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Lyme DiseaseDefinitionLyme disease is a bacterial infection. The infection is spread from the bite of an infected deer tick. Causes TOPLyme disease is caused by bacteria found in some deer ticks. An infected tick passes Lyme disease to humans through its bite. If untreated, the bacteria can pass into the blood. The blood will carry it through the body. The bacteria may then settle in various body tissues. Risk Factors TOPFactors that may increase your chances of Lyme disease:
Symptoms TOPThe symptoms of Lyme disease will be different in each person. They can also range from mild to severe. The first sign may be a red rash. The rash starts as a small red spot at the site of the tick bite. It will then spread over the next few days or weeks to form a circular or oval-shaped rash. Sometimes, the rash resembles a bull's eye with a red ring around a clear area with a red center. The rash may cover a small dime-sized area or a wide area of the body.
Early InfectionIn the first 3-30 days after the bite, if the infection has not spread you may notice:
These symptoms do not necessarily mean you have Lyme disease, even if you have spent time outdoors. See your doctor right away if you have these symptoms and think you have been exposed to a tick. Early Disseminated InfectionAn infection that has begun to spread may cause the following symptoms in days to weeks after the bite:
Late Infection TOPSymptoms can develop months or years after the tick bite in untreated infections. These symptoms may occur regularly or intermittently and include:
Less common symptoms of late Lyme disease include:
Diagnosis TOPLyme disease may be diagnosed based on your symptoms and the history of a tick bite. After 4 weeks of Lyme disease, your body may create antibodies against the infection. A blood test may help look for these antibodies. The blood test cannot confirm or rule out Lyme disease. Instead, the results of the blood test will be used in combination with your symptoms and personal history to make a diagnosis. Treatment TOPLyme disease responds well to antibiotics. These medications can kill bacteria. The length of your antibiotic treatment will depend on your condition. You may need to take them for 10 days to 3 weeks or more. You may be given the antibiotics by mouth or through an IV. To relieve pain from chronic arthritis you doctor may recommend:
Prevention TOPTo help reduce the chances of Lyme disease: OutdoorsIf you live or are visiting northeastern, northwestern, mid-Atlantic, or upper north-central regions of the US, and northwestern California:
Insect repellent can help prevent tick bites. Repellents containing DEET can be applied to clothes and exposed skin. Repellents that have permethrin can be applied to pants, socks, and shoes, but not to skin. Repellents can cause eye irritation and skin reactions. Be sure to read the label for instructions on application, including:
Tick ManagementDeer ticks are unlikely to pass the infection unless they are in contact with the skin for at least 24 hours. After spending time outdoors in a high risk area:
If you do find a tick, remove it by doing the following:
There are some steps that do not help. They may cause more problems.
If you have been bitten by a deer tick, especially if you live in an area where Lyme disease is common, you should watch for a rash to appear. A rash can occur in about 70-80% of infected persons and generally begins at the tick bite site. The rash may appear within 3-30 days, usually before the onset of fever. The rash is usually the first sign of infection, is usually circular, and is called erythema migrans (EM). Some may develop additional EM lesions on other parts of the body. Medication TOPIf you have a tick bite and live in a high-risk area, your doctor may recommend a dose of antibiotic. This may reduce the risk of contracting Lyme disease if taken within 72 hours after a tick bite. However, this antibiotic can have serious side effects in children younger than 8 years old. This prevention step is only used in people older than 8 years of age. The risk of getting Lyme disease after a single tick bite is low. Many experts do not recommend preventive antibiotic treatment. RESOURCES:Centers for Disease Control and Prevention Lyme Disease CANADIAN RESOURCES:Health Canada Lyme Disease Association of Canada REFERENCES:Lyme disease. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/lyme. Updated January 19, 2018. Accessed February 15, 2018. Lyme disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114365/Lyme-disease . Updated September 22, 2017. Accessed February 15, 2018. Lyme disease. Family Doctor—American Academy of Physicians website. Available at: https://familydoctor.org/condition/lyme-disease. Updated June 2017. Accessed February 15, 2018. Lyme disease. National Institute of Allergy and Infectious Diseases website. Available at: https://www.niaid.nih.gov/diseases-conditions/lyme-disease. Updated April 6, 2016. Accessed February 15, 2018. Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single dose doxycycline for the prevention of Lyme disease after an Ixodes Scapularis tick bite. N Engl J Med. 2001;345(2):79-84. 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. 1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114365/Lyme-disease : Warshafsky S, Lee DH, Francois LK, Nowakowski J, Nadelman RB, Wormser GP. Efficacy of antibiotic prophylaxis for the prevention of Lyme disease: an updated systematic review and meta-analysis. J Antimicrob Chemother. 2010;65(6):1137-1144. Last reviewed March 2018 by
EBSCO Medical Review Board
David L. Horn, MD, FACP |
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