When should you suspect you might have Lyme disease?

June 21, 2011

By Humphries June 13, 2011

Q. When should you suspect you might have Lyme disease?

A. Lyme disease is an inflammatory disease caused by a bacterial infection from

a tick bite. Massachusetts is among the states with the highest rates of Lyme

disease, and infection usually occurs in the summer months. Most people who get

infected recover fully if treated, but in some cases it can lead to long-term

health problems.

The disease can be tricky to recognize because symptoms vary and can be mistaken

for milder illnesses. Edlow, vice-chair of emergency medicine at Beth

Israel Deaconess Medical Center, says that most people have initial symptoms

within a week or 10 days of getting a tick bite. They feel generally ill and may

have a fever, headache, muscle pain, and stiffness. Most patients also develop a

rash on their skin. The hallmark rash of Lyme disease is a bull's-eye shape:

redness with a clear area around the small red center of the bite. But Edlow

emphasizes that many rashes look different, often a large oval or round splotch

of redness. The rash is usually closer to the center of the body than to hands

and feet; typical locations include the upper legs, torso, armpits, and the

hairline of children. Unlike most rashes from bites, this one tends not to be

painful and itchy.

" Taken together, all those different symptoms are clues, but nothing is 100

percent true all the time,'' Edlow says. If you have symptoms you suspect may be

Lyme disease, it's important to get treated early. The infection can be treated

successfully with antibiotics, but treatment is faster and more likely to be

effective the sooner it happens.

Even without treatment, many people will fight the infection off with their

immune systems. But if not, a second stage of symptoms can appear weeks to

months later. They include Bell's palsy, a paralysis on one side of the face,

nerve pain and irritation, or a mild form of meningitis. In some cases, Edlow

says, the heartbeat slows. Months to years later, the disease can lead to

arthritis of the joints and cognitive impairments like memory loss.

Edlow says the best prevention is to avoid walking in grass and brush where

ticks hide and always check for ticks after being outdoors. If you find one

engorged on your skin, a doctor may prescribe a single dose of antibiotics as a

precaution.

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