Lyme Arthritis Facts & Treatment

Caused by the Borrelia burgdorferi spirochete, Lyme Arthritis disease is transmitted to humans through the bite of infected ticks. Clinical manifestations can range from an initial skin rash at the site of the bite to neurologic and cardiac complications.

A common late-stage manifestation of the disease is Lyme arthritis, which can mimic bacterial septic arthritis, especially in children.

Early localized stage (3-30 days post-tick bite)

  • Red, expanding rash called erythema migrans (EM)
  • Fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes

Some people may get these general symptoms in addition to an EM rash, but in others, these general symptoms may be the only evidence of infection.

Some people get a small bump or redness at the site of a tick bite that goes away in 1-2 days, like a mosquito bite. This is not a sign that you have Lyme disease. However, ticks can spread other organisms that may cause a different type of rash. For example, Southern Tick-associated Rash Illness (STARI) causes a rash with a very similar appearance.

Erythema migrans (EM) or “bull’s-eye” rash

  • Rash occurs in approximately 70-80% of infected persons1 and begins at the site of a tick bite after a delay of 3-30 days (average is about 7 days).
  • Rash gradually expands over a period of several days, and can reach up to 12 inches (30 cm) across. Parts of the rash may clear as it enlarges, resulting in a “bull’s-eye” appearance.
  • Rash usually feels warm to the touch but is rarely itchy or painful.
  • EM lesions may appear on any area of the body.

Early disseminated stage (days to weeks post-tick bite)

Untreated, the infection may spread from the site of the bite to other parts of the body, producing an array of specific symptoms that may come and go, including:

  • Additional EM lesions in other areas of the body
  • Facial or Bell’s palsy (loss of muscle tone on one or both sides of the face)
  • Severe headaches and neck stiffness due to meningitis (inflammation of the spinal cord)
  • Pain and swelling in the large joints (such as knees)
  • Shooting pains that may interfere with sleep
  • Heart palpitations and dizziness due to changes in heartbeat

Many of these symptoms will resolve over a period of weeks to months, even without treatment2.However, lack of treatment can result in additional complications, described belo

Late disseminated stage (months to years post-tick bite)

Approximately 60% of patients with untreated infection may begin to have intermittent bouts of arthritis, with severe joint pain and swelling. Large joints are most often affected, particularly the knees3. Arthritis caused by Lyme disease manifests differently than other causes of arthritis and must be distinguished from arthralgias (pain, but not swelling, in joints).

Up to 5% of untreated patients may develop chronic neurological complaints months to years after infection4. These include shooting pains, numbness or tingling in the hands or feet, and problems with short-term memory.

Treatment

Early, correct diagnosis is the best way to prevent the development of Lyme arthritis in individuals with the tick-borne illness, according to a paper published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). In patients who do develop the condition, most cases can be treated successfully with antibiotics, the review found.

“In most patients, Lyme arthritis can be successfully treated with oral antibiotics,” Dr. Cruz said. “Nonsteroidal anti-inflammatory drugs may also be given to help manage symptoms while the patient is improving.” A small number of patients may continue to have symptoms even after treatment with antibiotics, said study author Aristides Cruz, MD, chief orthopaedic resident, Yale-New Haven Hospital. In these patients, surgical treatment may be needed to remove the diseased synovial tissue.

Source & More Info: CDC

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