Lyme disease (Borreliosis)
Description of the disease
Lyme disease (Lyme disease) – the most common disease transmitted by ticks ( Ixodes ricinus and Ixodes persulcatus species) in Europe, the USA, and Canada. The causative agent of Lyme disease is bacteria living in the tick’s gut, called Borrelia, which has 11 species. Three of them are dangerous to humans, namely: Borrelia burgdorferi sensu stricto , Borrelia garinii , and Borrelia afzelii (the latter dominates in the Baltic countries). The greatest risk of infection is if the tick has been attached for 48 hours.
Symptoms
9 out of 10 infected individuals have the infectious process remain in the skin. A rash can appear on any skin area, most commonly on the face, neck, or ears in children. The rash is > 5cm, painless, in the shape of a ring. The rash can appear in one skin area, then in another, and eventually disappear completely, ending the infection. For other individuals, Lyme disease spreads throughout the body and causes damage to the joints, heart, eyes, skin, and nervous system, which can manifest after several weeks, months, or even several years. These include:
a) Bluish-violet spots on the skin of the hands, feet, or buttocks, often with swelling. This spot later becomes sensitive, painful, with enlarged lymph nodes around it, sensory disturbances. Later, the skin thins, small blood vessels become visible through it.
b) Neuroborreliosis (Borrelia-induced damage to the nervous system) usually manifests within the first six months of infection. There is a condition called Garin-Bujadoux-Bannwarth syndrome, which consists of several symptoms. This includes meningitis, presenting as severe headaches, nausea, and vomiting; inflammation of the nerves exiting the spinal cord and/or facial nerve damage. In this syndrome, the pain is severe, constant, patients cannot find a comfortable position, the pain intensifies at night, causing patients to walk. Facial nerve damage manifests as impaired facial sensation, drooping of the corner of the mouth, drooling, inability to close the eye or clench the jaw. Cases of deafness, eye movement disorders, and imbalance may occur.
c) Joint inflammation – usually of the knees or elbows. The joint is swollen, painful, red, hot. In 10% of patients, acute joint inflammation progresses to chronic.
d) Eye involvement (sensitivity to light, redness, pain).
e) Heart damage. Characteristic changes in the electrocardiogram.
Diagnosis
Clinical symptoms and epidemiological data (tick attachment, presence in the forest) are very important for diagnosis.
The main laboratory tests include examination of cerebrospinal fluid, showing inflammation and antibodies against this bacterium (IgM). These are also tested in human blood.
Treatment
Lyme disease often resolves on its own, but antibiotic treatment is still applied. This helps alleviate the symptoms of the disease and promotes faster recovery. The most commonly prescribed are doxycycline, penicillin G, and third-generation cephalosporins (ceftriaxone).
Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology