If a person has symptoms of Lyme disease after being outdoors, then this is a sign of a dangerous infectious pathology. It is transmitted through tick bites. Patients do not always associate a deterioration in well-being and an increase in temperature with an attack of the parasite. The incubation period of this disease can be quite long. Often a person by that time already forgets about a tick bite and takes the first signs of pathology for a common cold or flu. Meanwhile, bacteria infect organs and systems of the body. This disease is also called tick-borne borreliosis. At an early stage, it responds well to antibiotic treatment. But if you do not start therapy in time, then the infection can lead to serious complications.
Pathogen and routes of transmission
What is Lyme disease in humans? This is an infectious pathology that occurs with damage to the central nervous system, joints and internal organs. Its causative agents are the bacteria of Borrelia from the class of spirochetes. These microorganisms have a spiral shape. They release toxic substances that cause inflammation of the joints and other organs, as well as pathological changes in the central nervous system.
Borrelia penetrate the body through the bites of ixodid ticks. These blood-sucking parasites live in the forests and city parks of central Russia. They feed on the blood of wild or domestic mammals and can bite an animal suffering from borreliosis. After this, ticks become carriers of Lyme disease. Insects themselves remain healthy, since spirochetes are not pathogenic to their body. Biting a person, an infected tick releases Borrelia along with saliva. Bacteria enter the bloodstream, and after a while the patient develops the first symptoms of Lyme disease.
This disease is spread only by ticks. A sick person is not contagious and poses no danger to healthy people.
Pathogenesis
The incubation period of tick-borne borreliosis can be different. It lasts from 2 days to 1.5 months. In extremely rare cases, the latent period can be delayed up to several months and even years.
First, redness, swelling and soreness of the skin in the bite occurs. Then the first signs of Lyme disease appear. At the initial stage, this translates into an increase in temperature, a deterioration in overall well-being, aching joints and muscle pain. However, such symptoms are noted in many other infections, and it is difficult to diagnose borreliosis at this stage.
With the bloodstream, bacteria spread throughout the body. They penetrate into the nerve fibers and move to the central nervous system, causing severe inflammatory processes in the spinal cord and brain.
Part of borrelia dies in the body. When bacteria die, toxic substances are released into the bloodstream. The body's defense system begins to respond to foreign agents, producing circulating immune complexes. These compounds lead to damage to the joints, internal organs and nerve nodes. Inflammation and infiltrates form in the tissues. Tick-borne borreliosis is a serious systemic disease that affects almost the entire body.
In addition, living microorganisms secrete polysaccharide substances. They stimulate the body's production of protein - interleukin. It causes arthritis with degenerative joint changes and eye damage.
After recovery, a person has a very unstable immunity. Re-infection with borrelia is quite possible.
Stages of the disease
Infectious disease doctors distinguish three stages of Lyme disease:
- 1st stage. Its duration is from 3 days to 1 month. During this period, the patient has only skin manifestations and general intoxication of the body. Symptoms of pathology are non-specific and are characteristic of many other infectious ailments. The acute onset of the disease is characteristic.
- 2 stage. Borrelia begins to affect the spinal cord and brain, as well as peripheral nerves. Disturbances in the work of the heart are noted. The occurrence of inflammatory processes in various organs. This stage of the development of the disease can last up to 6 months.
- 3 stage. Bacteria affect the joints, severe arthritis occurs with severe pain. In some cases, this is combined with inflammation of the cornea. This stage of the pathology means that the disease has passed into a chronic form. Without treatment, the symptoms of Lyme disease progress, and the disease can result in disability.
If you start antibiotic therapy in the first stage, then in the vast majority of cases this leads to a complete recovery. Antibacterial treatment at an early stage of the disease helps prevent severe damage to the nervous system, heart and joints. Therefore, at the first signs of malaise after a tick bite, it is urgent to seek medical help.
Symptoms of the first stage
The first sign of Lyme disease at an early stage is a sharp deterioration in well-being. The patient has a fever, weakness and malaise, headache, aching joints. Sometimes intoxication is accompanied by sore throat, runny nose and inflammation of the conjunctiva. Therefore, patients often take the symptoms of the initial stage of the disease as a severe cold or flu.
However, even at the first stage of the pathology, a specific symptom can be noticed. At the site of the bite, redness occurs. It looks like a red rim around the wound. Its diameter is constantly increasing, and hyperemia spreads further along the skin. Doctors call this symptom of Lyme disease ring-shaped migratory erythema. A photo of the redness around the bite site can be seen below.
In the area of erythema, severe itching, soreness and burning are noted. Some patients develop a rash on their skin. It has the appearance of small reddish dots.
At this stage, diagnosing the disease is quite difficult. However, a combination of malaise with characteristic erythema and a tick bite in the anamnesis allow an experienced infectious disease specialist to suspect Lyme disease.
Symptoms of the second stage
If antibiotic therapy was carried out at the first stage, then the disease very rarely passes into the second stage. If the patient did not consult a doctor or treatment was insufficient, then the pathology develops further.
In the second stage, the symptoms of Lyme disease are associated with damage to the central and peripheral nervous system. If Borrelia enters the brain, then the patient has signs of meningoencephalitis:
- A severe pulsating headache occurs.
- During the day, repeated vomiting appears, not associated with eating.
- The cervical and occipital muscles are very tense.
- The patient has a fear of light and harsh sounds.
- For a long time, an elevated temperature is kept.
- The memory and concentration of attention worsens, insomnia is often observed.
Bacteria also affect peripheral nerves (facial, auditory, trigeminal). In this case, immobility of one half of the face is observed. This is due to a violation of the innervation of the facial muscles. It becomes difficult for the patient to make lip movements. The face looks asymmetrical and skewed. Patients complain of tinnitus and hearing loss.
If the infectious process affects the spinal roots, then symptoms appear that resemble manifestations of radiculitis or osteochondrosis. The pains are wandering in nature, they spread from the lower back to the lower legs or from the neck to the hands. The limbs are often numb, there is a burning sensation, a tingling sensation and a crawling feeling.
In more rare cases, with borreliosis, the heart suffers. At the same time, no serious violations were noted on the ECG. Patients complain of the following discomfort:
- tachycardia;
- pressing pains in the chest;
- difficulty breathing.
In addition, borrelia spreads with blood throughout the body and can cause inflammation in the spleen, liver, kidneys, throat, testicles, and ocular conjunctiva. If you do not start treatment at this stage, then the disease becomes chronic.
The clinical picture of the third stage
The third stage of the disease means the chronicity of the pathological process. A person has severe pain in the joints and muscles. Especially often, discomfort is localized in the neck. Such symptoms suggest that Borrelia has already begun to affect the musculoskeletal system.
Bone pain is accompanied by inflammation of the joints. Doctors call this sign lime arthritis. There is swelling and pain in the joints, it becomes difficult for a person to walk. Bone damage in borreliosis can progress and lead to disability due to limitation of movement in the limbs. These manifestations are sometimes combined with inflammation of the cornea of the eye.
In addition to the musculoskeletal system, in the third stage of the pathology of borrelia, the skin is affected. Reddish-cyanotic spots appear on the hands, feet, knees and elbows. In the future, the rashes disappear, and the skin in their place atrophies and undergoes sclerotic changes.
Features of the course of the disease in childhood
Lyme disease in children occurs with the same symptoms as in adults. However, a child in the second stage of the disease often develops signs of meningoencephalitis. For adults, peripheral nerve damage is more characteristic.
After recovery, the child may persist for a long time weakness, fatigue, tearfulness, sleep disturbances. Over time, these phenomena pass.
It should be noted that Lyme disease is most susceptible to children over 7 years old. In preschool age, this pathology is very rare.
Complications
Complications of the disease usually occur in advanced cases, in the third stage of the pathology. The following effects of Lyme disease are most commonly noted:
- Chronic Encephalomyelitis This neurological disorder is characterized by constant bouts of headache, vomiting, weakness, dizziness. In severe cases, mental abnormalities occur: memory loss, dementia, hallucinations.
- Chronic polyradiculopathy. With such a disease, a person has weakness in the legs and a feeling of numbness in the limbs. As a result, gait is impaired. Frequent attacks of tachycardia and a decrease in blood pressure are noted.
- Spastic paraparesis. Pathology is characterized by spasms of different muscle groups and the occurrence of involuntary movements.
In addition, progressive chronic arthritis in the third stage of the disease can lead to a significant restriction of movement and complete or partial disability.
Diagnostics
Therapy and diagnosis of Lyme disease is carried out by an infectious disease doctor. He examines the patient and collects an anamnesis. It is necessary to find out if a tick bite has occurred in recent months. The specialist draws attention to the presence of migratory erythema, signs of meningoencephalitis, damage to peripheral nerves and arthritis.
To clarify the diagnosis, an analysis for Lyme disease is prescribed . For this, blood is taken from the patient and a serological examination of the biomaterial is performed using the following methods:
- Enzyme immunoassay. The presence of antibodies to borrelia is detected. A positive test result means that the patient is suffering from Lyme disease.
- Indirect immunofluorescence reaction. A titer of antibodies to the causative agent of borreliosis is detected. If it is less than 1:64, then this means that the person is not sick with this infection.
- PCR Blood borrelia is detected. The presence of these microorganisms indicates a disease.
If borreliosis is detected in a person, then the study is repeated after 4 to 6 weeks. This allows you to determine the dynamics of the development of pathology and the effectiveness of therapy.
Treatment
Therapy of pathology is usually carried out in a hospital. The leading role in the treatment of Lyme disease is played by antibiotics that affect borrelia. They are prescribed in oral or injectable form. The following types of antibacterial drugs are used:
- "Tetracycline";
- Unidox Solutab;
- Amoxicillin;
- "Benzylpenicillin";
- Cefuroxime;
- Sumamed.
The most effective drug is Tetracycline. It is the first choice for Lyme disease. The remaining antibiotics are prescribed only if there is no effect from the use of Tetracycline.
Antibacterial therapy affects the cause of the disease. In addition, the patient needs symptomatic treatment aimed at stopping unpleasant and painful manifestations of the pathology:
- To relieve joint pain with lime arthritis, non-steroidal anti-inflammatory drugs are prescribed: Indomethacin, Nimesulide, Ketanov, Naproxen.
- With an itch in the erythema area, antihistamines are shown: Citrine, Erius, Zirtek, Suprastin.
- At the beginning of the disease at a high temperature, droppers with saline solutions are prescribed.
- With symptoms of meningoencephalitis, diuretics are prescribed to reduce brain edema: Furosemide, Veroshpiron.
- With paresis of the facial nerves, drugs that improve neuromuscular conduction are indicated: Cerebrolysin, Proserin, Oxazil.
During the recovery period, it is useful to take multivitamin complexes and fortifying herbal preparations from ginseng and eleutherococcus.
Forecast
If therapy is started at the first or second stage of the disease, then in most cases the pathology is completely cured. If the infectious process goes into a chronic form, then the prognosis is significantly complicated. In the third stage of borreliosis, it is very difficult to achieve a full recovery. Often there comes a permanent disability due to irreversible changes in the nervous system and joints.
What to do after a tick bite
If a person was bitten by an ixodid tick, you must immediately contact the infectious disease office of the clinic. In this case, a preventive course of antibacterial therapy is carried out to prevent the disease.
Prescribe the antibiotic "Doxycycline" ("Unidox Solutab"). It is taken 100 mg once a day. The course of therapy is 5 days. At the same time, you need to use 1000 mg of Ceftriaxone per day for 3 days.
Such emergency prevention can prevent the onset of the disease in 80% of cases. However, these measures are effective for 3 to 5 days after the bite, while the bacteria have not yet managed to enter the bloodstream. The earlier the preventive treatment is carried out, the more chances to avoid the development of the disease.
Prevention
There is currently no vaccine for this disease. Therefore, the prevention of borreliosis is to prevent tick bites.
When walking through forests and parks, it is necessary to wear closed clothing and apply insect repellents to the skin. It is necessary to contact as little as possible with grass and foliage of trees, it is in such places that ticks most often live. You should periodically inspect your clothes and skin to make sure there are no parasites.
If the tick has stuck into the skin, then it must be removed. To do this, put on gloves on your hands and remove the insect with tweezers. It is very important to remove it completely so that the proboscis and head do not remain in the skin. In no case should you crush the tick, this can lead to infection.
It should be remembered that ticks attack not only people, but also pets. Therefore, during a walk in nature with a dog, you need to periodically inspect the pet's hair and remove parasites in time. This will help reduce the risk of contracting a dangerous infection.