LYME DISEASE

General Information

DEFINITION--An inflammatory disorder characterized by a skin rash, followed in weeks to months by symptoms in the central nervous system, cardiovascular system and joints. The majority who get Lyme disease do not become seriously ill. It can be a self-limited illness that goes away without treatment. Named for Lyme, Connecticut, where it was first described, it's often confused with juvenile rheumatoid arthritis of children.

BODY PARTS INVOLVED--Skin of the thighs, buttocks or underarms; central nervous system; heart and blood vessels; large joints, especially in the knee.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

Later stages--

any or some of the following:

• Muscle aches and pains.
• Fatigue and lethargy.
• Chills and fever.
• Stiff neck with headache.
• Backache.
• Nausea and vomiting.
• Sore throat.
• Enlargement of the spleen and lymph glands.
• Migrating joint pain, eventually accompanied by redness and warmth.
• Enlarged heart and heart-rhythm disturbances.

CAUSES--Infection with a spirochete (term for organism or germ), Borrelia burgdorferi, transmitted by a deer tick bite. Many patients report a tick bite at the site of the lesion 3 days to 4 weeks prior to the rash.

RISK INCREASES WITH--Areas where ticks are numerous, such as long grass or brush.

HOW TO PREVENT

• Wear protective clothing with tight collars and cuffs.
• Use effective insect repellents, such as 100% DEET, in areas with ticks.
• Have dogs and cats wear tick-repellant collars.
• Careful skin inspection; removal of any ticks.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and sometimes a skin biopsy (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis during treatment and convalescence.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Congestive heart failure.
• Permanent joint deformity.
• Permanent brain damage (rare).
• Nerve disorder (peripheral neuropathy).

PROBABLE OUTCOME--The skin rash is curable in some patients in 10 days with treatment, and this may prevent development of other symptoms. If not, symptoms in the joints, central nervous system and cardiovascular system usually subside slowly over 2 to 3 years. Symptoms often recur after several years--without another tick bite.

How To Treat

GENERAL MEASURES--

• Early treatment is important to prevent progression.
• Use crutches to keep weight off affected joints, if necessary.
• Heat relieves joint pain. Take hot baths or use heating pads, heat lamps or whirlpool treatments.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• An oral antibiotic for 14-21 days for early stage of the disease.
• Intravenous antibiotics for late stages.
• Nonsteroidal anti-inflammatory drugs.
• Cortisone drugs to reduce the inflammatory response in the heart or central nervous system.

ACTIVITY--Rest in bed until symptoms of active inflammation subside. Then resume normal activities gradually.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of Lyme disease.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.