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Lyme disease


Alternative Names:

Borreliosis; Bannwarth syndrome

Exams and Tests:

A blood test can be done to check for antibodies to the bacteria that cause Lyme disease. The most commonly used is the ELISA for Lyme disease test. An immunoblot test is done to confirm ELISA results. Be aware, though, in the early stage of infection, blood tests may be normal.

In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (Stage 2) without doing any lab tests.

Other tests that may be done when the infection has spread include:

Outlook (Prognosis):

If diagnosed in the early stages, Lyme disease can be cured with antibiotics. Without treatment, complications involving the joints, heart, and nervous system can occur. But these symptoms are still treatable and curable.

In rare cases, a person keeps having symptoms that interfere with daily life after they have been treated with antibiotics. This is also known as post-Lyme disease syndrome. The cause of this syndrome is unknown.

Symptoms that occur after antibiotics are stopped may not be signs of active infection and may not respond to antibiotic treatment.

Possible Complications:

Stage 3, or late disseminated, Lyme disease can cause long-term joint inflammation (Lyme arthritis) and heart rhythm problems. Brain and nervous system problems are also possible, and may include:

  • Decreased concentration
  • Memory disorders
  • Nerve damage
  • Numbness
  • Pain
  • Paralysis of the face muscles
  • Sleep disorders
  • Vision problems
When to Contact a Medical Professional:

Call your health care provider if you have:

  • A large, red, expanding rash that may look like a bull's eye.
  • Had a tick bite and develop weakness, numbness, tingling, or heart problems.
  • Symptoms of Lyme disease, especially if you may have been exposed to ticks.
Prevention:

Take precautions to avoid tick bites. Be extra careful during warmer months. When possible, avoid walking or hiking in the woods and areas with high grass.

If you do walk or hike in these areas, take measures to prevent tick bites:

  • Wear light-colored clothing so that if ticks land on you, they can be spotted and removed.
  • Wear long sleeves and long pants with pant legs tucked into your socks.
  • Spray exposed skin and your clothing with insect repellant, such as DEET or permethrin.
  • After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Shower as soon as possible to wash off any unseen ticks.

If a tick is attached to you, follow these steps to remove it:

  • Grasp the tick close to its head or mouth with tweezers. Do not use your bare fingers. If needed, use a tissue or paper towel.
  • Pull it straight out with a slow and steady motion. Avoid squeezing or crushing the tick. Be careful not to leave the head embedded in the skin.
  • Clean the area thoroughly with soap and water. Also wash your hands thoroughly.
  • Save the tick in a jar.
  • Watch carefully for the next week or two for signs of Lyme disease.
  • If all parts of the tick cannot be removed, get medical help. Bring the tick in the jar to your doctor appointment.
References:

Bhate C. Lyme disease: part II. Management and prevention. J Am Acad Dermatol. 2011;64:639-653.

Centers for Disease Control. Lyme disease. Page last updated November 15, 2013. Available at: http://www.cdc.gov/lyme. Accessed February 25, 2014.

Halperin JJ, Shapiro ED, Logigian E, et al. Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2007;69:91-102.

Steere AC. Borrelia burgdorferi (lyme disease, lyme borreliosis). In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 242.

Wright WF. Diagnosis and management of Lyme disease. Am Fam Physician. 2012;85:1086-1093.


Review Date: 2/3/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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