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Lyme Disease Information - Symptoms (With Pictures) And Treatment

In 1975 Lyme disease got its name when two mothers, in Lyme and East Haddam Connecticut, contacted the health department because they were alarmed at the many cases of arthritis in children in their area. "Lyme arthritis" as it was named by researchers from Yale was discovered in 39 children and 12 adults. This same illness, although not formally named until 1975, was observed in the 1800s.

In 1981 the bacteria which passes the disease via the bite of a tick was isolated by Willy Burgdorfer at the Rocky Mountain Laboratories. It was named "Borrelia burgdorfere" (Bb) after the man who discovered it.

A multisystemic disorder, Lyme disease is caused by the spirochete, Borrelia burgdorferi, which is carried by the minute tick Ixodes dammini or another tick in the Ixodidae family. It often begins in the summer with the classic skin lesion called erythema chronicum migrans (ECM). Weeks or months later, cardiac or neurologic abnormalities sometimes develop, possibly followed by arthritis

Initially, Lyme disease was identified in a group of children in Lyme, Connecticut. Now Lyme disease is known to occur primarily in three parts of the United States:

• in the northeast, from Massachusetts to Maryland
• in the midwest, in Wisconsin and Minnesota
• in the west, in California and Oregon.

Although Lyme disease is endemic to these areas, cases have been reported in 43 states and 20 other countries, including Germany, Switzerland, France, and Australia.

Causes of Lyme disease Lyme disease occurs when a tick injects spirocheteladen saliva into the blood­stream or deposits fecal matter on the skin. After incubating for 3 to 32 days, the spirochetes migrate out to the skin, causing ECM. Then they disseminate to other skin sites or organs by the blood­stream or lymph system. The spirochetes' life cycle isn't completely clear: They may survive for years in the joints or they may trigger an inflammatory response in the host and then die.

Signs and symptoms of Lyme disease

Lyme disease is an infection that causes an inflammatory disease affecting the skin, joints, nervous system, and other organ systems. Symptoms usually appear within a week of infection but may develop up to 30 days after the tick bite. In some cases, there are no symptoms at all. Typically, Lyme disease has three stages.

Stage 1 :- ECM heralds stage I with a red macule or papule, often at the site of a tick bite. This lesion often feels hot and itchy and may grow to more than 20" (50 cm) in diameter. Within a few days, more lesions may erupt along with a malar rash, conjunctivitis, or diffuse urticaria. In 3 to 4 weeks, lesions are replaced by small red blotches, which persist for several more weeks.

Malaise and fatigue are constant, but other findings are intermittent: headache, fever, chills, achiness, and regional lymphadenopathy. Less common effects are meningeal irritation, mild encephalopathy, migrating musculoskeletal pain, and hepatitis. A persistent sore throat and dry cough may appear several days before ECM.

Stage 2 :- Weeks to months later, the second stage begins with neurologic abnormalities - fluctuating meningoencephalitis with peripheral and cranial neuropathy - that usually resolve after days or months. Facial palsy is especially noticeable. Cardiac abnormalities, such as a brief, fluctuating atrioventricular heart block, may also develop

Stage 3 :- Characterized by arthritis, stage 3 begins weeks or years later. Migrating musculoskeletal pain leads to frank arthritis with marked swelling, especially in the large joints. Recurrent attacks may precede chronic arthritis with severe cartilage and bone erosion.

Diagnosis

Because isolation of B. burgdorferi is unusual in humans and because indirect immunofluorescent antibody tests are marginally sensitive, diagnosis of­ten rests on the characteristic ECM lesion and related clinical findings, especially in endemic areas. Mild anemia and an elevated erythrocyte sedimentation rate, leukocyte count, serum immunoglobulin M level, and aspartate aminotransferase level support the diagnosis.

Treatment of Lyme disease

A 10- to 20-day course of oral tetracycline is the treatment of choice for adults. Penicillin and erythromycin are alternates. Oral penicillin is usually prescribed for children. When given in the early stages, these drugs can minimize later complications. When given during the late stages, high-dose penicillin LV. may be a successful treatment. There is now a vaccine (Lymerix) available to prevent Lyme disease. For maximal effectiveness, it's given as a series of three injections.

CLINICAL TIP Neurologic abnormalities are best treated with LV. ceftriaxone or LV. penicillin.

There is no specific home treatment for children with Lyme disease. Make sure your child takes the required medication as prescribed by your child's doctor, and take steps to prevent and control Lyme disease.

Prevention of Lyme disease

• The best way to prevent Lyme disease is to prevent tick bites. Wear light-colored clothing that covers most of your skin when you go into the woods or an area overgrown with grass and bushes. This makes it easier to see and remove ticks on your clothing.
• Take a detailed patient history, asking about travel to endemic areas and exposure to ticks.
• Keep long hair pulled back or placed in a cap for added protection.
• Check for drug allergies, and administer antibiotics carefully.
• For a patient with arthritis, help with range-of-motion and strengthening exercises, but avoid overexertion.
• When outside, don't sit on the ground.
• Assess the patient's neurologic function and level of consciousness frequently. Watch for signs of increased intracranial pressure and cranial nerve involvement, such as ptosis, strabismus, and diplopia.
• Check for cardiac abnormalities, such as arrhythmias and heart block.
• Don't use the old methods of putting petroleum jelly, nail polish, kerosene, gasoline or matches on the tick to try to remove it. These don't work.