Early localized Lyme infection

Definition

Lyme disease is an inflammatory disease spread through a tick bite.

Primary Lyme disease is the first stage of the disease. For specific information on the other stages or general information about Lyme disease, see:

• Lyme disease
• Stage 2 Lyme disease
• Stage 3 Lyme disease

Alternative Names

Early localized Lyme infection; Lyme borreliosis; Stage 1 Lyme disease; Lyme disease - primary

Causes

Lyme disease is caused by the bacteria Borrelia burgdorferi (B. burgdorferi). Certain ticks carry the bacteria. The ticks pick up the bacteria when they bite mice or deer that are infected with Lyme disease. You can get the disease if you are bitten by an infected tick.

The first stage of Lyme disease is considered the "primary" stage.

Risk factors for Lyme disease include walking in high grasses, taking place in activities that increase tick exposure, and having a pet that may carry ticks home.

Symptoms

Not everyone infected with the Lyme disease bacteria gets ill. Among those who do become ill, the first symptoms resemble the flu and include fever, headache, chills, muscle pain, and lethargy. This is the primary stage of the disease, also known as primary Lyme.

There may be a "bulls-eye" rash, a flat or slightly raised red spot at the site of the tick bite often with a clear area in the center. This lesion can be larger than 1 to 3 inches wide.

Stiff neck, joint inflammation, body-wide itching, unusual or strange behavior, and other symptoms may be seen in persons with later stages of the disease.

Note: 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.

Exams and Tests

A blood test can be done to check for antibodies to the bacteria that causes Lyme disease. The most common one used is the ELISA for Lyme disease test. A western blot test is done to confirm ELISA results. The tests are 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 Lyme disease bacteria.

Treatment

Antibiotics are used to treat Lyme disease. The specific antibiotic used depends on the stage of the disease and your symptoms.

Outlook (Prognosis)

If diagnosed in the early stages, Lyme disease can be cured with antibiotics, usually in 3 to 4 weeks. Without treatment, complications involving joints, the heart, and the nervous system can occur.

Possible Complications

Untreated, advanced stages of Lyme disease can develop. Complications related to advanced Lyme disease include long-term joint inflammation (Lyme arthritis) and heart rhythm problems. Neurological problems are also possible, and may include:

• Decreased concentration
• Memory disorders
• Nerve damage
• Numbness
• Pain
• Paralysis of the facial muscles
• Sleep disorders
• Visual disturbances

Another complication is an additional infection with ehrlichiosis or babesiosis bacteria.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have symptoms of Lyme disease, particularly if you could have been exposed to ticks.

Call your health care provider if you have had a tick bite and develop weakness, numbness or tingling, or heart problems.

Prevention

When walking or hiking in wooded or grassy areas, tuck long pants into socks to protect the legs, and wear shoes and light-colored, long-sleeved shirts. Ticks show up better on white or light colored-clothing than dark items. Spray your clothes with insect repellant.

Check yourself and your pets frequently. If you find ticks, remove them immediately by using tweezers, pulling carefully and steadily.

Ticks that carry Lyme disease are usually so small that they are almost impossible to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp.

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