Lyme Disease

Lyme disease is a multi-system infectious disorder of the skin, nervous system, heart or joints. It can occur after a bite from an infected tick. It is most commonly reported in the endemic areas of the Northeastern and upper Midwestern U.S. However, some cases are also reported from northern California and other areas of the Pacific Northwest. It is currently the most common vector-borne illness in the U.S. but also occurs worldwide in generally temperate regions.

Causes and Risk Factors

Lyme disease is caused after a bite from a tick infected with Borrelia burgdorferi. This bacterial organism in the family of bacteria called spirochetes. Usually a tick requires at least 36 hours of feeding before the bacteria is transferred to humans.

Symptoms

Lyme disease has symptoms in a localized stage and disseminated stage which is based upon how long the Borrelia organism has been growing in your body. Common symptoms of Lyme disease may include:

  • Localized -Lyme Disease
    • Red ring like and spreading rash named Erythema Migrans
    • Flu-like symptoms
    • Localized swollen lymph nodes
  • Disseminated Lyme Disease
    • Multiple secondary circular rashes
    • Flu-like symptoms
    • Joint pain/swelling
    • Swollen knee or Bakers’ cyst

Other symptoms of disseminated Lyme disease include Bell’s palsy (facial paralysis) or meningitis and rarely encephalitis. Lyme disease can also cause heart block, a slow heartbeat.

Diagnosis

In the early localized stage, Lyme disease can be diagnosed on the basis of the classic red ring rash, even if blood tests are negative. Later, an antibody test will be positive, which requires confirmation with a Western blot test.

The diagnosis is usually not made with a culture test since the Borrelia species is difficult to grow in the laboratory. Sometimes, if a patient with Lyme disease has recurrent joint swelling despite antibiotic therapy, your doctor will drain the joint fluid and send it for PCR (polymerase chain reaction) analysis for evidence of DNA in the fluid which can prove the presence of persistent infection.

Treatment

Lyme disease is typically treated with a course of antibiotics, given either by mouth or intravenously depending on the severity or organ involvement from the infection.

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To learn more about our services or to make an appointment with a Brigham and Women’s Hospital rheumatologist, contact one of our trained coordinators at 1-800-294-9999 to get connected with the best doctor for your needs.

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