Lyme Disease Symptom Check List (printable)
Highlight each symptom and bring the check list to your next doctor's appointment.
Aute (early) Lyme disease symptoms:
* rash - This rash, called erythema migrans (EM), is usually oval or circular, uniform in color and centered on the initial bite site. Although the bulls eye rash is the classic Lyme disease rash, it occurs in only 10-20% of the patients who have a rash during their illness. The bullseye rash is not the most common rash.
The most common rash is oval and uniformly colored.
The rash appears 2-3 days after the bite. This usually expands and clears over several weeks. Blood tests will likely be negative during this stage of Lyme disease. If a patient has multiple rashes, this is considered later lyme and should be treated differently.
One third of all Lyme disease patients never have an EM rash (click here to see rash photos).
* fever* malaise* fatigue* headache* muscle and joint aches
The incubation period from tick bite to the onset of symptoms is usually 1-2 weeks but it can be as long as one month. It is possible for an infected person to have no symptoms or display only one or two symptoms; this can make obtaining a correct diagnosis difficult. Persistent (late) Lyme disease symptoms:* fatigue* muscle and joint aches* Bell's palsy* pain* numbness, tingling or burning sensations* meningitis* tremor, muscle twitches* short-term memory loss* depression, anxiety, panic attacks* hallucinations and many others.
The symptoms of late Lyme disease can appear months to years from infection. Left untreated, Lyme disease can cause chronic disability, but it is rarely fatal. Cases of persistent infection have been known to linger for 20 years before being correctly diagnosed.
The most reliable method for diagnosing Lyme disease is a thorough medical history and physical exam. The history includes details about possible tick exposure, current medical problems and a complete review of all symptoms. The physical exam includes a good general exam plus detailed dermatologic, neurologic and joint exams.The laboratory tests used to assist in the diagnosis of Lyme disease include the ELISA and Western blots.
The ELISA is called the screening test; if it is positive then Western blots are done.
Unfortunately, neither test is a reliable indicator of illness; test results vary between labs and within the same lab and false positives and false negatives are common.
A 2003 study by CDC researchers demonstrated that the C6 ELISA, a commonly used test for Lyme disease, performed well for patients with arthritis but missed patients with acute disease and many with early or late neurologic Lyme disease.
Because of these sorts of testing problems, Lyme disease must be diagnosed on clinical grounds.
Lab tests may confirm a clinical diagnosis but by themselves they cannot rule the disease in or out.
Read, Understanding Lyme Tests Results, by Dr. Charles Ray Jones
The treatment of Lyme disease requires the use of antibiotics.In cases where an EM rash is present, treatment should begin immediately.
Blood tests are not recommended because they are often falsely negative.
Most studies on the treatment of early Lyme disease used at least 20 days of antibiotic therapy. Treatment is usually successful; overall cure rates for this stage are roughly 90%.
Late Lyme disease is much more difficult to treat and while most patients improve with antibiotic therapy, cure rates are much lower. The duration of treatment can be quite long; some patients may need to be on antibiotics for months or even years. Others may require intermittent courses of antibiotics.
Each case is unique and care need to be individualized.
A true EM rash does not last for only a few days. An untreated EM expands and regresses over weeks; the clearing is much faster if antibiotics are given.
Dr. Maloney's paper, The Management of Ixodes Scapularis Bites in the Upper Midwest, can be found here.
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Minnesota Lyme Association materials, meeting presentations, and website information are provided for educational purposes only. The information is not intended as medical advice and should not be relied upon to diagnose or treat any disease. Where medical advice is needed, a licensed healthcare professional
should always be consulted.
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