Individuals with this rash usually do not feel pain though the area affected by the rash may feel warm. Apart from the rash, at this stage the patients also do exhibit symptoms such as fever, generalized fatigue, headaches, swollen lymph nodes, chills, joint aches and muscle aches (CDC, 2008). Without medical intervention, this rash takes approximately one month to resolve (CDC, 2008). For some individuals, the symptoms may stop here or may proceed to the next phases.
The next two phases of the disease are characterized by dissemination of the disease to other body parts especially the cardiac and nervous systems. This takes days to weeks and it leads to symptoms such as severe headaches, joint aches, heart palpitations due to inflammation of cardiac muscles, neck stiffness as a result of meningitis, loss of muscular tonicity which can occur on one or both sides of the face (Bell’s palsy) (ALDF, 2010). These symptoms do resolve naturally after a while though medical intervention can also be employed.
If the disease goes untreated for several months, serious problems do start to occur. They include numbness in limbs as a result of peripheral neuropathy, arthritis which usually occurs in form of intermittent bouts and usually affects one or two large joints, confusion, and impaired concentration ability accompanied by a short memory (ALDF, 2010). There is need for care when diagnosing Lyme disease as most of the symptoms associated with this disease are also seen with other diseases.
Mostly, the basis for the diagnosis of this disease is the symptoms, presence of findings such as Bell’s palsy, erythema migrans and arthritis upon physical examination, and possibility of one having been exposed to infected ticks (ALDF, 2010). Laboratory tests such as serologic testing can be done but in the presence of the circular rash they are not recommended as this rash is characteristic of Lyme disease (CDC, 2008). The diagnosis of Lyme disease applies the exclusion method where the doctor will carefully examine the patient’s body as well as the patient’s history to exclude diseases whose symptoms are similar.
Signs and symptoms that the disease shares with other diseases include fever, headaches, general fatigue, fever, meningitis, joint aches, heart palpitations and confusion. If the signs and symptoms are characteristic of Lyme disease, then the patient should go for laboratory testing. In diagnosis, there are two blood methods that are currently recommended by the CDC but there is ongoing research on this area. These are serologic tests and so they detect the presence of antibodies against the bacteria in blood. The two tests are done together in a two-step process.
In the first step, an ELISA (enzyme linked immunosorbent assay) or IFA (indirect fluorescent antibody) is carried out. These tests are so sensitive that it tests positive for all people with the disease and sometimes it even gives false positives. In case a test turns negative, chances are usually high that the individual has no Lyme disease and in such a case more tests are not recommended (CDC, 2008). On the other hand if the test is positive or uncertain, the blood sample is usually analyzed further using western blot method and this forms the second step of the process (CDC, 2008).
Its aim is usually to confirm the results obtained with the ELISA method and the property that makes them suitable for this purpose is that they are very specific. This means that it cannot give a positive if an individual is not infected with the bacterium. It is so specific that if the first stage of analysis gave a positive and then gives a negative with the second stage it means that the original findings using ELISA were wrong (CDC, 2008). The two types of western blots that are sometimes applied include IgG and IgM.
For patients who test positive for only IgM, the test is usually repeated after a few weeks if the symptoms persist. If at this time the results are still positive for only IgM, then the results are interpreted as a false positive. There are shortcomings that are associated with laboratory tests and one of them is the possibility of a false negative in the early stages of infection (CDC, 2008). The other shortcoming is that there is possibility of getting false positive results as the antibodies do remain in the body for years after successful treatment of the disease.
In addition, false positives also do occur with patients who have symptoms which are not specific to Lyme disease. If after diagnosis the patient is confirmed as having been infected by the bacteria for Lyme disease, the patient is usually put on treatment. Mostly, the disease is cured by use of oral antibiotics. However, the treatment plan depends on the organs that are affected as well as the stage of the disease (Nitch, 2007). The earlier the treatment is done, the higher the rate of cure.
The commonly used antibiotics for treatment of this disease in early stages include cefuroxime axetil, doxycycline, and amoxicillin (CDC, 2008). Use of these antibiotics leads to resolution of the rash within duration of 1-2 weeks with no possibility of future recurrence. In later stages of the disease where the nervous system and the heart are affected, the treatment plan involves use of intravenous drugs such as penicillin G and ceftriaxone.
This gives good results but in some individuals the disease persists for years following commencing of treatment and yet others will experience recurrent symptoms (CDC, 2008). Prolonged treatment with these intravenous drugs is not recommended due to the side effects experienced by patients (Lipsker & Jaulhac, 2009). To relieve the symptoms, the patients are given painkillers. If the patient has swollen joints, the fluid is usually removed through a method known as anthrocentesis. References American Lyme Disease Foundation. (2010).
Lyme disease. Retrieved May 11, 2010 from http://www. aldf. com/lyme. shtml#prevalent Centers for Disease Control. (2008). Lyme disease. Retrieved May 11, 2010 from http://www. cdc. gov/ncidod/dvbid/lyme/ld_prevent. htm Lipsker, D. & Jaulhac, B. (2009). Lyme borreliosis: Biological and clinical aspects. Switzerland: Karger. Nitch, P. V. (2007). Research on Lyme disease. New York, NY: Nova Science Publishers, Inc. Todar, K. (2008). Online textbook of bacteriology. Retrieved May 11, 2010 from http://textbookofbacteriology. net/Lyme. html