Lyme Disease – Diagnosis and Treatment
Diagnosis
Doctors check for signs and symptoms such as fever, joint pain, rash (like erythema migrans), and fatigue. A physical examination helps doctors spot rashes or arthritis.
Blood tests, including the Western blot, detect antibodies against Borrelia burgdorferi bacteria. Doctors also consider risk factors and recent tick bites.
Treatment
Pills for Antibiotic Therapy
Doctors usually prescribe antibiotic pills as the main treatment for people with Lyme disease. Treatment with these pills lasts from 10 to 14 days, but doctors may extend it if symptoms do not improve.
Patients should finish all doses as instructed, even after feeling better. Completing the full course helps prevent relapse or incomplete recovery. Medical organizations recommend starting treatment as soon as possible for best results.
Intravenous Use of Antibiotics
Doctors may give antibiotics through an IV (intravenous line) for more severe cases, especially when the brain, heart, or joints are affected.
Doctors recommend IV antibiotics if pills are not enough to control the disease. This method may require treatment lasting several weeks and is used for complications that do not respond to pills.
Using Antibiotics to Prevent Lyme Disease
Doctors sometimes give antibiotics to people bitten by a tick before symptoms appear.
This preventive treatment, called prophylactic therapy, is only used if all three conditions below are met:
| Condition | Description |
|---|---|
| The tick is a deer tick. | Only deer ticks spread Lyme disease. |
| The area has a high rate of Lyme disease. | More likely to get Lyme disease. |
| The tick was attached for at least 36 hours. | Risk increases with longer tick attachment. |
Doctors do not recommend prophylaxis if any of these conditions are not met. Preventive antibiotics are only for those with a confirmed risk.
Persistent Symptoms After Treatment
Some people have symptoms after finishing antibiotic treatment. These symptoms may include pain, tiredness, or mental fog.
Studies show that ongoing symptoms are not caused by active Borrelia infection, and more antibiotics do not help. Doctors do not use the term โchronic Lyme diseaseโ as a diagnosis.
People should talk to their healthcare provider if symptoms persist to rule out other causes and get support.
Everyday Practices and At-Home Measures
People can lower their risk of tick bites and Lyme disease by taking careful steps outside and at home.
Wearing long sleeves and pants helps keep skin covered in grassy or wooded areas. Tucking pants into socks gives extra protection, especially for children who play or hike outdoors.
Avoiding tall grass and walking in the center of trails reduces contact with ticks. Insect repellents help prevent tick bites.
There are several types, and each can be effective when used correctly:
| Repellent Type | Where to Use | Use in Children |
|---|---|---|
| DEET | On skin (not face) | Safe when used as directed for age |
| Permethrin | On clothing and gear | Not for skin, allow gear to dry first |
| Picaridin | On skin | Generally safe for children |
| IR3535 | On skin | Approved for family use |
| Oil of Lemon Eucalyptus | On skin (age limited) | Not for children under 3 years old |
Only use permethrin on clothes, shoes, and gear, and allow them to dry before use.
Apply DEET, picaridin, IR3535, and oil of lemon eucalyptus to skin as directed on the label. Do not put repellents on hands, eyes, or mouth, and use lower concentrations for children.
When coming indoors, check the body closely for ticks. Ticks often hide under arms, behind knees, around ears, and at the hairline. Check children and pets as well.
Showering soon after outdoor activities may help wash ticks away before they attach. If you find a tick, use fine-tipped tweezers to grab it close to the skin.
Gently and slowly pull the tick straight out without twisting. Wear gloves for extra protection during removal. Do not use home remedies like petroleum jelly, matches, or nail polish to remove ticks.
These methods do not work and can cause harm. After removing the tick, clean the area and your hands with soap and water.
Keep the tick in a container labeled with the date and location in case it is needed for examination. Dispose of the tick by placing it in alcohol, wrapping it in tape, or sealing it in a plastic bag before putting it in the trash or freezer.
There is currently no widely available vaccine for Lyme disease. Personal protective steps remain the best defense.
Questions Your Healthcare Team Might Ask
When you plan to meet with a healthcare provider about Lyme disease or other tickborne diseases, come prepared.
Bring the tick you removed after your bite, if possible. Also, bring any pictures of your rash or symptoms.
List outdoor places you have recently visited. Focus on areas known for blacklegged ticks or deer ticks.
You may be asked:
| Information to Bring | Importance |
|---|---|
| Dates of tick exposure | Helps track transmission |
| Type of tick (if known) | Blacklegged tick info |
| Allergy list | Medication safety |
| Current medications | Avoids drug interactions |
- When and where did you notice a tick bite?
- What outdoor activities did you do before the bite?
- Have you traveled to places where ticks carrying disease are common?
- What symptoms, such as fever, rash, joint pain, or headaches, have you had?
- When did these symptoms start, and have they gotten better or worse?
- Are you currently taking any prescription or over-the-counter medicines, supplements, or herbal products?
