Lyme Disease

Lyme Disease
Lyme disease is an infectious disease, the causative agents of which are the motile spirochete Borrelia Burgdorferi, known today as the causative agent of Lyme disease or lyme borreliosis. The disease has become known to modern medicine relatively recently. In 1975, in the town of Lyme (hence the name of the disease), several children living in the neighborhood suffered atypical forms of rheumatoid arthritis with uncharacteristic symptoms. Scientists have suggested the bacterial etiology of this disease, and in the course of research, a motile spirochete Borrelia Burgdorferi was discovered. Another name for this disease is tick—borne borreliosis. This is due to the fact that the disease is classified as infectious, transmitted by transmission when bitten by a special kind of ixoid mites. In turn, the tick can become infected after it has bitten ungulates, some birds, small rodents, dogs, etc.

The content of the article:
Causes of Lyme disease
How does infection occur?
Symptoms of Lyme disease
Diagnosis of Lyme disease
Lyme disease: treatment, prevention and medical prognosis
Lyme Disease
Lyme disease occurs only when a tick is bitten. There is no data on infection of one person from another, however, there are cases when the disease was transmitted vertically — from the mother to the fetus during pregnancy, which suggests the ability of the infection to penetrate the placental barrier.

At the onset of the disease, the patient has localized skin lesions (more often single, but there are also multiple). With the development of the disease, the patient has various changes in the work of internal organs and their systems. In most cases, various systemic manifestations are diagnosed with a characteristic lesion of the central nervous system, musculoskeletal system, cardiovascular system, etc.

Causes of Lyme disease
The causative agents of the disease are considered to be bacteria of the genus borrelia of three different species. One of the species is common in North America and is not found elsewhere. The other two species that can cause Lyme disease are more common in Eurasia.

Recent studies suggest that the transmission of bacteria can be carried out not only by ticks, but also by some other parasites. It was noticed that the occurrence of Lyme disease was preceded by infection of the patient with pediculosis. Scientists have found that such types of lice as human and pubic lice can also be carriers of a bacterial infection that causes borreliosis.

How does infection occur?
The bacteria that cause borreliosis are contained in a special secret of the salivary glands of parasites. Bacteria enter the human body when a tick or lice bite. Almost immediately, a characteristic redness appears at the bite site. On the periphery of the affected area there are elements of a rash — erythema.

From the bite site, bacteria enter the human lymphatic system and quickly spread to all organs and tissues of the human body. This process is accompanied by the appearance of various foci of inflammation. Most often, the inflammatory process involves the structures of the skin, spleen, brain and musculoskeletal system. Any inflammation automatically causes the immune system to work in an emergency mode. This leads to the fact that the virus cells begin to die, a huge amount of decay products enters the human body, which leads to general intoxication of the body. Moreover, some decay products are capable of triggering a number of autoimmune reactions. The formed antibodies begin to destroy not only the causative agent of infection, but also their own tissues. This applies to those areas where the largest number of bacterial cells has accumulated. Gradually, such autoimmune reactions come to naught, and the processes of restoration of damaged tissues or regeneration begin.

Symptoms of Lyme Disease
In the clinical course of this disease, it is customary to distinguish early and late periods. The early period includes two stages: local infection and spread throughout the body (dissemination). The late period is characterized by the persistence stage, this is the period when the virus is in the most active state. Each of these periods has characteristic symptoms.

Immediately after the insect bite, the patient may not experience any discomfort. Only a barely noticeable redness appears on the skin. This period is considered to be incubation, and its duration is 1-2 weeks (some sources indicate that the incubation period can last from 3 to 32 days). The bite mark is so small that the patient often does not notice it at all.

At the end of the incubation period, the papule at the site of the lesion begins to increase in size, sometimes reaching 20 centimeters in diameter. Such a lesion has a specific appearance. Along the edge of the reddened area, a very clear outer border is formed, having a bright pink or red color. Closer to the center of the formation, the skin is lighter. This formation is called migrating chronic ring erythema, it is noted in 75% of all clinical cases. In addition to the skin signs of the disease, there are often phenomena of general intoxication of the body: fever, chills, muscle pain, weakness, nausea, dizziness, fatigue, etc. These symptoms go away after a few weeks, even if the patient does not take any symptomatic therapy.

There are also a number of non-specific symptoms that are noted in Lyme disease: allergic reactions (urticaria), various pathological conditions of the visual organs (conjunctivitis), lesion of ENT organs (rhinitis, pharyngitis and others), and the lymph nodes closest to the bite site may also increase and become inflamed.

The next stage in the development of Lyme disease is the period of dissemination. It occurs one to three months after the onset of the disease. At this stage, there is an infectious lesion of all human organs and tissues. The most serious damage is to the nervous, musculoskeletal and cardiovascular systems.

On the part of the nervous system , the following signs of Lyme disease may be observed:

encephalitis phenomena;
meningitis;
various neuritis, including facial nerve neuritis;
myelitis;
chorea;
cerebral ataxia, etc.
Such pathologies are noted both in independent types and in various combinations. These changes in the work of the nervous system can either pass within a month, or acquire threatening chronic forms.

Quite often, the joints of the human skeleton are involved in the pathological process (large joints, often the knee). In this case, the patient may have:

arthralgia;
migrating joint pain;
mono- or polyarthritis with characteristic symmetry;
myalgia;
bursitis and other lesions.
In most patients, Lyme disease causes cardiac syndrome, which is represented by the following pathologies:

arrhythmia;
tachycardia;
myocarditis, etc.
At the second stage of the disease, the patient may experience various disorders of attention and concentration, impaired coordination of movements, sleep and consciousness disorders may occur (up to dementia), etc.

In some patients, Lyme disease goes into a chronic stage. This happens, according to various sources, in the period from six months to two or more years after infection. Cutaneous erythema has the property of degenerating into various benign tumor—like neoplasms affecting the skin of the upper and lower extremities, face, neck, etc. It should be known that such a benign formation as a lymphocytoma can eventually degenerate into a malignant tumor – lymphoma.

Articular manifestations of the chronic course of tick-borne borreliosis are considered the most common. In most clinical cases, symmetrical chronic oligoarthritis (damage to two joints) occurs. The changes concern not only the synovial membranes of the joint, but also other periarticular tissues. This leads to the fact that the patient develops chronic forms of bursitis (inflammation of the articular bag), myositis (inflammation of muscle tissue), destructive processes of cartilage tissue, etc. Lesions of the skin, nervous or cardiovascular systems are not typical for the chronic stage of Lyme disease.

Particular attention should be paid to the course of Lyme disease in pregnant women. This pathological condition is threatening both for the mother and for the fetus. In some cases, pregnancy, regardless of the term, ends with spontaneous abortion (miscarriage). Even if it is possible to maintain pregnancy, there is a possibility of severe congenital fetal pathologies.

Diagnosis of Lyme disease
A thorough history collection is crucial for the diagnosis of Lyme disease. It is important not to miss the facts that indicate the possibility of infection with tick-borne borreliosis (country walks, tourist trips, etc.). Also, experts pay attention to the presence of primary signs of the disease: erythema of the skin and the phenomena of general intoxication.

Depending on the stage at which the disease develops, various serological and immunological laboratory studies are used (PCR, RIF, ELISA, microscopic studies, etc.). In order to identify structural disorders of various organs and tissues, additional research methods are used, prescribing X-ray, puncture followed by laboratory examination of the material, electrocardiogram, tissue biopsy epidermis, etc.

Differential diagnosis should be carried out with diseases such as encephalitis, rheumatoid arthritis, dermatitis of various genesis, neuritis, rheumatism, Reiter’s disease and others with similar symptoms.

In patients suffering from syphilis and various autoimmune diseases (infectious mononucleosis or rheumatism), serological reactions are false positive, which requires additional confirmation of the diagnosis of Lyme disease.

Lyme disease: treatment, prevention and medical prognosis
If the patient is diagnosed with Lyme disease, treatment is carried out in an infectious hospital. The basis of treatment is antibiotic therapy. If there is an early detection of the pathogen, then to prevent the spread of bacteria throughout the body, it is advisable to use tetracycline antibiotics or amoxicillin. The course of treatment is 14 days. If the pathology could not be diagnosed at an early stage, and it has passed into the stage of dissemination or chronic course, then cephalosporin antibiotics are used for a long course (from 21 to 28 days). Treatment with antibiotics can cause a temporary exacerbation of the symptoms of the disease. This is due to the death of bacteria and general intoxication. In this situation, treatment is suspended for a short period of time, and then resumed with a decrease in the dosage of drugs.

Specialists also use symptomatic and detoxification therapy. According to the indications of narrow specialists who conduct mandatory periodic examination of the patient, nonsteroidal anti-inflammatory drugs, glucocorticoid drugs (in combination with intra-articular injections), pacemakers, etc. are prescribed.

Treatment is prescribed individually, based on a detailed study of the clinical picture. Self-medication can cause conditions that threaten the life and health of the patient.

Lyme disease, the treatment and symptoms of which are a heavy burden for the patient, can be prevented. When going to nature, it is necessary to wear protective clothing or clothing made of dense fabric. If the bite still occurred, you should immediately contact the nearest medical institution. With timely diagnosis and adequate therapy, the medical prognosis of the disease is considered conditionally favorable. If you let the disease take its course, it can lead to disability and even death.

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