Lyme disease

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Lyme disease is a bacterial infection caused by the Borrelia burgdorferi bacterium (and related species in some regions), transmitted through the bite of infected black-legged ticks (commonly called deer ticks). If left untreated, it can cause serious complications affecting the skin, joints, heart, and nervous system — but it's treatable, especially in early stages.

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🧠 What Is Lyme Disease?

🔬 Definition:

Lyme disease is a vector-borne illness that occurs when an infected tick bites a human and transfers Borrelia bacteria into the bloodstream.

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🦟 How It Spreads

Factor	Details
Vector	Black-legged tick (Ixodes scapularis in the U.S.)
Transmission time	Usually requires tick attachment for 24–48 hours
Seasons	Most common in late spring and summer
Geography	Common in Northeast, Midwest, Pacific Northwest (USA), parts of Europe & Asia

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📆 Stages of Lyme Disease

Stage	Timing	Symptoms
Early localized	Days to weeks	Erythema migrans (bull’s-eye rash), fever, chills, muscle aches, headache
Early disseminated	Weeks to months	Multiple rashes, facial palsy (Bell’s palsy), meningitis, heart block
Late disseminated	Months to years	Arthritis (especially knees), neuropathy, cognitive issues, fatigue

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🔴 Classic Sign: Erythema Migrans Rash

• Appears in ~70–80% of cases

• Expands over days

• Often shaped like a bull’s-eye, but not always

• Not itchy or painful

• May appear at tick bite site or elsewhere

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🧪 Diagnosis

Test	Description
Clinical signs	Especially rash + exposure history
2-step blood test

1. ELISA (initial screening)

2. Western blot (confirmation)
   → Used if no rash or symptoms are unclear
   | PCR testing | For joint fluid or CSF in late disease |
   | CSF analysis | If neurological symptoms present |

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💊 Treatment of Lyme Disease

🟢 Early-Stage Lyme (Localized)

Drug	Dosage	Duration
Doxycycline	100 mg twice daily	10–21 days
Amoxicillin	500 mg 3x daily	14–21 days
Cefuroxime axetil	500 mg 2x daily	14–21 days

Doxycycline also treats co-infections like Anaplasma.

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🟡 Late-Stage Lyme (Neurologic/Cardiac)

• IV ceftriaxone for 14–28 days

• Alternatives: IV penicillin G, oral doxycycline (in selected cases)

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🔄 Post-Treatment Lyme Disease Syndrome (PTLDS)

• Some patients have fatigue, pain, or “brain fog” lasting months

• Cause unclear, may involve immune or nervous system

• Long-term antibiotics are not recommended

• Supportive care: rehab, pain relief, mental health support

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❌ What Not to Do

• Don’t take antibiotics “just in case” after tick bite — unless prescribed for prophylaxis

• Avoid long-term or repeated antibiotics without medical need

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🧩 Prevention Tips

• Wear long clothing in tick-prone areas

• Use DEET or permethrin-based repellents

• Check for ticks daily (especially behind ears, knees, scalp)

• Remove ticks with fine-tipped tweezers

• Prophylactic doxycycline (single dose) may be prescribed if:

  • Tick attached ≥36 hrs

  • Started within 72 hrs of removal

  • High-risk region

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📚 Key References

1. Centers for Disease Control and Prevention (CDC) – Lyme Disease Overview
   Link

2. Wormser, G. P., et al. (2006). The clinical assessment, treatment, and prevention of Lyme disease. CID, 43(9), 1089–1134.
   DOI

3. Stanek, G., et al. (2012). Lyme borreliosis. The Lancet, 379(9814), 461–473.
   DOI

4. Hu, L. T. (2016). Lyme Disease. Annals of Internal Medicine, 164(9), ITC65–ITC80.
   DOI

5. National Institute of Allergy and Infectious Diseases (NIAID) – Lyme Disease Research
   Link