Symptoms and treatments for Lyme disease (borreliosis)

In our last article, we talked in detail about what ixodid ticks are, how they hunt us - their potential victims, and how you can most effectively protect yourself from them. This material is a continuation of the previous one, where we will talk about the symptoms and treatment of borreliosis in humans, and perhaps start with how to properly remove a stuck tick, because we remember that the longer it bites, the higher the risk of contracting Lyme disease and other dangerous tick-borne infections.

How to get a tick out?

It is worth noting that you need to avoid such folk remedies that supposedly help to better remove the tick, such as treating it with nail polish or petroleum jelly, as well as using heat.

All these actions will only harm, because the tick, feeling irritated, will inject more saliva into the cancer, possibly rich in infectious pathogens.

People who have removed a tick often wonder if they should take it for testing. Some public health authorities offer identification and testing of ticks as potential carriers of infectious agents or for research purposes, for example, to assess the carrier rates of pathogens among ticks in a region. Although in the conditions of medical statistics in our country, such an approach may be of little interest to anyone.

If you still succeed in passing the tick for research, you need to remember the following:

If the test shows that a tick contained pathogens, this does not necessarily mean that the person who was bitten by the tick was infected.
If a person is infected, the first symptoms appear, as a rule, before the results of the texts are ready. Therefore, there is no need to wait for the test results to start the appropriate treatment.
Negative test results can lead to false confidence. Thus, the presence of symptoms of the disease always takes precedence over the results of research.

Borreliosis symptoms

Left untreated, Lyme disease can produce a wide range of symptoms, depending on the stage of the infection. These include fever, rash, facial palsy, and arthritis. It is imperative to see a doctor if any of these symptoms have been noticed, and history remembers the presence of a tick bite. In addition, has knowledge that the patient lives in a region known to be endemic for Lyme disease, or has recently been to such a region.

Early signs and symptoms of Lyme disease (3 to 30 days after a tick bite):

Fever, chills, headache, fatigue, muscle and joint pain, swollen lymph nodes.
A migratory erythematous rash occurs in about 70 to 80 percent of infected individuals. It begins at the site of the tick bite after a delay of 3 to 30 days (on average, this period is about 7 days).
The rash expands gradually over a period of several days, reaching up to 30 cm in diameter.
The rash may be warm to the touch, and less often itching or soreness.
The general appearance of erythema migrans resembles a target - a common pink space with darker circles.
It can appear anywhere on the body.

Late signs and symptoms (days to months after a tick bite):

Severe headaches and stiff neck.
Additional rashes of erythema migrans on other parts of the body.
Arthritis with severe joint pain accompanied by swelling, especially in the knees.
Bell's facial palsy is a loss of muscle tone in the facial muscles, which creates a pattern of drooping cheeks on one or both sides of the face.
Intermittent pain in tendons, muscles, joints, and bones.
Rapid and irregular heartbeat (Lyme carditis).
Episodes of dizziness and shortness of breath.
Inflammation of the brain and spinal cord.
Painful sensations in the walk of large nerve trunks.
Shooting pains, numbness, or tingling in the arms and legs.
Short-term memory problems.

When trying to identify symptoms on your own, you need to remember the following conditions:

Fever and other common symptoms of Lyme disease can occur in the absence of a rash.
A small bump or redness at the site of a tick bite that develops immediately and resembles a mosquito bite is common. This irritation usually goes away on its own within 1 to 2 days and is not a sign of Lyme disease.
Ticks can spread other pathogens that can cause various types of rashes, including those very similar to erythema migrans.

How to distinguish a borreliosis rash from other forms of rash?

When trying to determine the quality of erythema migrans in borreliosis from diseases with similar symptoms, the following should be taken into account:

Hypersensitivity to insect bites. A large area of a rash lesion, characterized by severe itching and swelling, develops.
Local reaction to medication. A skin condition that usually develops within two weeks of taking the medication. Dark blue patches with a lighter reddish border appear in the same spot each time a particular drug is taken again.
Lichen (dermatomycosis). Lichen is a common skin infection that is caused by a fungus. Popularly referred to as ringworm, the disease can result in a ring-shaped, circular rash that is usually itchy, bright red with raised edges. If the lesion develops in the area of the hairy part of the body, hair loss in this area is possible.
Pink versicolor. A rash with no known cause, which may be round or oval, pink and scaly with raised borders, sometimes with itching. It often develops on the whole body at the same time.
Granuloma annular rash. Reddish bumps on the skin, located in a circle or rings.
Urticaria multiforme. Also known as urticaria. Often caused by an allergic reaction to food, waste products of microorganisms, or drugs. May burn or itch.

Lime cardite

The chronic stage of borreliosis is often characterized by a pathological condition called Lyme carditis. It occurs when the bacteria of the causative agent of the disease enter the tissues of the heart and form their colonies here. This can interfere with the normal movement of the heart's electrical signals that communicate the work of the upper and lower half of the heart.

As a result, a condition develops that disrupts the coordination of the work of these halves, which is clinically reflected in the form of arrhythmias, tachycardia and many accompanying symptoms, for example, shortness of breath.

Doctors call this condition a heart block, which can be mild, moderate, or severe. Heart block with Lyme cardiac arrest can progress rapidly.

Patients may experience rapid fatigue, fainting, shortness of breath, heart palpitations, and chest pain associated with the underlying clinical signs of borreliosis, such as erythema migrans.

Some additional information about Lime Card:

This heart disease occurs in about 1% of all cases of Lyme disease.
Lyme carditis can be treated with oral or intravenous antibiotics, depending on how severe the disease is. Some patients may need a temporary pacemaker.
Between 1985 and 2008, four deaths were officially recorded worldwide due to cardiac arrest caused by Lyme carditis.
The condition is relatively quickly treated and has a comforting prognosis. Typically, the patient is treated with antibiotics for 14-21 days. Most symptoms disappear within 1-6 weeks.

Diagnosis of the disease

Lyme disease is diagnosed based on two conditions:

Evaluations of clinical signs and symptoms assessed in a patient.
Stories of possible contact with infected tick bites.

A laboratory test for blood borreliosis is useful when used correctly and performed using proven methods. Laboratory tests are not recommended for patients who do not have Lyme disease symptoms. In the case of this pathology, it is extremely important to avoid misdiagnosis and unnecessary treatment of Lyme disease when the true cause of the symptoms lies elsewhere.

Professional diagnostic medicine currently recommends a two-step process when testing blood for antibodies against Lyme disease bacteria. Both steps can be done with the same blood sample.

The first stage uses a testing procedure called ELISA (enzyme-linked immunosorbent assay) or, less commonly, the method of indirect immunofluorescence. If this step shows a negative result, further testing of the sample is not recommended. But if the results here are positive or uncertain (questionable), the second stage must be performed without fail.

The second stage uses a test called Western blot or Western blot. The results are considered positive only if both stages show positive results.

Both stages of testing for Lyme disease are intended for cumulative diagnosis. It is not recommended to skip the first test and run a Western blot right away. This can increase the rate of false positives and lead to misdiagnosis and therefore inappropriate treatment.

More about enzyme immunoassay

There are several types of tests within this category. Validated for Lyme disease are the direct enzyme immunoassay and enzyme linked fluorescence immunoassay). Both methods measure the concentration of a person's antibodies, that is, the quality of their immune response, to antigens from bacteria that cause Lyme disease.

That is, if they are, then bacteria are most likely present in the body. The ELISA is designed to be very “sensitive” to the presence of even small amounts of antigens, which means that if used properly, almost all tests for Lyme disease will show a positive test result.

In some cases, a false positive ELISA test result may be shown. This can happen due to the presence of other medical conditions and medical conditions, including:

Tick-borne relapsing fever.
Syphilis.
Anaplasmosis, formerly known as granulocytic ehrlichiosis.
Leptospirosis.
Certain autoimmune diseases, such as lupus.
Bacterial endocarditis.
Helicobacter pylori infection, Epstein-Barr virus, or heavy contamination with Treponema denticola bacteria, which causes gum disease in the mouth, as a common infection after dental procedures.

For this reason, doctors want to further verify positive and questionable results by performing the second stage - the immunoblot test, which more accurately helps to separate patients who actually suffer from Lyme disease.

Immunoblot tests in the diagnosis of Lyme disease can detect two different classes of antibodies in bacteria: IgM and IgG. IgM antibodies appear earlier, so testing for them can be useful for identifying patients within the first few weeks after infection. The downside to testing for IgM antibodies is that they are more likely to give false positives. IgG antibody tests are more reliable, but the process can take 4-6 weeks, which is not always convenient for early treatment.

In addition, the following should be remembered:

Immunoblot should not be started without first performing ELISA.
Immunoblot should not be performed at all if ELISA tests are negative.
A positive IgM immunoblot is meaningful only during the first 4 weeks of illness.
If a patient shows symptoms for more than 4-6 weeks, and the IgG immunoblot test is negative, then it is unlikely that he has Lyme disease, even if the immunoblot is IgM positive.

Lyme disease treatment

Patients receiving appropriate antibiotics in the early stages of Lyme disease usually recover quickly and completely. Drugs commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with some neurologic or cardiac disease may require intravenous treatment with drugs such as ceftriaxone or penicillin. It is worth noting that the vaccination in such cases does not deny the desired effect, folk remedies for borreliosis are not treated.

In a small percentage of cases, symptoms of the disease can last for more than 6 months. Although sometimes referred to as chronic Lyme disease, this is not entirely true. This condition is properly known as post-treatment Lyme syndrome.

Post-treatment Lyme Syndrome

It is not uncommon for patients treated with Lyme disease with the recommended course of antibiotics for 2 to 4 weeks to retain symptoms of fatigue, joint and muscle pain, which are essentially the consequences of the main treatment. In a small percentage of cases, these symptoms can last for more than 6 months. It was this condition that began to be called post-treatment syndrome, since the term chronic Lyme disease would be appropriate if there were no previous treatment at all.

The exact cause of the development of the syndrome is not yet known. Most medical experts believe that persistent symptoms are a consequence of residual tissue and immune system damage that occurred during the infection. Similar complications and autoimmune reactions are known to occur under the influence of other infections, including campylobacteriosis (Guillain-Barré syndrome), chlamydia (Reiter's syndrome), and streptococcal sore throat (rheumatic heart disease).

In contrast, some healthcare professionals tell patients that these symptoms reflect a chronic infection with borreliosis, which is fundamentally wrong. Clinical studies are ongoing to determine the true cause of post-treatment Lyme syndrome in humans.

Regardless of the cause, the results of the studies did not show that patients who received long-term courses of antibiotics were less likely to develop the syndrome in the long term than those who were treated with placebo. In addition, long-term antibiotic treatment for Lyme disease is associated with serious complications. The good news is that patients with post-treatment Lyme syndrome almost always have a favorable prognosis over time. The bad news is that this improvement process can take several months.

If the patient still feels unwell after treatment for Lyme disease, they should see a doctor to discuss how to alleviate the pain, which is sometimes very severe.

In addition, it is worth giving some advice in this case:

You need to track your symptoms. It can be helpful to keep a diary of symptoms, sleep, diet, and exercise to see how they affect your well-being as a function of the environment and how variable they are.
You need to maintain a healthy diet and get good rest.
You need to share your feelings. If family and friends cannot provide the support you need, you can talk to a counselor who can help you find ways to manage situations in your life during this difficult time.

As with any pathology, Lyme disease can have consequences not only on the patient, but also on his loved ones. This does not mean that the symptoms are not real. This means that the patient is a person who needs additional support in difficult times.