Early localized Lyme infection
Key points
- An 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.
- Primary Lyme disease, a flu-like illness with fever, chills, and muscle aches, occurs in about 50% of those infected with Lyme disease.
- Deer ticks can be so small that they are almost impossible to see.
- The goal is to eliminate the infection with antibiotics, and prevent secondary or tertiary infection.
Alternative names
Lyme disease - primary; Lyme borreliosis; Stage 1 Lyme disease
Definition
An 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.
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 with Lyme disease. If untreated, the disease may progress to secondary Lyme disease and tertiary Lyme disease.
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.
Symptoms
Deer ticks can be so small that they are almost impossible to see. Therefore, many people with Lyme disease never even saw a tick. These people are more likely to develop symptoms because the tick remained on their body longer.
The symptoms of Lyme disease include:
- a flat or slightly raised red lesion at the site of the tick bite
- expansion of the red lesion (rash) to several inches over several days. The rash usually will clear in the center, creating an annular rash, looking somewhat like a bull's eye.
- fever
- headache
- lethargy
- muscle pains and aches
- joint aches
- swollen glands, either near the rash or all over the body
Signs and tests
- An 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 identify the organism.
Treatment
The goal is to eliminate the infection with antibiotics, and prevent secondary or tertiary infection. Antibiotics 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)
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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