Related articles: Lyme disease
Definition
Lyme disease is an infectious disease caused by the bacterium (spirochete) Borrelia burgdorferi .
Infection is transmitted by ticks, humans and animals; it is more easily contracted in wooded and deer-rich areas, especially in summer and early autumn. The bacterium B. burgdorferi penetrates through the skin at the tick bite.
Lyme disease typically develops in 3 phases:
- early localized
- early disseminated
- late.
Most common symptoms and signs *
- Asthenia
- Chills
- Cachexia
- dizziness
- Cardiomegaly
- Conjunctivitis
- Dementia
- Difficulty concentrating
- Language difficulties
- Dyspnoea
- Mood disorders
- Chest pain
- Articolar pains
- Muscle pains
- Erythema
- Temperature
- Tingling in the Left Arm
- Tingling in the legs
- Joint swelling
- Hydrops Fetal
- Insomnia
- Intracranial hypertension
- Swollen lymph nodes
- Livedo Reticularis
- macules
- Sore throat
- Backache
- Headache
- Meningitis
- Nausea
- papules
- Paralysis of the vocal cords
- Bell's palsy
- Memory loss
- Rheumatism
- Joint stiffness
- Stiffness in the muscles of the back and neck
- Drowsiness
- splenomegaly
- Cough
- He retched
Further indications
The first sign to appear, as well as a clinical indicator of the infection, is a characteristic skin rash (erythema migrante). This manifestation occurs during the early localized phase in approximately 75% of patients. At the injection site, after 3-32 days, the migrating erythema begins as a macula or a red papule. The affected area, therefore, expands maintaining a diameter between 10 and 50 cm: the lesion is annular and takes on an appearance similar to a bull's eye, with clarification of the part between the center and the periphery. The central area of the primitive lesion, on the other hand, can become darker, hardened and warm to the touch. Immediately after the onset, about half of untreated patients develop multiple secondary lesions, generally smaller than the primitive one and without hardening in the center. Without treatment, in general, migrant erythema vanishes within 3-4 weeks.
Symptoms of disseminated early Lyme disease begin days or weeks after the appearance of the primary lesion; their onset coincides with the spread of the bacterium in the body via the blood and the lymphatic system. Therefore, a flu-like syndrome occurs with malaise, fatigue, chills, fever, headache, neck stiffness, muscle pain and arthralgia. Less frequent are back pain, nausea, vomiting, sore throat, lymphadenopathy and splenomegaly. Most of the symptoms are variable or intermittent, however the asthenia and the sense of discomfort can persist for several weeks.
At a distance of weeks or months from the migrating erythema, neurological alterations may develop which include motor and sensory neuropathies, meningoencephalitis, cranial nerve neuritis and Bell's palsy. Heart involvement produces myocardial lesions (eg myopericarditis and cardiomegaly) and can lead to atrioventricular block.
In untreated Lyme disease, the late phase begins months or years after the initial infection and is characterized by intermittent arthritic attacks. In some cases, chronic CNS changes may occur (peripheral neuropathies, difficulty concentrating, mood, memory and sleep disorders).
The clinical evaluation of Lyme disease is supported by serological tests performed both in the acute and late phases when cardiac, neurological and rheumatologic complications occur.
The therapy includes several possible alternatives, which vary with the stage of the disease. Usually, these include amoxicillin, doxycycline and ceftriaxone.
