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| '''To go back to Lyme disease main page, click [[Lyme disease|here]]'''
| | {{CMG}}; {{AE}} {{Anmol}} |
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| {{CMG}}; {{AE}}{{Anmol}}
| | ==Tables== |
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| ==Overview== | | |+ |
| * [[Lyme disease]] is a condition commonly caused by bite of a tick infected with Borrelia burgdorferi.
| | !Diagnosis |
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| ==What are the symptoms of Lyme disease?==
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| * It's important to know the symptoms of Lyme disease and to seek medical help if you think have Lyme disease.
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| *Early signs and symptoms (3 to 30 days after tick bite):
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| **The first symptom is usually a red rash at the site of tick bite, which may look like a bull's eye. But not all people with Lyme disease have a rash. The rash is called erythema chronicum migrans or erythema migrans (EM).
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| ***EM occurs in approximately 70 to 80 percent of infected persons.
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| ***EM begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days).
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| ***Em expands gradually over a period of days reaching up to 12 inches or more (30 cm) across.
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| ***EM may feel warm to the touch but is rarely itchy or painful.
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| ***Sometimes, EM clears as it enlarges, resulting in a target or “bull’s-eye” appearance.
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| ***EM may appear on any area of the body but majority of times present in areas including axilla, inguinal region, popliteal fossa, or along belt line.
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| **The rash may or may not be associated with flu-like symptoms including:
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| ***Fever and/or chills
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| ***Headache
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| ***Body aches
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| ***Joint aches
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| ***Headaches
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| ***Stiff neck
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| ***Fatigue
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| [[Image:Classic Lyme disease rash.jpg|thumb|250px|center|Classic Lyme disease rash - [https://www.cdc.gov/lyme/signs_symptoms/rashes.html Source: CDC.gov]]]
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| *Later Signs and Symptoms (days to months after tick bite):
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| **Severe headaches and neck stiffness
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| ***Multiple EM rashes on other areas of the body
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| ***Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
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| ***Facial palsy (loss of muscle tone or droop on one or both sides of the face)
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| ***Intermittent pain in tendons, muscles, joints, and bones
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| ***Heart palpitations or an irregular heart beat (Lyme carditis)
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| ***Episodes of dizziness or shortness of breath
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| ***Inflammation of the brain and spinal cord
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| ***Nerve pain
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| ***Shooting pains, numbness, or tingling in the hands or feet
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| ***Problems with short-term memory
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| ===Notes===
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| *Fever and other flu-like symptoms may occur in the absence of rash.
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| *A small bump or redness at the site of a tick bite that occurs immediately and resembles a mosquito bite, is common. This irritation generally goes away in 1-2 days and is not a sign of Lyme disease.
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| *A rash with a very similar appearance to EM occurs with Southern Tick-associated Rash Illness (STARI), but is not Lyme disease*
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| *Ticks can spread other organisms that may cause a different type of rash.
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| ==What causes Lyme disease?==
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| * Lyme disease is caused by a bacterial infection you get from bite of an infected tick.
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| *The majority of Lyme disease in North America is caused by bite of black-legged tick, or deer tick(''[[Ixodes Scapularis]]'').
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| *Other ticks that transmit Lyme disease are [[Ixodes ricinus|sheep tick]], [[Ixodes ricinus|castor bean tick]], or [[Ixodes ricinus|European castor bean tick]] (''[[Ixodes ricinus]]'') in the Europe; [[Ixodes pacificus|Western black legged tick]] (''[[Ixodes pacificus]]'') in the Pacific region of North America; taiga tick (''Ixodes persulactus'') Europe, Central and Northern Asia, China, and Japan.
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| *Only 20% of individuals [[Infection|infected]] with [[Lyme disease]] by the [[Ixodes scapularis|deer tick]] are aware of having had any [[tick]] bite.
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| [[Image:Ixodes scapularis.png|center|200px|thumb|'''''I. scapularis'', the primary vector of Lyme disease in Eastern North America''' - Source: Gross L (2006) A New View on Lyme Disease: Rodents Hold the Key to Annual Risk. PLoS Biol 4(6): e182. https://doi.org/10.1371/journal.pbio.0040182
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| ==Who is at highest risk?== | | ==References== |
| Individuals who spend time outdoors and/or have pets that go outdoors in [[Endemic (epidemiology)|endemic]] regions are at risk for [[tick-borne disease]]. <ref name="TGI CDC”">General Information (2015). http://www.cdc.gov/ticks/index.html Accessed on December 30, 2015</ref>
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| ===Exposure to ticks===
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| *Individuals with frequent exposure to dogs and who reside near wooded areas or areas with high grass may also be at increased risk of [[tick-borne infection]].
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| *Individuals with outdoor occupations and who work outside with bare or exposed [[skin]] are at a high risk of contracting Lyme disease.
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| *Failing to remove a [[tick]] as soon as you see it on your [[skin]] (the longer a [[tick]] is attached to your skin, the greater your risk of developing [[Lyme disease]]) also increases risk of developing Lyme disease.<ref name="urlLyme disease: All - MayoClinic.com">{{cite web |url=http://www.mayoclinic.com/print/lyme-disease/DS00116/METHOD=print&DSECTION=all |title=Lyme disease: All - MayoClinic.com |format= |work= |accessdate=2013-03-14}}</ref>
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| ===Endemic Regions===
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| *About 95% of all reported cases are confined to 14 states including Connecticut, Delaware, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.<ref name="urlLyme disease data tables | Lyme Disease | CDC">{{cite web |url=https://www.cdc.gov/lyme/stats/tables.html |title=Lyme disease data tables | Lyme Disease | CDC |format= |work= |accessdate=}}</ref><ref name="urlData and Statistics | Lyme Disease | CDC">{{cite web |url=https://www.cdc.gov/lyme/stats/index.html |title=Data and Statistics | Lyme Disease | CDC |format= |work= |accessdate=}}</ref>
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| *Any individual traveling or living within these five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central is at a heightened risk of exposure to [[Lyme disease]].
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| ===Seasonal Variation===
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| *The majority of [[Lyme disease]] cases are reported during the summer months of May to August.
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| *Case incidence increases in May, peaks in June and July, and tapers off in August.
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| ===Rarer forms of Transmission===
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| * Cases of [[blood transfusion]] and [[organ transplantation]] have been recorded as methods of [[Transmission (medicine)|transmission]] but this is a rare mode of transmission. <ref name="translyme">Lyme disease transmission. Centers for Disease Control and Prevention. http://www.cdc.gov/lyme/transmission/index.html Accessed February 9, 2016. </ref>
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| ==Diagnosis==
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| *Following points should be taken into consideration in order to make a diagnosis of Lyme disease:
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| **A history of exposure to potentially infected ticks, especially in areas of the country known to have Lyme disease.
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| **Symptoms, including physical findings such as the characteristic rash.
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| **Results of blood tests that check for antibodies to the bacterium that causes Lyme disease.
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| ==When to seek urgent medical care?==
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| *Lyme disease is rarely fatal.
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| ==Treatment options==
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| *According to CDC, patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely.
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| *Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil (Ceftin).
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| *Patients with certain neurological or cardiac forms of illness may require intravenous treatment with drugs such as ceftriaxone or penicillin.
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| ==Where to find medical care for Lyme disease?==
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| *In this section you can provide links for reputable places that the patient can find good treatment for there condition.
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| ==Prevention==
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| *Educate yourself about Lyme disease, and try not to get bitten by ticks. More specifically:
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| *Avoid wooded, brushy, and grassy areas, especially in May, June, and July. (Contact the local health department or park/extension service for information on the prevalence of ticks in specific areas.)
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| *Wear light-colored clothing so that you can see ticks that get on you.
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| *Wear long pants and long-sleeved shirts.
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| *Wear shoes that cover the entire foot. Tuck pant legs into socks or shoes, and tuck shirts into pants.
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| *Wear a hat for extra protection.
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| *Spray insect repellent containing DEET on clothes and exposed skin other than the face, or treat clothes with permethrin, which kills ticks on contact.
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| *Walk in the center of trails to avoid brush and grass.
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| *Remove your clothing, and wash and dry them at high temperatures after being outdoors.
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| *Do a careful body check for ticks after outdoor activities.
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| *If a tick is attached to you, remove it!
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| **Using tweezers, grasp the tick close to the skin, pull straight back, and avoid crushing the tick's body.
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| **Save the tick for possible identification by a doctor or the local health department.
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| ==What to expect (Outlook/Prognosis)?==
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| *For early cases, prompt treatment is usually curative.
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| *However, the severity and treatment of Lyme disease may be complicated due to:
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| **Late diagnosis
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| **Failure of antibiotic treatment
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| **Coinfection with other tick-borne diseases including Ehrlichiosis and Babesiosis
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| **Immune suppression in the patient
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| *Some patients with Lyme disease have fatigue, joint and/or muscle pain, and neurocognitive symptoms persisting for years despite antibiotic treatment.
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| *Patients with late stage Lyme disease have been shown to experience a level of physical disability similar to that seen in congestive heart failure.
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| *Though rare, Lyme disease can be fatal.
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| ==Possible complications==
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| *Late Lyme disease can cause long-term joint inflammation (Lyme arthritis) and heart rhythm problems. Brain and nervous system problems are also possible, and may include:
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| **Decreased concentration
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| **Memory disturbances
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| **Nerve damage
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| **Numbness
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| **Pain
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| **Paralysis of the face muscles
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| **Sleep disorders
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| **Vision problems
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| ==Sources==
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| * https://medlineplus.gov/lymedisease.html
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| * https://www.cdc.gov/lyme/index.html
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| * https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049298.htm
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| * Place your patient page in the patient information category as well as any other doctor categories the condition may fit into. To place a category onto a page, use the following code:
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| **<nowiki>[[Category:Patient information]]</nowiki>
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| * As with all WikiDoc pages, create hyperlinks for key words and diseases. However, make sure that the hyperlinks link to other patient's information pages and not to regular WikiDoc pages.
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| ** Example: Heart failure should be linked to <nowiki>[[Congestive heart failure (patient information)]]</nowiki> and not to <nowiki> [[Heart failure]]</nowiki>.
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