Achy Stiff Or Swollen Joints
Joint pain and stiffness, often intermittent, are early Lyme symptoms. Your joints may be inflamed, warm to the touch, painful, and swollen. You may have stiffness and limited range of motion in some joints .
Pain may move around. Sometimes your knees may hurt, whereas other times its your neck or your heels. You may also have bursitis . Bursae are the thin cushions between bone and surrounding tissue.
The pain may be severe, and it may be transitory. More than one joint may be affected. Most often the large joints are involved .
People often attribute joint problems to age, genetics, or sports. Lyme should be added to that list, as these statistics indicate:
- One study estimates that 80 percent of people with untreated Lyme have muscle and joint symptoms .
- Fifty percent of people with untreated Lyme have intermittent episodes of arthritis .
- Two-thirds of people have their first episode of joint pain within six months of the infection .
- Use of anti-inflammatory drugs may mask the actual number of people with joint swelling .
Joint pain that comes and goes, or moves from joint to joint, could be a sign of Lyme.
Patients Own Descriptions Of Symptoms
One day, after I had been ill for about a month, I got into my car and realised I had forgotten how to drive. I sat puzzling over the pedals and controls, but I couldnt even remember how to start the engine. Id had my driving license for fifteen years, and I just felt so ashamed.
I used to get strangers coming up to me every time I left the house. They asked me personal questions and they knew everything about my family and my life, but I had no idea who they were. I couldnt recognise anyones face except my own family. It went on for months and I found it so upsetting I just didnt want to leave the house any more. I lost so many friends because I literally lost all memory of them.
I forgot how to read. I love reading but I couldnt even remember the alphabet. Eventually I could read again after nearly a year.
One day I got lost while I was driving my son to his nursery. It was the pre-school Id been taking him to for over two years. So my four-year-old had to tell me how to get there, but on the way back home I got so lost I just pulled the car over and cried for half an hour. I was terrified.
I keep losing words. Ill be in the middle of a sentence, and stop dead because my brain cant find some everyday word like shoes or microwave. It gets dead annoying.
I always suffered from migraines and when I caught Lyme disease, I got a headache as bad as a migraine which lasted me 6 months.
Chronic Lyme Disease Vs Post
Patients typically use the term chronic Lyme disease to describe the cluster of symptoms that started after getting Lyme disease and that persist despite having received a course of antibiotic treatment which has been deemed curative by the Infectious Diseases Society of America. Patients say, “I’m not cured. I have symptoms now that I never had before Lyme disease. I’m fatigued 90% of the day. My muscles ache. My brain is in a fog. I can’t think clearly any more. I’m super sensitive to light and sound. What is going on? Chronic Lyme disease does exist – I’m a living example of it!”
Whatever one calls it, the experience is the same. Most often these patients experience profound fatigue, pain, and/or cognitive impairment. Mild to moderate levels of depression and anxiety may also accompany these symptoms, as the functional limitations can lead to social isolation, inability to work, and loss of sense of one’s identity as a provider, caretaker, or friend. Sometimes patients find themselves identifying with Job – the just and good man in the Bible whose life was wrecked by illness, death of loved ones, and economic disaster he felt tormented by God.
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Inspection And Tick Removal
Because recommendations for avoidance are not always practical, particularly for children and during the summer, daily close inspection for ticks should be performed each time one has been outdoors. Parents of children in endemic areas must be vigilant to check for ticksespecially the nymphs, because of their smaller size from the spring to the fall. Checking inside skin folds, behind ears, the umbilicus, groin, axilla, hairline, and scalp must be routine. If one tick is found, search thoroughly for others.
See the image below for a tick removal diagram and instructions.
While these instructions may represent the optimal method for removing the tick, it is more important to remove it promptly than to delay removing it while obtaining forceps or gloves.
A common misperception is that pressing a hot match to the tick or trying to smother it with petroleum jelly, gasoline, nail polish, or other noxious substances is beneficial. This only prolongs exposure time and may cause the tick to eject infectious organisms into the body. Finally, do not squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms.
Once the tick is removed, wash the bite area with soap and water or with an antiseptic to destroy any contaminating microorganisms. Additionally, the person who removed the tick should wash his or her hands. The removed tick should be submitted for species identification.
When To See A Healthcare Provider
Keep in mind that not all people have all of the classic Lyme disease symptoms, which makes it important to see your practitioner if you develop a rash or fever following a tick bite, especially if you live in or visited an area where there are a lot of Lyme disease cases. In the United States, this includes the Northeast, Mid-Atlantic, or north-central states.
Lyme Disease Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Even in hyperendemic areas , the risk of developing Lyme disease is usually estimated to only be 3.5 percent at the most. It’s so low because even though up to 50 percent of ticks in endemic areas are infected with the bacteria that causes Lyme disease, most people remove ticks before the bacteria has had enough time to infect them.
Lyme disease is normally easily treated with common antibiotics. The earlier you’re treated for Lyme disease, the better, but even later stage cases usually respond well to medication.
Simple blood tests, which sometimes must be repeated to rule out infection, can give you and your family peace of mind.
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Your Heartbeat Is Slow
Lyme disease can cause heart problems, the most common being heart block, when inflammation blocks the electrical signals that let the heart know when to contract, causing it to beat too slowly, Dr. Liegner says. If the heart becomes too slow, a person will pass out, he says. Dont miss these other scary diseases you can pick up from ticks.
Determining The Source Of Your Symptoms
Again, its important to note that symptoms of tick-borne diseases in humans can vary greatly from person to person and can change over time if diseases are not diagnosed and treated in a timely manner.
The presence of any one of the symptoms above does not alone guarantee that you have a tick-borne disease, but if you do experience them alongside any other potential symptoms, its important to talk to a trusted doctor and get tested immediately.
IGeneX is proud to offer highly accurate, highly sensitive diagnostic testing for all major tick-borne diseases in the U.S., including Lyme disease, Tick-Borne Relapsing Fever, Rocky Mountain Spotted Fever, Bartonellosis, Babesiosis, and Ehrlichiosis and Anaplasmosis. Learn more about IGeneX testing today.
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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.
Borrelia Burgdorferi Infectious Cycle
The infectious cycle of B burgdorferi involves colonization, infection of Ixodes ticks, and then transmission to broad a range of mammalian hosts, including humans. Variation in environmental and host conditions promotes different gene expression and changes in the composition of the membrane proteins of the spirochete. This adaptation is a critical step in the pathogenesis and transmission of Lyme disease.
The Ixodes tick progresses through four stages of development: egg, larva, nymph, and adult . Only larvae, nymphs, and adult female ticks require blood meals, and only ticks in the nymphal and adult stages can transmit B burgdorferi.
The life cycle of Ixodes ticks spans 2 years . The adult lays eggs in the spring, and the larvae emerge in the summer. The larvae feed once, in late summer, on any of a wide variety of small animals . The following spring, the larvae emerge as nymphs. Nymphs feed once, in the spring and summer. The white-footed mouse is the preferred feeding source of nymphs, but other animals apparently suffice. Nymphs molt into adults the following fall and feed once on a larger animal, with the white-tailed deer being the preferred host.
Ticks carry B burgdorferi organisms in their midgut. The bacteria are introduced into the skin by a bite from an infected tick, and disease is transmitted to humans as the spirochete is translocated from the gut to the salivary glands and then to the person at the site of the bite.
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What Are Signs And Symptoms Of The Third Stage Of Lyme Disease
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 and pain in joints, particularly in the knee joints. Late neurologic disease is a 3rd stage condition that can also be debilitating and difficult to diagnose. Late disseminated Lyme disease symptoms include a variety of symptoms that are often neurologic in origin including: numbness in extremities, mental fogginess and concentration problems, and difficulty following conversations or processing information.
Lyme Disease Symptoms To Watch For According To Doctors
Knowing the symptoms to look for can help diagnose Lyme disease early on, when it’s easily treatable.
Fever or fatigue, with or without a rash, can be a symptom of many thingsand Lyme disease is just one possibility. To diagnose Lyme, doctors say they have to consider symptoms and circumstances. If youve been hanging out in wooded or grassy areas, especially in certain regions of the country during the spring, summer, or even autumn months, it might make sense to entertain the possibility that you were bitten by a tick. And whats the most commonly reported tick-borne illness in America? Its Lyme disease, by far.
But Timothy P. Flanagan, MD, associate professor of medicine in the infectious diseases division at Brown Universitys Alpert Medical School, says it would be a mistake to latch on to a Lyme diagnosis without ruling out other possible causes, including other infections transmitted by ticks. You could have a different tick-borne infection entirely, such as anaplasmosis or babesiosis, or you could have Lyme with one or more co-infections. Thats because the same ticks that transmit Borrelia can carry other disease-causing microbes, too.
Its super important that we think of all the tick-borne diseasesnot just Lyme, Dr. Flanagan tells Health. Babesia, a parasite that causes babesiosis, is treated differently than Borrelia, for example.
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Racial Differences In Incidence
Lyme disease is reported primarily in whites, although it occurs in individuals of all races. No genetic explanation is known for this the disparity most likely stems from social or environmental factors and possibly to the fact that erythema migrans is more difficult to diagnose in dark-skinned individuals.
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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What Are The Symptoms Of Lyme Disease
Symptoms of Lyme disease can be different from person to person.
Early signs and symptoms of Lyme disease usually start 3 to 30 days after you have been bitten by an infected blacklegged tick. Most people experience mild flu-like symptoms soon after being bitten, while a small number may have more serious symptoms, sometimes weeks after the bite.
Early signs and symptoms of Lyme disease may include:
- Rash, sometimes shaped like a bull’s eye )
- Muscle and joint aches
- Swollen lymph nodes
If left untreated, more severe symptoms may occur and can last from months to years. Severe symptoms may include:
- Severe headaches
- Facial paralysis
- Intermittent muscle, joint, tendon and bone aches
- Heart disorders , known as Lyme carditis
- Neurological disorders
- Arthritis with severe joint pain and swelling, particularly the knees and less commonly in other joints such as the ankle, elbow and wrists.
In rare cases, Lyme disease can lead to death usually because of complications involving infection of the heart.
You Have Panic Attacks
Some Lyme patients experience extreme fear. The episodes pass after a short time, but they can be scary in the moment, Smith says. With a panic anxiety attack, oftentimes the heart starts racing and they get this fear and think theyre going to die, she says. Dont miss these other clear signs of a panic attack.
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Online Lyme Disease Questionnaire
There is an online test is based on the questionnaire created by the well-known and experienced Lyme-literate Dr. Richard Horowitz.
It is not a definitive diagnostic tool, but it can help to indicate how likely it is that you may be suffering from Lyme disease or a other tick borne illness.
Its free to get the results and takes about 10 minutes to fill in.
For those who think they may be suffering from a long term, chronic Lyme infection, this can be useful food for thought.
You Feel Tired And Wired
Lyme never sleeps, which means that people with it often have trouble sleeping as well. It’s common for those with Lyme to report having trouble falling asleep, waking up throughout the night, and waking up earlier than intended. One study in Sleep even found that 100 percent of Lyme patients had sleep issues. Even when they do get lots of sleep, the fatigue caused by Lyme can make people feel like they haven’t slept at all. Yet Lyme’s effects on the adrenal gland and hypothalamus can leave people feeling hyperactive and jittery even as they are sleep-deprived, says Reihman. So, many Lyme patients describe themselves as “tired and wired.”
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Your Pain Moves Around Your Body
Another hallmark sign of Lyme is migratory pain â that is, pain that travels from one body part to the other. You might, for example, find that your right knee is hurting one day and your left knee is hurting the next. Common kinds of pain associated with Lyme include joint paint and nerve pains that create shooting or zapping sensations, says Reihman.
Madison Area Lyme Support Group
Nature Microbiologyvolume 6, pages 15831592 Cite this article
Peptidoglycana mesh sac of glycans that are linked by peptidesis the main component of bacterial cell walls. Peptidoglycan provides structural strength, protects cells from osmotic pressure and contributes to shape. All bacterial glycans are repeating disaccharides of N-acetylglucosamine –linked to N-acetylmuramic acid . Borrelia burgdorferi, the tick-borne Lyme disease pathogen, produces glycan chains in which MurNAc is occasionally replaced with an unknown sugar. Nuclear magnetic resonance, liquid chromatographymass spectroscopy and genetic analyses show that B. burgdorferi produces glycans that contain GlcNAcGlcNAc. This unusual disaccharide is chitobiose, a component of its chitinous tick vector. Mutant bacteria that are auxotrophic for chitobiose have altered morphology, reduced motility and cell envelope defects that probably result from producing peptidoglycan that is stiffer than that in wild-type bacteria. We propose that the peptidoglycan of B. burgdorferi probably evolved by adaptation to obligate parasitization of a tick vector, resulting in a biophysical cell-wall alteration to withstand the atypical torque associated with twisting motility.
This finding could lead to potential diagnostic tests and treatments that target this unique sugar.
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Severe Hyperbilirubinemia: A Rare Complication Of Lyme Disease
1Internal Medicine Residency Program, Inspira Medical Center in Vineland, Vineland, NJ 08360, USA
2Division of Hospital Medicine, Department of Medicine, Cooper Medical School of Rowan University, Camden, NJ 08103, USA
Gastrointestinal signs and symptoms are common in the early stages of Lyme disease. However, hyperbilirubinemia from Lyme disease is extremely uncommon. There are only two case reports in literature attributing Lyme disease to hyperbilirubinemia. Here we report a case of severe hyperbilirubinemia as the presenting symptom of Lyme disease. Other plausible etiologies have been ruled out after extensive workups, including liver biopsy. His hyperbilirubinemia gradually resolved after being started on doxycycline. With high incidence of Lyme disease, it should be considered for patients who present with hyperbilirubinemia in endemic areas with possible tick exposure.
Lyme disease is a multisystemic infection caused by the tick-borne spirochete, Borrelia burgdorferi. Gastrointestinal involvement, such as acute hepatitis, could present in the early stages of Lyme disease . However, hyperbilirubinemia secondary to Lyme disease is extremely uncommon. There are only two case reports in literature attributing Lyme disease to hyperbilirubinemia one of which was in a pediatric patient . Here we present a rare case of hyperbilirubinemia secondary to Lyme disease.
2. Case Presentation
Conflicts of Interest