Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.
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Lyme disease symptoms can vary widely, which makes it hard to diagnose. The disease can affect different parts of the body at different times. How the bacteria are transmitted depends on the feeding habits of the Ixodes tick. Knowing how the infection spreads and what symptoms to look for is important for early treatment and preventing long-term problems.
An Infectious Disease Specialist acts as a medical detective. They are consulted when an infection is difficult to diagnose, is accompanied by a high fever of unknown origin, does not respond to standard treatment, or involves a patient with a weakened immune system. Furthermore, this department plays a critical role in public health and hospital safety, managing infection control protocols to prevent the spread of resistant bacteria (superbugs) within healthcare settings.
Lyme disease is not passed right away when a tick bites. The tick must stay attached for a while. The bacteria live in the tick’s gut and only become active when the tick starts feeding. They then move to the tick’s salivary glands, a process that usually takes 36 to 48 hours of feeding.
The hallmark of the early localized stage is the Erythema Migrans (EM) rash. While classically described as a “bull’s-eye” rash, clinical reality is more diverse.
If Lyme disease is not treated, the bacteria can spread and cause more serious problems in different organs weeks or months after the bite.
If not treated, some people develop long-term symptoms months or years after being bitten.
Symptoms can differ depending on the type of Borrelia bacteria. In Europe, some strains are more likely to cause nerve problems, while in North America, joint pain is more common. Borrelia mayonii, a newer strain, can cause unusual symptoms like nausea, vomiting, and widespread rashes instead of the typical single rash.
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The classic Lyme disease rash, known as Erythema Migrans, often resembles a bull’s-eye target, with a red center surrounded by a clear ring and an outer red ring. However, many rashes do not follow this pattern and may appear as a solid, expanding red or pink oval. It is usually flat, warm to the touch, and develops over several days, rarely causing itching or pain.
Yes, a significant percentage of patients diagnosed with Lyme disease do not recall having a rash. Estimates vary, but some studies suggest that 20% to 30% of patients may not develop or notice the Erythema Migrans rash. Therefore, the absence of a rash does not rule out Lyme disease if other symptoms and risk factors are present.
In general, a tick must be attached for at least 36 to 48 hours to transmit the Lyme disease bacterium effectively. The bacteria reside in the tick’s gut and require time to multiply and migrate to the salivary glands once feeding begins. Prompt removal of ticks within 24 hours of attachment significantly reduces the risk of infection.
Lyme carditis occurs when the bacteria enter the heart tissue and interfere with electrical signals. The most common symptom is heart block, which can cause the heart to beat too slowly or irregularly. Patients may experience lightheadedness, fainting, shortness of breath, palpitations, or chest pain. It is a serious complication that requires immediate medical attention.
If left untreated, Lyme disease can cause chronic arthritis, particularly in the knees. While the inflammation can be severe and recurrent, it typically does not cause the same level of permanent bone destruction seen in rheumatoid arthritis. However, long-standing untreated inflammation can damage the cartilage and surrounding tissues, leading to lasting joint dysfunction in some cases.
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