It seems that in recent years there has been an increasing trend in the relative incidence of Lyme disease in endemic area , as well as a geographical expansion of its transmitter , the Ixodes ricinus check mark .
How Long Does It Take To Show Signs Of Lyme Disease?
Lyme disease is characterized by various symptoms . The discomfort are very wide-ranging and move many electronic organ . If a individual becomes infected with the Borrelia burgdorferi bacterium by mean value of a tick bite , a cerise and annular wound on the skin may appear after several days or weeks ; this would be the first manifestation .
In the first month of exposure to the check , which in most lawsuit the patient role does not retrieve , early localized infection ( first phase ) occur , which is usually manifested by nonspecific grippe - like symptoms and the appearance of migratory erythema , which is a papule or macula that gallop painlessly to take the form of a target with the clearer shopping mall . Since a quarter of patients do not have migratory erythema , it is not rare for this first leg to go unnoticed and doctors receive a affected role with symptoms of an early disseminated infection ( second stage ) , after hebdomad or month of exposure . This stage could be initiated , for example , as a general stipulation with intense discomfort , diffuse pains , headache , asthenia or new cutaneous symptoms : annular lesion smaller than migrant erythema , or the rare bearing of lymphocytoma cutis ( violaceous nodules , preferably in lobules , the ear or nipples ) .
Considering the inconstancy and clinical variability of borreliosis in this phase , it has been called “ the great impersonator ” .
In any case , and if we leave out the almost constant fatigue / phlegm , it seems that the most relevant and frequent presentation symptom ( 63 % ) are neurologic , follow by the musculoskeletal and dermatologic sign .
In Europe and Asia , the first Lyme disease neurological sign is a characteristically radicular pain , which continues with lymphocytic pleocytosis in cerebrospinal fluid ( Bannwarth ’s syndrome ) and which is normally play along by cranial neuritis , peculiarly peripheral facial palsy . Other rarified symptom would be encephalitis , myelitis or multiple mononeuritis . two-sided facial paralysis is a rarefied but suggestive , although not diagnostic , clinical presentation of Lyme disease .
Due to the difficulty in naturalize this microaerophilic bacterium , the diagnosis is established by the comportment of migratory erythema or by a compatible clinical introduction , ideally confirmed with serological tests and supported by epidemiological data , such as the localisation of the case in an endemic area or the history of the gyp of the tick . Lyme disease substantiation is established by serology , which can be negative in the first calendar week ( only 30 - 40 % of migratory erythema will be positive in the penetrative form and up to 70 % in 2 - 4 weeks ) . The detection of anti - Borrelia antibodies is commend in two stages : first , by a raw method such as ELISA , and more specific confirmation by Western blot . Serology , which is not passable to distinguish active and inactive disease ( can continue convinced for long time after healing , or negative in those partly do by ) , also has the job of standardization ; it is commodious , in any case , to settle IgG and IgM antibodies , and to equate two samples separated by 2 - 4 weeks .
It is important that the solvent are considered in a clinical and epidemiologic context that suggests Lyme disease , and it is not appropriate to request serology for Borrelia in patient with nonspecific symptom without suspicious history since , in add-on , it can give falsely positivistic results in rheumatoid arthritis , systemic lupus erythematosus ( SLE ) , systemic induration , and others . It should also be remembered that a seronegative borreliosis is usually mild and attenuate .
The craw has a very low lucrativeness due to the need for a complex procedure and specific means , as well as the small number of Borrelia in the sample distribution .
The most specific trial is the detection of spirochete DNA by PCR , which showed good sensitivity in synovial fluid or skin , although much less in blood , urine or cerebrospinal fluid ( CSF ) .
If there is Lyme disease , it is substantive to start treatment early . The earliest therapy begin , the good the fortune of avoiding a serious line of the disease .
Also translate :
