Lab tests to identify antibodies to the bacteria can help confirm or rule out the diagnosis. These tests are most reliable a few weeks after an infection, after your body has had time to develop antibodies.
They include:. But because it can sometimes provide false-positive results, it's not used as the sole basis for diagnosis. This test might not be positive during the early stage of Lyme disease, but the rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease.
Antibiotics are used to treat Lyme disease. In general, recovery will be quicker and more complete the sooner treatment begins. Oral antibiotics. These are the standard treatment for early-stage Lyme disease. These usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or breast-feeding women.
A to day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective. Intravenous antibiotics. If the disease involves the central nervous system, your doctor might recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take you some time to recover from your symptoms. But antibody production takes time, which means early detection can be hard.
And once produced, antibodies can last for years, which makes it difficult to see whether an infection is resolved, or even whether a new one has occurred. I was confused. My doctor showed me mixed results from three labs.
Two had a positive response on one part of the test but not the other, while the third had a negative response on both parts. Because of my medical history as well as particular findings on my tests, she concluded that I probably did have Lyme disease. But she also noted that I had a few nasty viruses, including Epstein-Barr. In addition, the test may have been picking up on autoimmune antibodies, given my earlier diagnosis. At the recommendation of a science-writer friend, I finally went to see Richard Horowitz , a doctor in upstate New York who specializes in Lyme disease and had earned a reputation as a brilliant diagnostician.
He recently served as a member of the Tick-Borne Disease Working Group convened by the Department of Health and Human Services, which in issued a report to Congress outlining problems with the diagnosis and treatment of Lyme patients.
I had brought along a stack of lab results nearly half a foot tall—a paper trail that would scare off many doctors. He perused every page, asking questions and making notes. Finally, he looked up. In his waiting room, I had completed an elaborate questionnaire designed to single out Lyme patients from a pool of patients with other illnesses that affect multiple biological systems.
It has since been empirically validated as a screening tool. Now Dr. H did a physical exam and ordered a range of tests to rule out further thyroid problems, diabetes, and other possible causes of my symptoms. Curious, I told him that I had always thought of Lyme as a primarily arthritic disease, whereas I had many neurological and cognitive symptoms. He explained that B. If not, we were on the wrong track.
The next morning, I took a dose of the doxycycline, along with Plaquenil, which is thought to help the antibiotics penetrate cells better. I took another dose that night with dinner. I went to bed and woke up feeling like hell. My throat was sore and my head was foggy. My neck was a fiery rebar. Two days later, we went out to get lunch. I was still groggy and unwell. It was a heavy, gray day, with low clouds. Returning home, I felt rain all over my bare arms.
I told Jim we should hurry. A dozen pips of cold popped along my arm. But there was no rain. As we walked home, cold drops rushed all over my body, my skin crawling as if a strange, violent water were cleansing it. Several days later, though, I felt excited to fly to a conference in Chicago, rather than exhausted by the prospect.
For three more weeks, I took the drugs and supplements Dr. H had prescribed. The doxycycline made me allergic to the sun. One late-spring morning, I forgot to put sunblock on my right hand before taking a walk with a friend, holding a coffee cup. By the time I got home, my hand felt tender. Over the next few days a second-degree burn developed, blistering into an open wound. After a month of antibiotic treatment, I took the train back up to Dr. On his questionnaire, I rated my symptoms as less severe than I had a month earlier, but my total score still fell in the high range.
H changed the protocol, adding an antimalarial drug. He was concerned about my continued night sweats and air hunger. When I started taking the new drugs, in June , I was nearly as sick as I had ever been.
Within two days of arriving, I could barely walk down the street. Violent electric shocks lacerated my skin, and patches of burning pain and numbness spread up my neck.
I shook and shivered. The reaction lasted five days, during which panic mixed with the pain. How was I to know whether this was herxing and a positive reaction to the drugs as they killed bacteria and parasites, or a manifestation of the disease itself?
Or were weeks of antibiotics themselves causing problems for me? On the sixth day, I was sitting on the couch in my rented apartment and the shocks were so violent, racing across my forearms and thighs and calves, that when I looked up at the tall open windows, the sun streaming through them, it occurred to me that I could jump out of them and find relief.
The next morning I woke up to the same bright sun, feeling better than I had in ages. Stunned by my energy, I went out for a run. As the weeks passed, I felt better and better. My drenching night sweats vanished. The air hunger was gone.
I had loads of energy. I took antibiotics for several more months, and each month I had fewer symptoms. After eight months of treatment, Dr. H decided that I could stop. It was the spring of Because testing the tick is not a good indicator of Lyme disease transmission, most hospital or state-run medical labs will not test ticks for Lyme bacteria. New Tests Under Development. Healthcare providers need tests to distinguish between people who have recovered from the previous infection and those who continue to suffer from active infection.
To improve the accuracy of Lyme disease diagnosis, National Institutes of Health NIH -supported researchers are re-evaluating existing tests and developing a number of new tests that promise to be more reliable than those currently available.
NIH scientists are developing tests that use the highly sensitive genetic engineering technique known as polymerase chain reaction PCR as well as microarray technology to detect extremely small quantities of the genetic material of the Lyme disease bacterium or its products in body tissues and fluids.
Since the genome of B. Lyme disease is sometimes called "The Great Imitator" because it so often mimics many other illnesses, according to LymeDisease. Conversely, other types of arthritis or other autoimmune diseases can be misdiagnosed as Lyme disease. Symptoms of Lyme disease can mimic conditions such as:. Your healthcare provider will consider all of these possibilities when making a diagnosis. Lyme disease has been diagnosed long enough, and the infectious bacteria that causes it is easy enough to identify, that most patients with early Lyme disease are able to find a healthcare provider who can accurately diagnose it.
Even those patients who are originally told by a healthcare provider that their symptoms are all in their head are often able to find another practitioner to help them get the accurate diagnosis. But in some cases, patients find great difficulty in getting a Lyme disease diagnosis. And that's because there is a controversy that surrounds such a diagnosis for patients who don't suffer symptoms until long after they were possibly bitten by a tick.
While some people exhibit symptoms, including the classic "bull's eye" rash, early after a tick bite, it's possible that symptoms won't show up for months or years after being infected. Furthermore, some patients are treated early with antibiotics, but those antibiotics don't completely destroy the Lyme Borrelia bacteria, or other symptoms occur even when no sign of any lingering infection remains.
Although no one denies that some people treated appropriately for Lyme disease go on to have persistent symptoms, there is a huge controversy over what it's called, what causes it , and how it's best treated. Using the term "chronic" suggests that an infection and inflammation are still present, but for PTLDS, there is little evidence that this is the case. The debate is less about whether patients are still suffering physical symptoms and more about if it's caused by persistent infection and whether people with PTLDS should be treated with antibiotics—a treatment that may not only be ill-advised but could create bigger problems for these patients.
In fact, the CDC is joined by other well-known and well-respected medical organizations and authorities in the United States in clarifying that available evidence does not support the idea that "chronic Lyme disease" is caused by persistent infection with the Lyme bacterium; this is why they prefer the name "post-treatment Lyme disease syndrome.
Further, healthcare professionals who treat PTLDS with long-term antibiotics may be putting their patients at unnecessary risk and increasing rates of antibiotic-resistant bacteria. Pursuing the Chronic Diagnosis. If you believe you do have PTLDS, or chronic Lyme disease, find a healthcare provider who understands the current science behind Lyme disease and post-treatment Lyme disease syndrome, even if they won't call it chronic Lyme.
Read more about preventing lyme disease. Yes, most Lyme disease cases resolve with a round of antibiotics for two to four weeks, but some people continue to experience symptoms for several months.
Untreated Lyme disease can lead to more severe symptoms and complications, including severe headaches and neck stiffness, more "bull's eye" rashes on other areas of the body, facial palsy, arthritis, pain in joints and bones, muscle pain, heart palpitations, dizziness, and nerve pain. Early detection and treatment are key to preventing these more severe symptoms from occurring. The incubation period for Lyme disease is three to 30 days, and symptoms may appear at any time after the incubation period.
Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Lyme Disease. In: StatPearls [Internet]. Social-cognitive determinants of the tick check: a cross-sectional study on self-protective behavior in combatting Lyme disease. BMC Public Health. Published Nov Nadelman RB. Erythema migrans. Infect Dis Clin North Am. Tick bites: Lyme disease. Cook MJ. Lyme borreliosis: a review of data on transmission time after tick attachment.
The development of new, rapid, clearly validated diagnostic tests continues to be a need. Working with CDC, NIAID plays a major role in encouraging the development of new approaches to improve Lyme disease diagnosis in people with tick-borne co-infections such as anaplasmosis or babesiosis.
New diagnostic tests are also needed to distinguish between people with B. Although Lyme disease vaccines for humans are no longer available in the United States, the discontinued LYMErix vaccine used between and was based on a specific part of B. In response to the vaccines, immunized individuals developed antibodies for OspA. Because the conventional ELISA measures OspA antibodies to determine if someone has Lyme disease, the test does not provide accurate results for immunized individuals.
People who received the vaccination will test positive whether or not they are actually infected with B. Department of Health and Human Services federal research on tickborne disease diagnostics. Greater advances in diagnostics are anticipated as genetic information is combined with advances in microarray technology, imaging, and proteomics.
These growing fields of science are expected to lead to improved diagnostic tools as well as provide new insights on the pathogenesis of Lyme disease.
Examples of tools being developed with NIAID support include use of metabolomics to characterize new biomarkers of infection, next generation T-cell based measurements, and novel antigens for improved measurement of effective treatment.
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