The Lyme disease Is an infectious disease caused by a bacterium called Borrelia burgorferi (National Institutes of Health, 2015) and transmitted by ticks of the genus Ixodes (Fernández, 2012).
Due to the broad clinical spectrum, Lyme disease is known as" The last great imitator "Because of the large number of symptoms Can provoke (Portillo et al., 2014).
Lyme disease is the most frequent tick-borne infection in Europe, in fact it is also the most common in the northern hemisphere (Portillo et al., 2014).
The clinical manifestations Of Lyme disease are very varied, with signs and symptoms dermatological, neurological, Cardiovascular and joint diseases, among others (Vázquez-López, 2015).
Specifically, Typical symptoms Of this disease include fever, fatigue, headache and a rash called Erythema migratory (Centers for Disease Control and Prevention, 2015).
In addition, in the clinical course of Lyme disease we can distinguish three stages between which infection can spread throughout the organism and if Is not treated, will cause severe multisystemic involvement (National Institutes of Health, 2015).
Lyme disease is diagnosed based on physical signs and symptoms, the identification of risk factors and the use of some tests. (Centers for Disease Control and Prevention, 2015).
Thus, most cases of Lyme disease are successfully treated through the use of drugs Antibiotics , However, it is important Take measures to prevent it (Centers for Disease Control and Prevention, 2015).
Characteristics of Lyme disease
The discovery of Lyme disease dates back to 1975, first reported in the city of Old Lyme in Connecticut, from which it receives its name (Healthline, 2015).
The Lyme disease Is a multiorganic pathology produced by the spirochete Borrelia burgdorferi Y Transmitted in Europe by the tick Ixodes ricinus (López-Hortas et al., 2008).
The spirochete Borrelia burgdorferi, is a type of bacteria that usually lives in mice, sheep, deer, goats, cows, or other mammals and is transmitted By the bite of a tick (Lymedisease, 2016).
Ticks are a type of insect that adhere to the skin, especially in humid areas and with a higher temperature, such as armpits, leather (National Institutes of Health, 2015).
Once the Tick bite , These insects begin to suck the blood and can transmit various toxicants that are going to produce Some medical complications (National Institutes of Health, 2015).
In most cases, tick bites do not usually lead to disease transmission; however, some carry Can lead to various pathologies, such as Lyme disease (National Institutes of Health, 2015).
About us
Lyme disease is the most common tick-borne disease in Europe and the northeastern Pacific, Northeastern and Midwestern states United States (Healthline, 2015).
In general, this type of pathology is distributed all over the world, however, it follows a pattern of endemic areas parallel to the presence of Type of tick transmitter of the bacterium that causes Lyme disease (Bonet Alvés et al., 2016).
In the case of Spain, in recent years cases of Lyme disease are increasing in specific areas of the north of the country, due to a greater Contact of the population with nature or an increase in the tick population (Vázquesz-López, 2015).
Specifically, the majority of cases of Lyme disease in Spain are diagnosed in the north, in places such as La Rioja, Navarra, Castilla y León, Asturias, Cantabria and the Basque Country (Portillo et al., 2014).
On the other hand, Lyme disease can affect people of any age, however, it is usually more common among children and the elderly (Centers for Disease Control and Prevention, 2015).
In addition, there are also some professions of risk like the one of fireman or ranger that by its exposure to activities in the open air, they present / display a Increased likelihood of exposure to ticks of the genus Ixodes (Centers for Disease Control and Prevention, 2015).
In the United States, Centers for Disease Control and Prevention has estimated that approximately 300,000 people are diagnosed each year With Lyme disease (Lymedisease, 2016).
Signs and symptoms
Lyme disease is a multiorganic pathology (López-Hortas et al., 2008) that can produce cardiac, neurological, cutaneous and Rheumatology (Alonso Fernández, 2011).
All the symptoms and medical signs characteristic of this pathology usually follow an evolution or clinical course in phases: Phase I (early stage); Phase II (early disseminated) and phase III (late disseminated) (Vázquez-López et al., 2015).
Phase I: Located early
In the first phase of Lyme disease, it is said that the pathology is still localized, as it has not yet spread throughout the body (National Institutes of Health, 2015).
The first symptoms of the disease usually begin a few days or weeks after you have contracted the infection (Clinica Dam, 2016) and usually include:
- Acne He Erythema migratory (MS), is a type of rash in the form of an ox eye that is usually Appear in the place of the bite as a central red spot surrounded by a paler color with the edges defined and red. This symptom It does not produce pain or itching, although to the touch it is shown with a higher temperature than other cutaneous areas. It is one of the earliest signs of Disease and is a sign that bacteria are in the bloodstream (Healthline, 2015).
Phase II: Early dissemination
In the second phase of Lyme disease, the bacterium that causes the infectious process has already begun to spread through the organism (National Institutes of Health, 2015).
Signs and symptoms typical of this phase can affect multiple systems and usually occur several weeks after the bite.
The medical complications characteristic of this phase usually include one or more Migratory erythemas , Neurological manifestations, cardiac and / or Acute articulations (Portillo et al., 2014; Healthline, 2015):
- Dermatological manifestations : Rash (MS) in several areas, in addition to the site of the bite.
- Neurological manifestations Severe headache , neck stiffness, meningitis , Numbness, tingling, Bell's palsy, between others.
- Cardiac manifestations : Myocarditis, arterioventricular block.
- Joint manifestations : Joint inflammation, oligoarticular arthritis.
In addition to the symptoms described above, it is common for this phase to present some symptoms similar to those of the processes Influenza A (Healthline, 2015):
- Shaking chills.
- High body temperature.
- Fatigue and tiredness.
- Muscle pain.
- Severe headache.
- Swollen lymph nodes.
Phase III: Late dissemination
In the third stage of Lyme disease, the bacterium that causes the infectious process has already spread throughout the body (National Institutes of Health, 2015).
Generally, those affected by Lyme disease usually reach this stage of the disease when no intervention has been performed (Healthline, 2015).
As in the previous phase, the signs and symptoms typical of this phase can affect multiple systems and can occur from weeks to months After the sting (Healthline, 2015).
The clinical course of the third stage of Lyme disease is characterized mainly by:
Severe headache
- Recurrent arthritis.
- Severe heart rhythm disturbance.
- Encephalopathy.
- Short-term memory loss, Difficulty concentrating , mental confusion.
- Numbness of hands or feet.
Specifically, depending on the affected systems, the symptoms of the third stage of this pathology can be classified into (Portillo et al. 2014):
- Dermatological manifestations : Slow resolution of erythema migratory (EM) or presence of Acrodermatitis Chronic atrophy - ACA- (Rash leading to generalized skin atrophy).
- Neurological manifestations : Sensory polyneuropathy, neuroborrelosis, encephalopathy, Cognitive impairment , Alteration of production Of intrathectal antibodies.
- Cardiac manifestations endocarditis And / or dilated cardiomyopathy.
- Joint manifestations : Recurrent or persistent arthritis and / or treatment-resistant arthritis.
Causes
Lyme disease is an infection caused by bacteria Borrelia burgdorferi And is transmitted to humans through Of the tick bite of the genus Ixodes (Lymedisease, 2016).
Ticks of the genus Ixodes are usually found in areas with vegetation, essentially trees and grass. Although it is usually associated with the territories or Warm areas can be found anywhere in the world (Lymedisease, 2016).
When a tick bites, bacteria enter the skin makes the blood stream and after 36-48 hours the symptoms begin to (Mayo Clinic, 2016).
Diagnosis
The diagnosis of Lyme disease is complicated since it usually presents a multisystemic affection with nonspecific symptoms and that, often Also found in other pathologies (Mayo Clinic, 2016).
In emergency medical services, specialists in addition to obtaining information about medical history, the latest activities performed and Visited places, try to detect some of the characteristic symptoms such as erythema migrans (Mayo Clinic, 2016).
In addition, laboratory tests are also usually used to confirm the presence of an infectious process (Mayo Clinic, 2016).
- ELISA technique (Enzyme-Linked ImmunoSorbent Assay): This test is used to detect the presence of antibodies against the bacteria Infection in the blood. It is usually not effective in the early stage of the disease, since the organism needs several days to weeks to Develop antibodies.
- Western Blot Test : If the ELISA technique offers a positive in Lyme disease as a result, it is usually used the test of Western Blot to detect the transfer of antibodies of B. burgorferi to several proteins, thus confirming the diagnosis.
Treatments
Lyme disease is treated effectively in the early stages, through the prescription of oral antibiotics (Healthline, 2015).
Generally, the drugs Under medical prescription More employees to treat this pathology are (Healthline, 2015):
- Doxycycline: This type of oral antibiotic is used in the treatment of Lyme disease in the child population with a Age greater than eight years and in the adult population.
- Ceforuxima and amoxicillin: Both types of oral antibiotics are used for the treatment of Lyme disease in the Young children, lactating women and adults.
In addition, it is also possible that other therapeutic measures are required for the treatment of secondary medical complications such as Neurological symptoms or cardiac abnormalities (Centers for Disease Control and Prevention, 2015).
Patients treated in this way, in the early stages of Lyme disease, usually recover completely and rapidly (Centers for Disease Control and Prevention, 2015).
However, in a small percentage of cases, the symptoms of Lyme disease usually persist for more than 6 months, persisting pathology and Becoming a chronic medical condition (Centers for Disease Control and Prevention, 2015).
Thus, the treatment used is based on intravenous antibiotics given between 14 and 21 days (Healthline, 2015).
After treatment, some of the symptoms, such as joint or muscle pain, fatigue, etc., may still be present, due to the development of a Medical condition known as Post-treatment Lyme Syndrome (Mayo Clinic, 2016).
The causes of these persistent and persistent symptoms are unknown and, furthermore, antibiotic treatment usually does not work (Mayo Clinic, 2016).
On the other hand, some health organizations warn about the use of Bismacine as an injectable drug used as an alternative medicine for Lyme disease (Mayo Clinic, 2016).
Bismacine, also known as chromatin, contains high levels of bismuth (Mayo Clinic, 2016).
He bismuth Is a chemical element of the group of metals, which is usually used safely in some pharmacological compounds for the treatment of Stomach ulcers, however, its injectable use is not approved for the treatment of Lyme disease since it can lead to poisoning And lead to poisoning and the development of heart and kidney failure (Mayo Clinic, 2016).
When we are suspected of suffering from a pathology or medical condition, it is essential that we go to emergency medical services and that the Specialists design the most appropriate therapeutic intervention.
References
- Alonso Fernández, M. (2012). Lyme disease. Is it so infrequent? Semergen. , 38 (2), 118-121.
- CDC. (2015). Lyme Disease . Retrieved from"Centers for Disease Control and Prevention."
- Clinic, M. (2016). Lyme disease . Obtained from Mayo Clinic.
- Clinica DAM. (2016). Lyme disease . Obtained from DAM Clinic.
- Healthline. (2015). What Is Lyme Disease? Retrieved from Healthline.
- López-Hortas, R., Castro-Torrado, R., Poblador-Holgín, D., & Calvo-Rivera, C. (2008). Lyme disease: the great imitator. Semergen. 201-204.
- LymeDisease. (2016). About Lyme Disease . Obtained from LymeDisease.org.
- NIH. (2015). Lyme disease . Obtained from MedlinePlus.
- Portillo, A., Santibáñez, S., & Oteo, J.A. (2014). Lyme disease. Enferm Infecc Microbiol Clin. , 32 (1), 37-42.
- Vázquez-López, M. E., Pego-Reigosa, R., Díez-Morrondo, C., Castro-Gago, M., Díaz, P., Fernández, G., et al. (2015). Epidemiology of the disease Lyme in a sanitary area of the northwest of Spain. Gac Sanit. , 29 (3), 213-216.
- Vázquez-López, M. E., Pérez-Pacín, R., Díez-Morrondo, C., Díaz, P., & Castro-Gago, M. (2015). Lyme disease in age. Annals of Pediatrics.