The first presentation of Lyme disease occurred in 1975 in a group of children in Lyme, Connecticut. The bacterial cause of this illness was not identified until 1982. Ticks found on deer carry the bacterium in their stomachs. The bacterium enters the human host following a tick bite. A distinctive rash and flu-like symptoms present in the early phase. As Lyme disease progresses, the joints, heart, and nervous system are affected. Early diagnosis and prompt medical treatment ensures the best prognosis.
Early Localized Disease: Bull's Eye Rash & Flu-like Symptoms
Within days of the tick bite, a “bull’s eye” rash develops at the site. Called erythema migrans, the rash develops an expanding ring of redness. MedicineNet further describes the rash pattern as an outer ring of brighter redness and a central area of clearing, thus a “bull’s eye” appearance. Interestingly, more than one in four individuals do not get a rash with Lyme disease. Typically, a person will have flu-like symptoms, such as fatigue, swollen glands, joint and muscle stiffness, and headache. Without treatment, the rash resolves in about one month, but the infection continues to spread throughout the body.
Early Disseminated Disease: Painful Joints, Lyme Carditis & Nervous System Involvement
The National Institute of Allergy and Infectious Diseases states that several months after the initial infection, more than half of the untreated cases will develop recurrent attacks of painful and swollen joints. The knee is the most commonly affected joint. An estimated 10 to 20% of people who are not treated with antibiotic therapy will suffer from chronic arthritis.
During this phase of untreated Lyme disease, there is cardiac involvement. Cardiac abnormalities include defects in the conduction system and inflammation of the heart muscle and pericardium. As the infection spreads to the heart, Lyme carditis develops. According to the Journal of Invasive Cardiology, an estimated four to ten percent of untreated patients develop Lyme carditis. Symptoms include cardiac arrhythmias such as a slow or irregular pulse. The cause is heart block which in varying degrees, indicates a delay in the transmission of electrical impulses through the AV nodes and bundle branches of the heart. Inflammation of the heart muscle called myocarditis Inflammation of the heart muscle and the pericardium which is the sac that surrounds the heart causes sharp chest pain, shortness of breath, and fatigue.
Involvement of the nervous system is displayed by numbness and weakness in the limbs. The Mayo Clinic warns that untreated, Lyme disease can progress to meningitis, which is the inflammation of the membranes surrounding the brain. Bell’s palsy, which is a temporary paralysis of one side of the face can occur.
Late Disease: Arthritis & Brain Inflammation
Untreated Lyme disease that advances to the late phase causes motor and sensory nerve damage, brain inflammation and arthritis. An article in the New England Journal of Medicine October 2007 issue lists arthritis as the most common symptom of late disease, often referred to as chronic Lyme disease. In the United States, there have been reported cases of untreated patients suffering from recurrent or persistent arthritis lasting up to several years. Rare manifestations of late disease include encephalopathy and peripheral neuropathy.
Maryann Gromisch - Maryann Gromisch is a registered nurse with clinical experience in medical, surgical, and critical care nursing. She has been a freelance ...
