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Lyme Disease


Lyme disease is an infectious disease caused by a bacterium named Borrelia, which is spread by ticks and has four main species. Lyme disease lies among the most common vector-borne diseases. It is caused by Borrelia burgdorferi and Borrelia mayonii in the United States and Borrelia afzelii and Borrelia garinii in other countries. It affects multiple systems of our body, with a rash called erythema migrans being the first and most common symptom, including fever, headache, malaise, etc. Bacteria can affect the joints, circulation, and the neurological system if left untreated. Symptoms, physical evidence, and the likelihood of exposure to infectious ticks are used to diagnose Lyme disease.

Most instances of Lyme disease can be effectively treated with antibiotics for a few weeks. Using bug spray, extracting ticks as soon as possible, using insecticides, and limiting the tick population are all ways to avoid Lyme disease.

If you reside in grassy or densely wooded regions where ticks bearing Lyme disease flourish, you're highly likely to contract the condition.


Spirochetes, spiral bacteria from the genus Borrelia, cause Lyme disease. Ticks may attach to any region of the body, although they are most commonly found in locations that are difficult to notice, such as the genital area, underarm, and head. The tick should be attached for at least 36 to 48 hours to transfer the Lyme disease bacteria. The bites of juvenile ticks called nymphs infect the majority of humans. Nymphs are quite small and difficult to spot. Mature ticks can also spread Lyme disease bacteria, but since they are bigger, they are more likely to be identified and eliminated before the infection has had a chance to spread. Adult Ixodes ticks are most prevalent in the fall and winter months.


Lyme disease is the most common disease spread by ticks in the USA. Every year, Over 30,000 cases of Lyme disease are reported. It is widely found in other regions like North America, Europe, and Asia. The dispersion of the illness's vectors significantly affects the disease's prevalence. The main vector in the Northeast and Central U.S. is Ixodes scapularis, but Ixodes pacificus is more widespread on the Pacific coast. In Europe, the carrier is Ixodes ricinus. The taiga tick, Ixodes persulcatus, is the carrier throughout Asia.

Signs And Symptoms

In most cases, the incubation period between infection and the start of symptoms is two weeks, but it can be much less (days) or much more prolonged (months to years). Not all individuals with Lyme disease experience all of the symptoms, and many of them aren't peculiar to Lyme disease and can also occur in other disorders.

The rash may be accompanied by fever, chills, tiredness, muscle aches, headache, stiff neck, and enlarged lymph nodes.

Erythema migrans (EM): A red patch that occasionally clears in the middle, forming a bull's-eye shape, may occur. The rash spreads slowly over several days and can reach a diameter of 12 inches (30 centimeters). It isn't usually itchy or uncomfortable, although it may feel slightly warm.

  • There is severe joint pain and inflammation, especially in the knee joints, although the discomfort might transfer from one joint to another.
  • You may develop irritation of the layers around your brain (meningitis),
  • Bell's palsy (facial weakness)
  • Hepatitis
  • Extreme tiredness
  • Tingling or weakening in the limbs.
  • Reduced muscle function 
  • Problems with the heart, such as an irregular pulse
  • Inflammatory disease of the eyes


Lyme diagnosis is confirmed based on symptoms, physical signs (such as a typical bulls-eye rash, facial palsy, or arthritis), a history of probable tick bites, particularly if you were outside during the summertime when Lyme disease is prevalent, and often laboratory tests.

Antibodies to the organisms can be found in lab testing, which can assist in verifying or excluding the diagnosis. After your body has had time to generate antibodies, these tests are most accurate a few weeks after an illness. They are as follows:

Enzyme-linked immunosorbent assay (ELISA). ELISA is the most common test for Lyme disease detection. It identifies proteins specific to B. burgdorferi. However, it is seldom utilized as the main basis for identification because it can often produce misleading data.

Although this test may not be affirmative in the initial stages of Lyme disease, the rash is unique enough to establish the diagnosis with no further testing in people who reside in Lyme disease-infested areas.

Western blot analysis. This test is frequently performed to verify the diagnosis if the ELISA results are positive. The Western blot identifies antibodies to many B. burgdorferi proteins in this two-step procedure.

Differential Diagnosis

Regional clinics, according to reports, misdiagnose 23–28 percent of Erythema migrans skin rashes and 83 percent of other clinical features of Lyme disease. Spider bites, abscesses, and shingles are all common misdiagnoses for EM rashes.

Many misdiagnoses can be attributed to the widely held belief that EM rashes typically resemble a bull's eye. The speed and degree to which the EM rash expands are, in fact, the major differentiating aspects of the rash.


In the initial phases of Lyme disease, those who are given the right medications improve quickly and thoroughly. Lyme disease can be prevented if it is diagnosed early and treated properly with antibiotics.


Adults and children over the age of eight should take doxycycline, whereas smaller kids and pregnant or breastfeeding mothers should take amoxicillin or cefuroxime. Antibiotics are normally prescribed for 14 to 21 days, but other research shows that regimens spanning 10 to 14 days are just as beneficial. If the sickness affects the nervous system, the doctor may prescribe intravenous antibiotic therapy for 14 to 28 days. Although this helps remove infections, it may take some time to heal from your problems.

Antibiotics used intravenously can induce a drop in white blood cell count, mild to severe diarrhea, or colonization or infection with antibiotic-resistant organisms unrelated to Lyme disease.


Ticks that have attached themselves should be removed as soon as possible. The chance of infection rises with the length of time the tick is attached, although the risk of Lyme disease is low if the insect is removed within 36 hours. Your doctor will insert a fine-tipped tweezer between the skin and the tick, grab it firmly, and pull the closed tweezer straight away from the skin without twisting, jerking, squeezing, or crushing the tick. Any tick pieces left in the skin after tick removal should be removed with a clean tweezer if feasible.


When individuals with Lyme disease are treated quickly with suitable antibiotic regimens, their outlook is often favorable. If an infected tick repeatedly attacks the patient, recurring infection is likely. A different variety of local Borrelia generally causes these infections.

Lifestyle Modifications

  • Wear shoes, long trousers pulled into your boots, a long shirt, a cap, and mittens while walking through woodland or meadow regions. Stick to the pathways and stay away from the low shrubs and tall grass. Have your dog under control at all times. Apply bug spray with a DEET dosage of 20% or more on your body. Parents should apply repellent to their kids while sparing their hands, eyes, and mouth.
  • Remember that chemical pesticides can be hazardous, so read the labels thoroughly. Use permethrin-containing products on clothing or purchase clothing that has already been treated.
  • Keep your yard tick-free. Tick-infested areas should be cleared of brush and leaves. Trim your grass regularly. To deter tick-carrying rodents, store wood properly in calm, sunny regions.
  • Take the tick by the head or mouth and firmly grab it. Remove the tick gently and slowly, rather than squeezing or smashing it. Once the tick has been fully separated, discard it by soaking it in ethanol or dumping it down the drain, then treat the bite area with an antiseptic.
  • Showering as soon as you enter the house is a good idea. Ticks can stay on your body for several hours before adhering. Unattached ticks may be removed by washing with a washcloth.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 24, 2023.


Lyme Disease | Lyme Disease | CDC


CIMB | Free Full-Text | Lyme Disease in Humans (mdpi.com)


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