An acute inflammatory disease characterized by a skin rash (or rashes) and flu-like symptoms caused by the bacterium Borrelia burgdorferi and transmitted by the deer tick .

Alternative Names

Early localized Lyme infection; Lyme borreliosis; Stage 1 Lyme disease

Causes, incidence, and risk factors

Primary Lyme disease, a flu-like illness with fever , chills, and muscle aches, occurs in about 50% of those infected. If untreated, the disease may progress to secondary and tertiary stages. Risk factors include recent tick bite or recent outdoor activities in endemic (high risk) areas. Approximately 16,000 people are affected annually in the United States. See also Lyme disease .

Signs and tests

ELISA

or Western blot may show

antibodies to Borrelia burgdorferi . This test is usually not positive in the first few weeks after the tick bite, so it is often not accurate early in the disease.

A

skin biopsy can sometimes show the organism.

Treatment

The objective of treatment is to eliminate the infection by antibiotic therapy, and prevent secondary or tertiary infection. Medications include: doxycycline, tetracycline, cefuroxime, or amoxicillin in children. Note: Oral tetracycline is usually not prescribed for children until after all the permanent teeth have erupted. It can permanently discolor teeth that are still forming.

Expectations (prognosis)

The signs and symptoms usually resolve in 3 to 4 weeks, even without treatment. With treatment, all signs and symptoms should resolve completely. The secondary or tertiary form of the disease may develop if the initial infection is not treated. Neurological or cardiac symptoms may develop in the second stage of the disease, followed by arthritis and brain or nerve damage in the third stage of the disease.

Complications

secondary Lyme disease

tertiary Lyme disease

can have co-infection with ehrlichiosis or babesiosis

Calling your health care provider

Call for an appointment with your health care provider if you exhibit symptoms of Lyme disease , particularly if you could have been exposed to ticks . Call your health care provider if sensory or muscular weakness , numbness or tingling , or heart irregularities develop.

Prevention

Contact your health care provider if you live in a Lyme disease high-risk area. Tucking long pants into socks (to protect the legs) and wearing shoes and long sleeved shirts, when walking or hiking in tick infested areas, will help to lower your risk of becoming infected. Ticks will show up on white or light colors better than dark colors, making them easier to remove from clothing. Remove ticks immediately by using a tweezers, pulling carefully and steadily. Insect repellent may be helpful. Check pets for ticks also.