Lyme disease (borreliosis) is a disease characterized by a special variety of manifestations. The clinical presentation of two patients may have a minimum in common, despite the same diagnosis. To this day, specialists in the field of medicine have not developed a unified approach to how to diagnose borreliosis, how to properly treat it. What can we say about ordinary people? The level of awareness is extremely low.
general information
Lyme disease (borreliosis) is a focal natural pathology from the group of vector-borne diseases. A sick person suffers from joints, skin, and the nervous system. A pathological condition can adversely affect the work of the heart. Often the disease becomes chronic, prone to frequent relapses.
Ticks can transmit a fairly wide variety of infectious pathologies, and the most common of them is Lyme disease (borreliosis). The disease got its name from the name of a small American city located in Connecticut - Old Lyme. In the 70s, it was here that cases of such a disease provoked by tick bites were recorded and described.
Lyme disease (borreliosis) in the European powers was known for a long time already, although there was no single name for the pathology. In some cases, patients were diagnosed with erythema, which tends to change the foci of manifestation, sometimes they talked about Bannwart syndrome, sometimes they used other names. In 1982, scientists first revealed what exactly provokes the disease, which pathogen is its source.
Technical points
The initiators of Lyme disease (tick-borne borreliosis) are Borrelia. A number of varieties are known that are dangerous to humans. These life forms belong to the class of microscopic aerophiles, belong to the group of gram-negative spirochetes. Like other representatives of this group, the causative agents of borreliosis are quite sensitive to the surrounding space.
Some causative agents of Lyme disease (tick-borne borreliosis) provoke arthritis. In North America, there are practically no other forms of pathogens, only this one. There are those under the influence of which the nervous system suffers. Certain pathogens cause chronic skin lesions. What unites all three types of disease provocateurs is the fact that their infection leads to a changing area of erythema localization.
Features of the transmission of the disease
Lyme disease (borreliosis) is provoked by borrelia, which normally live in the body of a wide variety of wild animals. Often the carriers are birds or representatives of the rodent order. Borrelia is found in the body of deer and other wildlife. What unites all these life forms is the fact that Ixodes ticks feed on them. They are the carriers of the causative agent of the disease. At the moment when the tick receives blood from the animal, the microscopic form of life penetrates the intestinal system of the parasite. Here the conditions are comfortable enough for active reproduction to begin. Isolation occurs during bowel movements.
As scientists have revealed, although Lyme disease (borreliosis) is provoked by infected ticks, this does not happen with every bite. The level of infection among ticks is extremely high, but in the salivary glands, Borrelia is contained in a relatively low concentration, and in some sick individuals are absent altogether.
The circulation of Borrelia is as follows: from ticks they are transmitted to wild animals, from them they again return to ticks. In addition to the wild, pets can also be affected. There is currently a theory that borrelia can be carried by some other life forms. In particular, presumably, such objects can be horseflies.
Man and Borrelia
Tick borreliosis infection (Lyme disease) most often occurs in the natural focus of distribution. This is usually a temperate forest. As experts were able to establish, tick-borne borreliosis and tick-borne encephalitis are common in approximately the same area. In our country, cases of infection in various regions are known. Lyme disease occurs twice as often as encephalitis, and sometimes four times as often.
Tick-borne borreliosis is found in Asian, European territories, in America. In our country, the prevalence is all zones of the forest-steppe, from the westernmost regions to the Far Eastern regions. Studies have shown that borreliosis in Russia is the most common tick-borne infection. The likelihood of infection after a tick bite is several times greater than the chance of getting encephalitis.
Natural foci of the disease are areas where the aforementioned genus of ticks is common. The incidence is strictly seasonal, characteristic of the period when ticks are active. Usually the first cases occur in March-April, the last - in October, if the weather is warm. Maximum - May, June. In different areas, the percentage of sick ticks is quite different. It has been established that at the same time the parasite can carry several pathogens at once, which means that a mixed infection is highly likely.
How is everything going?
How can a person get Lyme disease (borreliosis)? The photos in the article demonstrate a tick - it is with a bite of such a parasite that there is a risk of infection. The transmission method is transmissible, the pathogen passes into the human body at the time of a bite. Scientists believe that probably infection is also possible through tick-borne feces, if they first get on the skin, and then this area is combed or rubbed into the skin.
If you break the tick, remove it incorrectly, Borrelia can penetrate the body through the wound. The alimentary way is known - you can get sick by drinking raw milk from a sick cow, goat.
The highest risk is Lyme disease in people working in forestry, forestry, and hunting. High danger for those who live in wooded regions.
Notice Lyme Disease
Symptoms of borreliosis are explained by the immunopathological response of the body. Manifestations are associated with the presence of the pathogen itself, antigens. At the time of penetration, Borrelia provokes the appearance of papules, erythema. Introducing into the bloodstream, the causative agent of the disease spreads throughout the body, then there is localization in the tissues and organs. Adsorption occurs on cells. The most active interaction is with membrane elements of neuroglia. Infiltration of damaged tissues is observed with infiltrates consisting of various elements (plasmocytes, macrophages, lymphocytes).
Borrelia provokes vasculitis, vascular occlusion. It is known that often a person develops chronic Lyme disease. Symptoms of borreliosis are explained by the fact that the pathogen can live in organic tissues for many years, occasionally provoking relapses. This is more typical for cases when a person does not receive adequate treatment.
If the disease progresses, the pathogen becomes a trigger factor stimulating immunopathological processes. A symptom of Lyme disease (tick-borne borreliosis) is chronic arthritis. There is a possibility of neuroborreliosis. The response of the immune system is brighter when the disease has already progressed. To a greater extent, this is characteristic of the period when the joints were affected.
With the right treatment, it is possible to normalize the content of antibodies, the patient recovers. There are cases when the persistence of the pathogen in the late stages of borreliosis did not lead to clinical symptoms.
Infection
In the early days, it is almost impossible to notice the symptoms of Lyme disease (borreliosis) - the incubation period lasts first. In rare cases, its duration is only two days, in some up to a month. On average, the pathogen takes two weeks. The clinical picture varies from case to case, in some patients, symptoms are absent in principle.
It is customary to distinguish three main stages. The division is rather arbitrary, not all medical specialists agree with it. It is not necessary that each patient will experience all three stages at different periods of the disease. Cases of manifestation strictly in the form of a chronicle are known. This forces one to be especially attentive to patients who have arthritis, polyneuropathy, and a number of other conditions that are potentially associated with borreliosis. To clarify the diagnosis, you will first have to prescribe tests to rule out Lyme disease. The symptoms and consequences of tick-borne borreliosis should be known first of all to doctors in order to make the patient the correct diagnosis.
About the stages and forms
At an early stage of borreliosis, migratory erythema appears. This is one reddish spot located in the place where the tick bit. In some patients, several spots appear immediately. Gradually, centrifugal growth occurs. After several weeks, the diameter can reach 20 cm, and in some patients, the size of the formation is even larger. The more erythema, the pronounced regression in the center. A clear trace in the center of the outbreak is possible.
The area is often localized on the trunk, legs, arms, less often - on the face. A rim of erythema bordering is possible along the edges; the strip becomes like a garland. Perhaps the intersection of the chest, neck. It is erythema that is the key sign of borreliosis, which allows one to suspect which diagnosis should be made. The area is hot to the touch, responds with pain, itches and burns. Erythema is more often in shape - an oval or a circle, but an incorrect formation is possible.
In some patients, erythema persists for months, while in others it disappears after a couple of days. With etiotropic treatment, regression is observed after a week of a therapeutic course. Perhaps the complete disappearance of the damage, there is a possibility of skin peeling, pigmentation of the focus. The bite point is marked with a crust.
The appearance of daughter foci is possible. Often, borreliosis is accompanied by general poisoning, the temperature rises. Headache, chills, fever, sleepy.
Second stage
Usually this period occurs 4-5 weeks after infection. In some cases, observed in the second week, sometimes only in the 21st. Borreliosis manifests itself as meningitis, neuritis, impaired functionality of the heart and blood vessels. A syndrome similar in manifestations to the flu is possible - the headache, fever, the patient is weak. The lesions on the skin are more often secondary ring, their size is up to 5 cm. A rash is possible on the palms, skin lymphocytoma is likely.
Up to half of patients suffer from facial neuritis. Every third has moderate symptoms of encephalitis. Damage to the nervous system responsible for eye movement, hearing is possible. With borreliosis, peripheral NS suffers. A fairly typical manifestation is Bannwart syndrome, in which nerve roots are damaged, meningitis develops.
Neurological disorders often exhaust themselves in a month, but the risk of relapse is high. There are cases when, with Lyme disease, just such lesions were the only signs, and erythema did not appear, as well as signs of infectious processes in the body.
About 8% of patients at the 5th week experience cardiac dysfunction. The heart hurts, contracts with interruptions. Possible inflammatory processes in the heart tissues. Such symptoms can bother one and a half months. The entire second stage of borreliosis is accompanied by weakness and painful sensations localized in muscle, joint, and bone tissues.
Late chronic form
In the third stage, the joints suffer. Usually the stage begins two months after infection, sometimes later - after a year or two. Large joints are more likely to suffer, possibly only on one side, although there is a likelihood of symmetrical polyarthritis. Arthritis occurs with relapses, destructive processes affect cartilage, bones, a chronic disease.
Chronic borreliosis is a remission followed by relapse. Possible recurrence. Of the manifestations, the most pronounced is arthritis. Changes inherent in chronic inflammatory processes are frequent: cartilages become thinner and disappear, degenerate. Skin lesions, benign lymphocytomas are possible, which, when touched, respond with pain.
In the late stage, Lyme disease may be accompanied by chronic acrodermatitis. In the area of diseased areas, the skin integrates atrophy, in appearance it becomes similar to tissue paper. The duration of progress is months and years. Neuroborreliosis is observed. Encephalomyelitis, characteristic of the disease, is similar in manifestations to multiple sclerosis. Possible memory impairment, sleep impairment, speech disorder.
What to do?
If the disease proceeds at an average severity level, hospitalization is necessary, followed by the choice of a strategy for combating Lyme disease. Treatment of borreliosis is possible in an infectious hospital. With a mild form of the disease, treatment at home is allowed. Prescribe complex antimicrobial therapy. The choice of specific drugs, dosage regimen, dosage - at the discretion of the doctor. The doctor analyzes the severity of the disease, the particular case.
Persons who have suffered a bite and have had a disease are registered for at least two years in order to control the effects of tick-borne borreliosis (Lyme disease). Clinical examination involves a visit to a therapist, an infectious disease specialist. After 3, 6, 12, 24 months, full-fledged clinical studies are necessary, according to the results of which a referral to a cardiologist, neuropathologist or other highly specialized doctors is possible.
Particular attention should be paid to pregnant women with Lyme disease. Prevention of borreliosis currently does not involve the use of specific agents due to the lack thereof. The negative effect of the pathogen on the embryo is proved, especially strong at the beginning of gestation. In each case, individually decide how possible and reasonable to maintain a pregnancy.
How to warn?
So far, it has not been possible to develop such a vaccine that would prevent infection with borreliosis. The best method of ensuring health is to minimize the risk of a tick bite. Individual protective measures must be observed. An explanatory work is being carried out by doctors, responsible persons with the population, designed to convey the whole danger of tick bites and how to prevent them. As soon as a tick is noticed on the body, it is necessary to immediately remove the parasite. The causative agents of borreliosis live in the intestinal tract, so it takes some time to penetrate the human blood. The probability of infection is greater, the longer the parasite is on the human body.
The use of antibiotics after a tick bite to prevent Lyme disease currently remains open. It is believed that the course of antimicrobials in the first days after a tick bite can slightly reduce the risk of the disease, but the choice of drugs remains at the discretion of the doctor. To minimize the negative consequences, immediately after identifying a tick bite, contact the clinic for professional help.
Knowing the early signs is especially important given the lack of specific prevention of Lyme disease. The consequences of borreliosis detected on time are minimal if the patient is prescribed the correct treatment with antibacterial drugs.
What does it lead to?
The consequences of Lyme disease (borreliosis) should be feared to a greater extent if the patient has not received adequate treatment. In a predominant percentage, the prognosis for infection is positive. If the disease has progressed to the third, most difficult stage, has become chronic, the condition worsens over time. Possible skin degenerative processes, deformations in areas of localization of infectious foci. If untreated, there is a risk of disability or death.
Without adequate assistance, there is a likelihood of impaired functionality of the hearing and vision systems, memory loss and dementia, severe cardiac impairment, and muscle paralysis are possible. There are cases when borreliosis without treatment led to multiple arthritis and was the cause of the appearance of benign neoplasms. These are often localized near the point of a tick bite.
The disease belongs to the class of infectious, in the primary stage it is cured quite easily.It is much more difficult to achieve a cure at a late stage - in this case, the chance of negative consequences is especially high. To minimize the risks, after going out into the countryside, it is necessary to carefully examine the entire body for bites.
Important Nuances
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You can use cephalosporins or medicines containing erythromycin. The drug "Sumamed" has proven itself well.
If borreliosis is accompanied by arthritis, non-hormonal anti-inflammatory, analgesics and physiotherapy are prescribed. Antihistamines are indicated to reduce the chance of an allergic reaction. To restore the strength of the body at the stage of recovery, the patient is prescribed vitamin complexes, immunotherapy.