disease syndrome .

Some people who were treated for Lyme disease report muscle and joint pain, cognitive difficulties, sleep issues, or fatigue after their treatments were finished.

The cause of this is unknown. However, researchers believe it may be due to an autoimmune response in which your immune system attacks healthy tissues. It may also be linked to an ongoing infection with the bacteria that causes Lyme disease.

The practices below can reduce your likelihood of contracting Lyme disease and having it progress to the early disseminated stage.

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.

How Is Lyme Disease Treated

Antibiotics, usually doxycycline or amoxicillin, are effective treatments for Lyme disease. How long your treatment lasts depends on the stage of infection. In general, its true that the sooner youre treated, the quicker and more complete the recovery.

Pregnant people should receive treatment for Lyme disease as well. There is, however, no evidence that a fetus can get the infection from its parent. Theres also no strong evidence that miscarriages are more likely after Lyme disease.

What should I do if a tick bites me?

If a tick bites you, the best way to remove it is by taking the following steps:

  • Tug gently but firmly with blunt tweezers near the “head” of the tick at the level of your skin until it releases its hold on your skin.
  • Avoid crushing the tick’s body or handling the tick with bare fingers because you could expose yourself to the bacteria in the tick.
  • Wash the bite area thoroughly with soap and water.
  • Don’t use kerosene, petroleum jelly or hot cigarette butts to remove the tick.
  • Don’t squeeze the tick’s body with your fingers or tweezers.

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Causes Of Early Disseminated Lyme Disease

Lyme disease is caused by Borrelia burgdorferi bacteria. You can contract the infection when a tick that carries the bacteria bites you. Typically, blacklegged ticks and deer ticks spread the disease. These ticks collect the bacteria when they bite mice or deer.

These tiny ticks spread the infection by attaching themselves to various parts of your body. Theyre about the size of a poppy seed and favor hidden areas such as the groin, armpits, and scalp. Often, they can remain undetected in these spots.

Most people who develop Lyme disease report that they never saw a tick on their body. The tick transmits bacteria after being attached for about 36 to 48 hours .

Early disseminated Lyme disease occurs within a few weeks of a tick bite, after the initial infection goes untreated.

Lyme Disease Or Stari

Potential Patient

An erythema migrans-like rash has also been described in humans following bites of the lone star tick. This condition has been named Southern Tick-Associated Rash Illness . Although the rash may be accompanied by systemic symptoms, disseminated or severe disease has not been reported. Because the cause of STARI is unknown, diagnostic blood tests are not available. It is not known whether antibiotic treatment is necessary or beneficial for patients with STARI. Nevertheless, because STARI resembles early Lyme disease, physicians often treat patients with the same antibiotics recommended for Lyme disease.

Lone star ticks can be found from central Texas and Oklahoma eastward across the southern states and along the Atlantic Coast as far north as Maine.

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Where Are Ticks Found

Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.

They 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.

Treatment Of Erythema Migrans Rash

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. For treating other manifestations, see www.cdc.gov/Lyme/treatment.

Lyme Disease treatment regimens

30 mg/kg per day orally, divided into 2 doses 500 mg per dose 14

*When different durations of antibiotics are shown to be effective for the treatment of Lyme disease, the shorter duration is preferred to minimize 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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Basic Science Vs Social Networks

Case reports are a very useful approach for drawing attention to the possible effectiveness of a new treatment. Undoubtedly, the case report published by Liegner has played such a role. However, the next logical step should have been to examine the potential toxicity of DSF for Lyme patients. This could have been achieved first by using animal models, and then within a standardized clinical trial. These steps were rapidly short-circuited, due to the strong social demand for Lyme Disease treatments. This pressure is exerted largely by social networks, emphasizing their speed and efficiency, but at the same time a lack of analysis and scientific rigor.

Joint Pain And Swelling

Alternative treatments for Lyme disease symptoms brings new hope to those suffering

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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Symptoms Of Early Disseminated Lyme Disease

The onset of early disseminated Lyme disease can begin days, weeks, or months after a person is bitten by an infected tick. The symptoms reflect the fact that the infection has begun to spread from the site of the tick bite to other parts of the body.

At this stage, the infection causes specific symptoms that may be intermittent. They are:

  • multiple erythema migrans lesions, which are circular or oval rashes that occur near the bite site and can be solid or resemble a bulls-eye
  • Bells palsy, which is paralysis or weakness of muscles on one or both sides of the face
  • meningitis, which is inflammation of the protective membranes around the brain and spinal cord
  • neck stiffness, severe headaches, or fever
  • severe muscle pain or numbness in the arms or legs
  • pain or swelling in the knees, shoulders, elbows, and other large joints

Symptoms Of Lyme Disease

The symptoms of Lyme Disease are most often the erythema migrans rash, lymphadenopathy, fatigue, chills, fever, myalgia, headache, nausea, joint pains and sore throat. The most common sign of Lyme Disease is the erythema migrans rash. This is an expanding red lesion with central clearing or a ring around it. Other symptoms include flu-like infection with nausea and vomiting. Joint pain may start days to weeks after the rash appears. Causes of Lyme Disease

Lyme disease is caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through infected ticks. The infection can be transmitted by other ticks as well, but researchers found that the deer tick and its relatives were the primary carriers of this disease. The bacteria lodge in skin tissue and causes a localized infection. If it spreads, it will cause more serious problems and symptoms such as arthritis. In many cases, the bacteria remain in skin tissue with no symptoms until the later stages of Lyme disease.

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Diagnosis Of Early Disseminated Lyme Disease

In order to diagnose Lyme disease, a doctor will order a blood test that checks for titers, which are the level of antibodies to the bacteria that cause the disease.

The enzyme-linked immunosorbent assay is the most common test for Lyme disease. The Western blot test, another antibody test, was once used to confirm the ELISA results. Current recommendations from the and the Food and Drug Administration state that a second ELISA test may be used to confirm Lyme disease.

The antibodies to B. burgdorferi can take anywhere from 4 to 6 weeks after infection to show up in your blood. As a result, people tested within the first few weeks of infection may test negative for Lyme disease. In this case, your doctor may choose to monitor your symptoms and test again at a later date to confirm the diagnosis.

If youre in an area where Lyme disease is common, your doctor may be able to diagnose Lyme disease in stage 1 based on their clinical experience and your symptoms.

If your doctor suspects you have early disseminated Lyme disease and the infection has spread throughout your body, they may recommend testing potentially affected areas. These tests may include:

Other antibiotics or intravenous medication may be necessary depending on your condition and additional symptoms.

You will likely have a rapid and complete recovery if you receive antibiotics in one of the early stages of Lyme disease.

Is There A Vaccine For Lyme Disease

Lyme Disease Symptoms And Treatment In Humans

A vaccine for Lyme disease was once available in the United States, but it is no longer available. The vaccines manufacturer discontinued its production in 2002, citing low sales.

According to a 2011 analysis, there were likely a number of factors leading to the decision to suspend the vaccine. These factors included:

  • Class-action lawsuits
  • Low public support due to efforts by anti-vaccine groups
  • Concerns that the vaccine could cause arthritis
  • A difficult vaccination schedule.

The CDC also notes that the vaccine loses effectiveness over time, meaning that youre probably no longer protected against Lyme disease today if you received the vaccine when it was available.

In July 2017, the FDA granted Fast Track designation for another Lyme disease vaccine candidate, VLA15. The FDA designation is intended to facilitate development and expedite review of drugs that treat serious conditions in order to get them to patients faster.

Additional reporting by George Vernadakis.

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What Is The Treatment For Lyme Disease

The first-line standard of care treatment for adults with Lyme disease is doxycycline, a tetracycline antibiotic. Other antibiotics that have activity against borrelia include the penicillin-like antibiotic, amoxicillin, and the second generation cephalosporin, Ceftin. The mainstay of treatment is with oral antibiotics, but intravenous antibiotics are sometimes indicated for more difficult to treat cases of neurologic-Lyme disease, such as meningitis, and cases of late Lyme arthritis.

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.

Treatment regimens for localized Lyme disease.

Age Category
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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Symptoms Of Late Stage Lyme Disease

Your suffering has moved from an occasional inflammation flare-up to chronic pain in your muscles, tendons, and joints. You may have been diagnosed with some form of arthritis. Your headaches have become severe. You may even experience dizziness or vertigo.

Additional symptoms include a stiff neck, sleep disorders like insomnia, and numbness in your outer extremities. You may also lack the ability to focus, and paying attention when having conversations has become difficult. Your fatigue is so bad you sometimes do not want to attempt getting out of bed.

The worse symptom may be that you have tried to get the right help, but doctors have failed to give you an accurate diagnosis. Because of this, you may feel like you are crazy, or your friends and family may not believe you are in pain.

You may be wondering how you were able to reach late stage Lyme disease without proper treatment.

Why Are Antibiotics The First Line Of Treatment For Lyme Disease

Lyme Disease | Pathophysiology, Signs, and Treatment

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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What Are The Risk Factors For Post Treatment Lyme Disease

Risk factors for Post Treatment Lyme Disease include:

  • Delay in diagnosis
  • Increased severity of initial illness
  • Presence of neurologic symptoms

Increased severity of initial illness, the presence of neurologic symptoms, and initial misdiagnosis increase the risk of Post Treatment Lyme Disease. PTLD is especially common in people that have had neurologic involvement. The rates of Post Treatment Lyme Disease after neurologic involvement may be as high as 20% or even higher. Other risk factors being investigated are genetic predispositions and immunologic variables.

In addition to Borrelia burgdorferi, the bacteria that causes Lyme disease, there are several other tick-borne co-infections that may also contribute to more prolonged and complicated illness.

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.

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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.

Chronic Lyme Dos And Donts

Pharmetalon

Chronic Lyme disease is an ongoing Borrelia burgdorferi infection that can involve any body system or tissue. The infection produces a wide range of symptoms and signs, which can be debilitating for some patients. Common symptoms include severe fatigue, migratory musculoskeletal pain, headaches, and impaired memory. Unfortunately, chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health. Every patient concerned about Lyme disease and tick-borne illness should know the following.

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Using Antibiotics To Treat Lyme Disease

Lyme disease is typically treated with antibiotics, although the type of antibiotic used depends on what stage of the disease you have.

After you remove a deer tick that has been attached to you for at least 36 hours the amount of time it takes for the tick to transmit the bacteria Borrelia burgdorferi theres a 72-hour window during which your doctor may give you a single dose of the antibiotic doxycycline to prevent the development of Lyme disease.

Doxycycline is prescribed to patients age 8 and older, except for pregnant women. Not everyone in this situation will receive doxycycline the deer tick bite needs to have occurred in a highly endemic area .

If you have localized Lyme disease with the telltale bulls-eye rash, also known as erythema migrans, but no other significant symptoms, your doctor will most likely treat you with oral doxycycline, amoxicillin, or cefuroxime for 10 to 14 days. If you have early disseminated Lyme disease, which may include the characteristic rash along with cardiac or neurologic symptoms, the treatment duration is lengthened to 14 to 21 days.

But if you have severe neurologic disease, such as meningitis, encephalitis, or nerve issues, or serious cardiac symptoms, your treatment will require taking intravenous ceftriaxone for 14 days.

Late disseminated Lyme disease is also treated with various antibiotics:

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