MedlinePlus Medical Encyclopedia: Lyme disease

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Lyme disease - early disseminated

Contents of this page:
Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Alternative names

Lyme disease - secondary or stage 2

Definition Return to top

Secondary Lyme disease is an inflammatory disease characterized by cardiac and neurological symptoms caused by the bacterium Borrelia burgdorferi, which is transmitted by the bite of a deer tick.

Causes, incidence, and risk factors Return to top

See Lyme disease for a description of the initial stages of the disease. Secondary Lyme disease develops within days to months after the tick bite, when the infection spreads via the lymph system or bloodstream.

The central nervous system and cardiac system may be affected. Symptoms may be intermittent and may disappear after days, weeks, or months. Involvement of the heart occurs in 8% of people with untreated Lyme disease. Neurologic involvement occurs in 10% of patients with untreated Lyme disease.

Symptoms Return to top

headache
fatigue
general discomfort, uneasiness, or ill feeling (malaise)
lethargy
muscle pains
stiff neck
joint inflammation in the knees and other large joints
heart palpitations
fainting
blurred vision

Additional symptoms that may be associated with this disease:

speech impairment
numbness and tingling
nausea and vomiting
muscle function/feeling loss
movement, dysfunctional
hallucinations
facial paralysis (also called Bell's Palsy)
eyelid drooping
consciousness, decreased
confusion
abnormal sensitivity to light

Signs and tests Return to top

a physical examination to reveal signs of neurologic or cardiac involvement
ELISA test to screen for antibodies to Borrelia burgdorferi
Western blot to confirm the presence of antibodies to Borrelia burgdorferi
tests that detect cardiac abnormalities
- ECG (also called EKG)
- chest X-ray may show heart failure
- CSF analysis may show inflammation

Treatment Return to top

The objective of treatment is to eliminate the infection by antibiotic therapy. Penicillin, doxycycline, cefuroxime, and ceftriaxone are frequently used. Ceftriaxone is often used to treat secondary Lyme disease.

Note: Oral doxycycline is usually not prescribed for children until after all the permanent teeth have erupted -- it can permanently discolor teeth that are still forming.

Expectations (prognosis) Return to top

Symptoms of arthritis may fail to respond to treatment. Other symptoms should improve with treatment.

Complications Return to top

tertiary Lyme disease or late persistent infection

Calling your health care provider Return to top

Call your health care provider if symptoms of this disorder develop.

Prevention Return to top

Early diagnosis and appropriate antibiotic treatment of Lyme disease is the most effective way to prevent secondary Lyme disease.

Update Date: 2/3/2004

Updated by: Kenneth Wener, M.D., Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. Review provided by VeriMed Healthcare Network.

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