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- This is an illness named after the town of Old Lyme, Connecticut, where this disease was first found in the United States. Lyme disease is an infection caused by the spirochete bacterium Borrelia burgdorferi. It is transmitted to humans by Ixodid (deer) ticks. These ticks are found outdoors during the summer months. Lyme disease is often over-diagnosed (i.e., incorrectly).
- Lyme disease has 3 stages of
infection:
- Early local infection (infection at site of the tick bite)
- Early disseminated infection (infection spreads to the body) -- 10-20% of these patients have neurological involvement and 4-10% have cardiac (heart) involvement
- Late persistent infection
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- Stage 1 (early local infection):
- Red, flat, or slightly raised lesion at the tick bite site (you may not remember the tick bite)
- This red lesion enlarges over several days with the central part becoming clear.
- Fever
- Chills
- Muscle aches
- Stage 2 (early disseminated disease):
- Headache
- Stiff neck
- Joint stiffness and pain
- Muscle stiffness and pain
- Heart Palpitations
- Left sided chest pain on deep breath
- Facial droop
- Personality change
- Forgetfulness
- Weakness in a limb
- Numbness/tingling
- Eye problems
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- Serologic testing may be performed, but positive results do not prove the disease.
- Rarely, blood or cerebral spinal fluid may culture positive.
- Diagnosis is predominately made clinically (by the combination of the history and physical exam) and not by laboratory tests.
- Save the tick if found -- using tweezers, squeeze the site of attachment (not its body) until it release its hold. Then place in alcohol to preserve it.
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- Stage 1-- antibiotics for 10 days. Tetracycline typically used. Others may be considered.
- Stage 2 -- antibiotics for 20-30 days. Tetracycline or Doxycycline used. Amoxicillin is effective and may be used for children or pregnant/breast-feeding women. Cefuroxime axetil is also an effective medicine. If the central nervous system is involved (e.g., Encephalitis or brain infection) then the antibiotics are used intravenously (usually Ceftriaxone). Serious cardiac (heart) manifestations are usually treated with intravenous antibiotics as well (Penicillin or Ceftriaxone).
- Stage 3 Disease -- usually Tetracycline, Doxycycline, or Amoxicillin for 30 days.
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- Wear proper covered attire (i.e., closed shoes, socks, and pants) in regions of the country known to have Lyme disease.
- A vaccine for Lyme disease has been under development, but is not currently available.
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