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Lyme Disease (cont.)

Lyme Disease Symptoms

  • The initial infection can occur with minimal or no symptoms. But many people experience a flulike primary illness or a characteristic rash several days to a few weeks following a tick bite.

  • The flulike illness usually occurs in the warm weather months when flu (influenza) does not occur.

  • The rash is a red rash that grows in size daily. It is called erythema migrans.

    • The U.S. Centers for Disease Control and Prevention (CDC) defines this rash as a skin lesion that typically begins as a red spot and expands over a period of days to weeks to form a large round lesion, at least 5 cm (about 2 inches) across. A red circular spot which begins within hours and is smaller is usually a reaction to the tick bite.

    • When the rash occurs at the site of the tick bite, it is called a primary lesion. Multiple secondary lesions can occur that are a reaction to the infection and are not due to multiple tick bites. All of these lesions can grow up to the to the size of a football. This growing in size is characteristic of Lyme disease.

    • Its shape can be circular or oval.

    • As it grows, the rash can remain red throughout, although it often can develop a clear area. In a minority, it may take on the appearance of a target with multiple rings (alternating red with clear skin). This is known as a bull's eye lesion.

  • Left untreated, symptoms of the primary illness usually will go away on their own within a few weeks although the rash may recur.

  • Later, additional symptoms may occur. The organs affected later may lead to the following conditions:

    • Facial palsy is paralysis of the facial nerve that causes the facial muscles to be uneven (This may get better without treatment.)

    • Meningitis causes headache, fever, and stiff neck

    • Nerve inflammation causes numbness and tingling in the arms or legs

    • Brain swelling (encephalitis) causes learning difficulties, confusion, and dementia

    • Intermittent episodes of arthritis last about a week and usually involve the knee or wrist. These may recur over periods of weeks to months, and if the Lyme disease remains untreated, about 10% of people who have these episodes develop persistent arthritis in the knee. Occasionally, people with Lyme disease can present with an acute arthritis in the knee without a clear history of a rash or other joint complaints.

    • Inflammation of the heart (carditis) results in irregularities in heart rhythm
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Lyme disease is due to infection with the spirochete Borrelia burgdorferi and the body's immune response to the infection.

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