Early Disseminated Lyme Disease

Early disseminated Lyme disease is the phase of Lyme disease in which the bacteria that cause this condition have spread throughout your body. This stage can occur days, weeks, or even months after you are bitten by an infected tick. Lyme disease is a bacterial infection that is caused by bites from a blacklegged tick. Lyme disease occurs in three stages; this condition is associated with the second stage of the disease:

• stage I (localized Lyme disease): This stage occurs within several days of a tick bite and may cause redness at the site of the tick bite along with fever, chills, muscle aches, and skin irritation.
• stage II: This occurs within weeks of a tick bite. The untreated infection begins spreading to other parts of the body, producing a variety of new symptoms.
• stage III (late disseminated Lyme disease): This occurs months to years after an initial tick bite, when bacteria have spread to the rest of the body. According to the Centers for Disease Control and Prevention (CDC), 60 percent of people in this stage of the disease experience cycles of arthritis and joint pain along with neurological symptoms such as shooting pain, numbness in the extremities, and problems with short term memory (CDC, 2011).

Lyme disease is a bacterial infection. It is caused by bacterium called Borrelia burgdorferi. You can become infected when a tick that carries the bacterium bites you. Typically, black-legged ticks and deer ticks spread the disease. These ticks collect the bacteria when they bite diseased mice or deer.

You can become infected when these tiny ticks attach themselves to various parts of your body. They are about the size of a poppy seed and favor hidden areas such as the groin, armpits, and scalp. Often, they can remain undetected in these spots.

Most people who develop Lyme disease report that they never saw a tick on their body. The tick transmits bacteria after being attached for about 36 to 48 hours.

Early disseminated Lyme disease is the second stage of the infection. It occurs within a few weeks of a tick bite, after the initial infection goes untreated.

You are at risk for early disseminated Lyme disease if you have been bitten by an infected tick and remain untreated during the early stage of Lyme disease.

You are at an increased risk for contracting Lyme disease if you live in one of the areas where most Lyme disease infections are reported. They are:

• any of the northeastern states, from Maine to Virginia
• the north-central states, with the highest incidence in Wisconsin and Minnesota
• the west coast, primarily in northern California (CDC, 2011)

Certain situations also can increase your risk of coming in contact with an infected tick:

• gardening, hunting, hiking, or doing other outside activities in areas where Lyme disease is a potential threat
• walking or hiking in high grass or wooded areas
• having pets that may carry ticks into your home

The onset of early disseminated Lyme disease can begin days, weeks, or even months after being bitten by an infected tick. The symptoms reflect the fact that the infection has begun to spread from the site of the tick bite to other parts of the body.

At this stage, the infection causes specific symptoms that may be intermittent. They are:

• erythema migrans, a bull’s eye rash that occurs in areas other than the bite site
• Bell’s palsy: paralysis or weakness of facial muscles on one or both sides
• meningitis: an inflammation of the spinal cord
• neck stiffness, severe headaches, and/or fever from meningitis
• severe muscle pain or numbness in the arms or legs
• pain or swelling in the knees, shoulders, elbows, and other large joints
• heart complications, including palpitations and dizziness

Without treatment at this stage, complications of Lyme disease can include damage to the joints, heart, and nervous system. However, if diagnosed, the symptoms still can be treated successfully at this stage.

When the disease progresses from the early disseminated stage to the late disseminated stage (stage III) without treatment, it can lead to long-term complications. These may include:

• Lyme arthritis (which causes inflammation of the joints)
• heart rhythm irregularities
• brain and nervous system damage
• decreased short-term memory or the ability to concentrate
• pain or numbness
• sleep disorders
• vision deterioration

In order to diagnose Lyme disease, your doctor will order a blood test that checks for titers, or the level of antibodies in your blood, to the bacteria that cause the disease. The Enzyme-Linked Immunosorbent Assay (ELISA) test is the most common for Lyme disease. The western blot test, another antibody test, can be used to confirm the ELISA results. These tests may be done simultaneously.

The antibodies to Borrelia burgdorferi can take from two to six weeks after infection to show up in your blood. As a result, people tested within the first few weeks of infection may test negative for Lyme disease. In this case, your doctor may choose to monitor your symptoms and re-test at a later date to confirm diagnosis.

In areas where Lyme disease is common, physicians may be able to diagnose Lyme disease in stage I based on a person’s symptoms and their own clinical experience.

If your physician suspects you have early disseminated Lyme disease, and the infection has spread throughout your body, testing of potentially affected areas may be necessary. These tests may include:

• an electrocardiogram (EKG) or echocardiogram to examine heart function
• spinal tap to examine cerebrospinal fluid
• magnetic resonance imaging (MRI) of the brain to observe neurological conditions

When diagnosed at the early localized stage or early disseminated stage, standard treatment for Lyme disease is a 14- to 21-day course of oral antibiotics. Doxycycline, amoxicillin, and cefuroxime axetil are the most common medications used. Other antibiotics, or intravenous treatment, may be necessary depending on your condition and additional symptoms.

If you receive antibiotics in one of the early stages of Lyme disease, you can expect a rapid and complete recovery.

If you are diagnosed and treated with antibiotics at this stage, you can expect to be cured of Lyme disease. Without treatment, complications can occur, but they remain treatable.

In rare cases, you may experience a continuation of Lyme disease symptoms after antibiotic treatment, called post-Lyme disease syndrome. Approximately 10 to 20 percent of people treated for Lyme disease report muscle and joint pain, sleep issues, or fatigue. Although the cause for this is unknown, researchers believe it may be due to an autoimmune response (in which a person’s immune system attacks healthy tissues), or may be linked to an ongoing infection with the bacteria that causes Lyme disease (CDC, 2011).

Tips to Avoid Contracting Lyme Disease

By taking specific precautions, you can prevent coming in direct contact with infected ticks. These practices can reduce your likelihood of contracting Lyme disease and having it progress to the early disseminated stage:

• Use insect repellant on your clothing and all exposed skin when walking in wooded or grassy areas where ticks thrive.
• When hiking, walk in the center of trails to avoid high grass.
• After walking or hiking, change your clothes and perform a thorough check for ticks, focusing on the groin, scalp, and armpits
• Check your pets for ticks.
• Treat clothing and footwear with permethrin, an insect repellant that will remain active through several washings.

If you have been bitten by a tick, contact your physician. You should be observed for 30 days for signs of Lyme disease.

Tips to Prevent Lyme Disease from Progressing

Learn the signs of early Lyme disease so that you can seek treatment promptly if you are infected. With timely treatment, you can avoid the potential complications of early disseminated Lyme disease and later stages.

The signs of early Lyme disease can occur from three to 30 days after you are bitten by an infected tick. Look for:

• a red, expanding bull’s-eye rash at the site of the tick bite
• fatigue, chills, and general feeling of illness
• all-over itching
• headache
• feeling dizzy or faint
• muscle and/or joint pain
• neck stiffness
• swollen lymph nodes