Summary about Disease
Lyme arthritis is a late-stage manifestation of Lyme disease, an infection caused by the bacterium Borrelia burgdorferi. It typically develops months or even years after an initial tick bite that transmits the bacteria. Lyme arthritis is characterized by joint pain, swelling, and inflammation, primarily affecting large joints like the knees. If left untreated, it can lead to chronic joint damage.
Symptoms
Joint pain (often severe and intermittent)
Joint swelling (especially in the knees)
Warmth and redness around the affected joint(s)
Stiffness (particularly in the morning)
Fatigue
Fever (less common)
Causes
Lyme arthritis is caused by the bacterium Borrelia burgdorferi, which is transmitted to humans through the bite of infected blacklegged ticks (also known as deer ticks). The bacteria spread through the bloodstream and can eventually reach the joints, triggering an inflammatory response that leads to arthritis.
Medicine Used
Oral antibiotics: Doxycycline, amoxicillin, or cefuroxime axetil are typically prescribed for several weeks to eradicate the Borrelia burgdorferi* bacteria.
Intravenous antibiotics: Ceftriaxone or penicillin are used in more severe or persistent cases.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen or naproxen can help manage pain and inflammation.
Joint aspiration: Removing fluid from the affected joint can relieve pain and pressure.
Corticosteroid injections: Injected directly into the affected joint to reduce inflammation (used sparingly).
Disease-modifying antirheumatic drugs (DMARDs): Hydroxychloroquine or methotrexate are sometimes used if arthritis persists after antibiotic treatment, but this is less common.
Is Communicable
No, Lyme arthritis is not communicable. It cannot be spread from person to person. It is only contracted through the bite of an infected tick.
Precautions
Wear protective clothing: Long sleeves, long pants tucked into socks or boots when in wooded or grassy areas.
Use insect repellent: Apply insect repellent containing DEET, picaridin, or permethrin.
Check for ticks: Thoroughly check yourself, your children, and your pets for ticks after spending time outdoors.
Remove ticks promptly: If you find a tick, remove it carefully with tweezers, grasping it close to the skin and pulling straight out.
Shower after being outdoors: Showering within two hours of being outdoors can help wash off unattached ticks.
Maintain your yard: Keep grass short and remove leaf litter to reduce tick habitat.
How long does an outbreak last?
With prompt antibiotic treatment, Lyme arthritis typically resolves within a few weeks to a few months. However, some individuals may experience persistent joint pain and inflammation even after antibiotic therapy. In rare cases, chronic arthritis can develop, lasting for years.
How is it diagnosed?
Physical examination: A doctor will examine the affected joints for swelling, warmth, and range of motion.
Medical history: The doctor will ask about symptoms, tick bites, and travel history.
Blood tests:
ELISA (enzyme-linked immunosorbent assay): Used as an initial screening test for Lyme disease antibodies.
Western blot: Used to confirm a positive or equivocal ELISA result.
Joint fluid analysis: Fluid may be drawn from the affected joint (arthrocentesis) to rule out other causes of arthritis and to test for Borrelia burgdorferi DNA via PCR (polymerase chain reaction).
Timeline of Symptoms
Early localized Lyme disease (days to weeks after tick bite): Erythema migrans (a characteristic bullseye rash), fatigue, fever, headache, muscle aches.
Early disseminated Lyme disease (weeks to months after tick bite): Multiple erythema migrans rashes, facial palsy, meningitis, carditis.
Late disseminated Lyme disease (months to years after tick bite): Lyme arthritis, neurological problems (e.g., cognitive difficulties, neuropathy). The timeline can vary, and not everyone experiences all stages. Some individuals may not recall a tick bite or rash.
Important Considerations
Early diagnosis and treatment of Lyme disease are crucial to prevent the development of Lyme arthritis.
Even after successful antibiotic treatment, some individuals may experience persistent symptoms (post-treatment Lyme disease syndrome or chronic Lyme disease). This is a controversial topic, and the best approach to managing these symptoms is still being researched.
It is important to differentiate Lyme arthritis from other forms of arthritis, such as rheumatoid arthritis and osteoarthritis.
Consult with a healthcare professional for proper diagnosis and treatment.