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Lyme disease


Alternative Names:

Borreliosis; Bannwarth syndrome

Signs 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.

In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (Stage 1) without doing any lab tests. In the early stage of infection, blood tests can be normal.

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

Expectations (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. However, these symptoms and stages are still treatable and curable.

Rarely, a person will continue having symptoms that can interfere with daily life after they have been treated with antibiotics. Some people call this post-Lyme disease syndrome. The cause of this syndrome is unknown.

Symptoms that occur after antibiotic treatment for Lyme disease may not be signs of active infection and may not respond to antibiotic treatment.

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
Calling your health care provider:

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 direct contact with ticks. Be extra careful during warmer months. Whenever possible:

  • Avoid wooded or bushy areas, or areas with high grasses and leaf litter.
  • Walk in the center of trails.
  • Check yourself and your pets frequently during and after your walk or hike.

When walking or hiking in wooded or grassy areas, spray all exposed skin and your clothing with insect repellant.

See also: Bug repellent safety

You may also treat clothing, such as boots, pants, and socks, with a product that contains permethrin. It remains protective for several washings.

Ticks that carry Lyme disease are so small that they are very hard to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Shower soon after coming indoors to wash off any unseen ticks.

See also: Tick removal

References:

Centers for Disease Control. Lyme disease. Page last updated November 15, 2011. Accessed February 4, 2012.

Halperin JJ, Shapiro ED, Logigian E, Belman AL, Dotevall L, Wormser GP, 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. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 242.

Wormser GP. Lyme disease. In: Goldman L, Schafer AI,e ds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 329.

Wormser GP, Dattwyler RJ, Shapiro ED, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43(9):1089-1134.


Review Date: 2/27/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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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