Lyme disease

Health and Nutrition > Diseases > L Reviewed by Dr Paul Klenerman, specialist

What is Lyme disease?

Lyme disease is an infection that derives from a tick bite. The disease has a variety of symptoms, including changes affecting the skin, heart, joints and nervous system. It is also known as borrelia or borreliosis.

What causes Lyme disease?

Lyme disease is caused by an infection from a micro-organism (Borrelia burghdor feri), itself transmitted by a bite from the wood tick, a blood-sucking parasite which normally lives on deer.

The wood tick is found in many areas, particularly in forests where deer are common. A tick will settle anywhere on a human body, but prefers warm, moist and dark places like the crotch or armpits.

When the tick has found a suitable place on the body, it sticks in its probe to draw up blood, exposing the host to the risk of infection.

What does Lyme disease feel like?

Simply seeing a tick somewhere on your body does not mean that you have contracted Lyme disease. Unfortunately, not everyone knows when they have been bitten, so consult your GP if you detect the following symptoms.

- A red spot around the location of the tick's bite. The spot will gradually grow bigger, often with a pale area in the middle. This symptom is called erythema migrans.
- Erythema migrans can also appear at other places on the body where the tick has not bitten. Some people get many red spots.
- Usually one to four weeks will pass between the bite and when erythema migrans appears.

Some patients with Lyme disease feel like they have caught influenza - the symptoms may be:

- drowsiness
- headaches
- mild fever
- joint and muscle pains
- swollen lymph glands.

What complications may occur?

Acrodermatitis chronica atrophicans This is a condition that often develops in older women. Several years may pass from the tick bite until the development of this phenomenon. The symptoms usually involve changes in the skin around the tick bite, such as:

- swelling
- bluish or reddish discoloration of the skin.

Neuro borrelia

About 15 per cent of people with borrelia develop so-called neuro borrelia, between one and five weeks after the tick bite. The central nervous system is affected and the symptoms that result are very mixed and not specific.

- The symptoms often begin with back pain, typically between the shoulder blades and in the neck like a slipped disc. The pain worsens at night.
- Distorted feelings around the area of the bite. The nerves become numb, especially in the face. This may occur at any time up to four weeks after the pain began.
- Sometimes neuro borrelia may present itself as meningitis, with fever, headache and stiffness in the neck.
- In rare cases, the disease may become chronic, with a slowly developing destruction of the nervous system, numbing, partial hearing impairment and the development of dementia.

- Neuro borrelia demands immediate treatment, usually with an admission to hospital.

Inflammation of the joints or Lyme arthritis

. This condition may present itself in days or, rarely, years after the bite, but it is very rare. The inflammation of the joints causes pain and swelling. Often, only one joint is inflamed and, rarely, more than three. The most commonly affected joint is the knee followed by the shoulder, elbow, foot, and hip. It has symptoms similar to arthritis.

When treated, the swelling will go away in about one to four weeks but it may return in later months or even years.

Effects on the heart

Lyme disease may cause:

- inflammation of the heart tissues, along with arrhythmia
- heart failure may develop in severe cases.

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