LYME

DISEASE
Submitted by:

Apple S. Estacio
BSN III-2

Submitted to:

Ms. Leah Ann H. Beltran,RN

Clinical Instructor

December 2010
 Lyme Disease

Definition:
Lyme disease is an infection that is spread by ticks. Lyme disease
is common in the United States. It can also be found in Canada,
Europe, and Asia.
Lyme Disease is caused by the organism, Borrelia burgdorferi, a
spirochete.

The spirochete is carried by a tick which can be as small as a pin

head. Lyme disease is caused by bacteria. Infected ticks spread the
bacteria by biting people or animals.
Nymphal and adult deer ticks can be carriers of Lyme disease. Nymphs are about the size of a poppy seed.ete.

Two types of ticks carry the Lyme disease bacteria in the U.S. They
are:

o Deer ticks

- They spread the disease in the Northeast and Midwest.

o Western black-legged ticks

- They spread the disease along the Pacific coast, mostly in northern
California and Oregon.

Pathophysiology
Lyme disease is spread when you are bitten by a tick that is infected with B. burgdorferi bacteria.
When an infected tick bites you, bacteria travel to the tick's salivary glands and then into your
body through your skin. It takes about 24 hours for a tick to attach itself to the skin and begin to
feed. The tick generally must be attached to you for about 36 hours in order for it to transmit the
Lyme disease bacteria.

Is Lyme disease contagious?

Lyme disease is not contagious and cannot be spread from person to person. But certain
precautions should be taken to prevent spread of the illness through ways such as blood
transfusions.
  People with active Lyme disease should not donate blood, because the bacteria that
cause the illness can be transmitted this way. People who were previously treated for
Lyme disease may be able to donate blood, but they should check with the blood bank
first.
 A pregnant woman may be able to pass Lyme disease to her unborn child, but proven
cases are rare. Lyme disease has not been shown to cause birth defects or fetal death.
 There is no evidence that breast-feeding mothers can pass the illness to their babies
through breast milk. But a nursing mother who is suspected of having Lyme disease
may be asked to stop nursing until she has completed a course of antibiotic therapy.
The baby is also watched closely for symptoms of Lyme disease.

Clinical Manifestations:

One sign of Lyme disease is a round, red rash that spreads

at the site of a tick bite. This rash can get very large.
Flu-like symptoms are also very common. People in the
early stages of Lyme disease may feel very tired and have
headaches, sore muscles and joints, and a fever.
Heart, nervous system, and joint symptoms may be the first
signs of Lyme disease in people who did not have a rash or
other symptoms of early infection.
These symptoms can start at any time, from 3 days up to a month after you have been bitten.
Some people don't have any symptoms when they are in the early stages of Lyme disease. And
they may not even remember getting a tick bite.
If Lyme disease goes
untreated, you can have
more serious symptoms over
time. These include:

 Swelling and joint pain

(like arthritis).
 Tingling and numbness
in your hands, feet, and
back.
 A lack of energy that
does not get better.
 Trouble focusing your
thoughts.
 Poor memory.
 Weakness or paralysis
in your face muscles.
If Lyme disease is left untreated, it may progress in stages from mild symptoms to serious, long-
term disabilities. There are three stages of Lyme disease: early localized,
early disseminated, and late persistent.
Stage 1: Early localized infection (1 to 4 weeks)
Some people with Lyme disease have a rash (called erythema
migrans) at the site of the tick bite. The rash is usually circular and
it gets larger over time. Other people don't have any symptoms in
the early stages of Lyme disease and do not remember having had
a tick bite. About half the people infected with Lyme disease
develop a rash within 1 to 4 weeks.

Characteristic "bulls-eye" rash caused by Lyme disease

Some people with Lyme disease will have flu-like symptoms with or without a rash. These
symptoms may include:

 Lack of energy, which is the most common symptom.

 Headache and stiff neck.
 Fever and chills.
 Muscle and joint pain.
 Swollen lymph nodes.

In some cases of Lyme disease, the person does not notice any symptoms during this stage.
Stage 2: Early disseminated infection (1 to 4 months)
If Lyme disease is not detected and treated while early symptoms are present, or if you do not
have early symptoms that trigger the need for treatment, the infection may affect the skin, joints,
nervous system, and heart within weeks to months after the initial infection.
Symptoms at this stage may include:

 Being tired.
 Additional skin rashes in several places on your body that develop as the infection spreads.
 Pain, weakness, or numbness in the arms or legs.
 Inability to control the muscles of the face (paralysis of the facial nerves).
 Recurring headaches or fainting.
 Poor memory and reduced ability to concentrate.
 Conjunctivitis (pinkeye) or sometimes damage to deep tissue in the eyes.
 Occasional rapid heartbeats (palpitations) or, in rare cases, serious heart problems.

Stage 3: Late persistent infections

If Lyme disease is not promptly or effectively treated, damage to the joints, nerves, and brain
may develop months or years after you become infected (late Lyme disease). Symptoms at this
stage may include:

 Swelling and pain (inflammation) in the joints, especially in the knees.

 Numbness and tingling in the hands, feet, or back.
 Severe fatigue.
 Partial facial nerve paralysis, which usually occurs within the first few months after the
tick bite.2
 Neurologic changes, including problems with memory, mood, or sleep, and sometimes
problems speaking.
 Chronic Lyme arthritis, which causes recurring episodes of swelling, redness, and fluid
buildup in one or more joints that last up to 6 months at a time.

Heart, nervous system, and joint symptoms may be the first signs of Lyme disease in people who
did not have a rash or other symptoms of early infection.

Diagnosis

Your doctor will ask you questions about your symptoms. A round, red rash may be a sign of
Lyme disease. Your doctor will also ask about your activities to try to find out if you have been
around infected ticks. You may have a blood test to see if you have certain antibodies in your
blood that could mean you have the disease.

Treatment

(Medical Management)
• Lyme disease is treated with antibiotics such as doxycycline or amoxicillin. Antibiotic
treatment for early Lyme disease is effective, and symptoms usually go away within 3
weeks of treatment.
• Oral antibiotics are usually prescribed first for chronic Lyme arthritis (recurring swelling
and joint pain), but IV antibiotics may be tried if the oral antibiotics do not work.
• If Lyme disease is not diagnosed and treated until later problems arise, it may take you a
long time to get better or you may need additional treatment.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are usually
helpful for symptoms of arthritis that can occur with late Lyme disease. These symptoms
may include pain, swelling, redness, warmth, and limitation of movement.
• There used to be a vaccine for prevention of Lyme disease in high-risk areas, but it is no
longer available because of uncertainty over its effectiveness and lack of demand.
(Nursing Management)
 The best way to prevent Lyme disease is to protect you from ticks. Cover up as much
skin as you can when you're going to be in wooded or grassy areas. Wear a hat, a long-sleeved
shirt, and long pants with the legs tucked into your socks. And keep in mind that it’s easier to see
ticks on light-colored clothes.

 Use a bug spray that has the chemical DEET to repel ticks. You can spray it right on your
skin. Check your pets for ticks after they've been outside. You can't get Lyme disease from your
pet. But your pet can bring infected ticks inside. These ticks can fall off your pet and attach to
you.