Lyme disease (borreliosis) is a disease characterized by a particular variety of manifestations. The clinical pictures of two patients may have little in common despite the same diagnosis. To this day, specialists in the field of medicine have not developed a unified approach to how to diagnose borreliosis, how to properly treat it. What can we say about ordinary people? The level of awareness is extremely low.
General information
Lyme disease (borreliosis) is a focal natural pathology from the transmissible group. A sick person suffers from joints, skin, nervous system. A pathological condition can adversely affect the work of the heart. Often, the disease becomes chronic, prone to frequent relapses.
Ticks can transmit a fairly wide variety of infectious pathologies, and the most common of them is Lyme disease (borreliosis). The disease got its name from the namea small American city located in the state of Connecticut - Old Lyme. In the 70s, it was here that cases of such a disease provoked by tick bites were recorded and described.
Lyme disease (borreliosis) in the European powers by that time had been known for a long time, although there was no single name for the pathology. In some cases, patients were diagnosed with erythema, which tends to change foci of manifestation, sometimes they talked about Bannwart's syndrome, sometimes they used other names. In 1982, scientists first discovered what exactly provokes the disease, which pathogen is its source.
Technical points
The initiators of Lyme disease (tick-borne borreliosis) are Borrelia. A number of species are known to be dangerous to humans. These life forms belong to the class of microscopic aerophiles, belong to the group of Gram-negative spirochetes. As well as other representatives of this group, the causative agents of borreliosis are quite sensitive to the surrounding space.
Some pathogens of Lyme disease (tick-borne borreliosis) provoke arthritis. In North America, there are practically no other forms of pathogens, only this one. There are also those under the influence of which the nervous system suffers. Certain pathogens cause chronic skin lesions. All three types of provocateurs of the disease are united by the fact that infection with them leads to changing areas of localization of erythema.
Peculiarities of disease transmission
Lyme disease (borreliosis) is provoked by borrelias, which normally live inbody of various wild animals. Often the carriers are birds or representatives of the order of rodents. Borrelia found in the body of deer and other representatives of the wild. What unites all these life forms is the fact that Ixodes ticks feed on them. They are the carriers of the pathogen. The moment a tick receives blood from an animal, a microscopic life form enters the intestinal system of the parasite. Here the conditions are comfortable enough for active reproduction to begin. Excretion occurs during defecation.
Scientists have found that although Lyme disease (borreliosis) is triggered by infected ticks, it doesn't happen with every bite. The level of infection among ticks is extremely high, but Borrelia are contained in the salivary glands in relatively low concentrations, and in some sick individuals they are completely absent.
The circulation of Borrelia is as follows: from ticks they are transmitted to wild animals, from them they return to ticks again. In addition to wild animals, domestic animals can also be affected. There is currently a theory that Borrelia may be carried by some other life forms. In particular, presumably, horseflies can be such objects.
Man and Borrelia
Infection with tick-borne borreliosis (Lyme disease) most often occurs in the natural focus of distribution. It is usually forest in temperate climates. As specialists managed to establish, tick-borne borreliosis and tick-borne encephalitis are common in approximately the same area. On the territory of our country, cases of infection are known in variousregions. Lyme disease is twice as common as encephalitis, and sometimes four times more common.
Tick-borne borreliosis occurs in Asian, European territories, in America. In our country, the prevalence is all forest-steppe zones, from the westernmost regions to the Far Eastern regions. Studies have shown that borreliosis in Russia is the most common infection carried by ticks. The likelihood of infection after a tick bite is several times greater than the chance of getting sick with encephalitis.
Natural foci of the disease are areas where the genus of ticks mentioned above is common. The incidence is strictly seasonal, characteristic of the period when ticks are active. Usually the first cases occur in March-April, the last - in October, if the weather is warm. Maximum - May, June. In different areas, the percentage of sick ticks is quite different. It has been established that the parasite can simultaneously carry several pathogens at once, which means that the probability of mixed infection is high.
How is it going?
How can a person get Lyme disease (borreliosis)? The photos in the article show a tick - it is with the bite of such a parasite that there is a risk of infection. The transmission route is transmissible, the pathogen passes into the human body at the time of the bite. Scientists believe that it is likely that infection is also possible through tick feces, if they first get on the skin, and then this area is combed or the discharge is rubbed into the integument.
If you break the tick, remove it incorrectly, borrelia can penetrate intoorganism through the wound. The alimentary way is known - you can get sick by drinking the raw milk of a sick cow, goat.
The highest risk of getting Lyme disease is among people working in the field of forestry, forestry, hunting. The danger is high for those who live in forested regions.
Notice Lyme disease
Symptoms of borreliosis are explained by the immunopathological response of the body. Manifestations are associated with the presence of the pathogen itself, antigens. At the time of penetration, Borrelia provoke the appearance of papule, erythema. Entering the bloodstream, the causative agent of the disease spreads throughout the body, then localization occurs in tissues and organs. Adsorption takes place on cells. The most active interaction is with membrane elements of neuroglia. There is an infiltration of damaged tissues with infiltrates consisting of various elements (plasmocytes, macrophages, lymphocytes).
Borrelia provoke vasculitis, vascular occlusion. It is known that often a person develops chronic Lyme disease. Symptoms of borreliosis are explained by the fact that the pathogen can live in organic tissues for many years, provoking relapses from time to time. To a greater extent, this is typical for cases where a person does not receive adequate treatment.
If the disease progresses, the pathogen becomes a trigger factor that stimulates immunopathological processes. A symptom of Lyme disease (tick-borne borreliosis) is chronic arthritis. There is a possibility of neuroborreliosis. The response of the immune system is more vivid when the diseasealready progressed. To a greater extent, this is characteristic of the period when the joints suffered.
With the right treatment, it is possible to normalize the content of antibodies, the patient recovers. There are cases when the persistence of the pathogen in the late stages of borreliosis did not lead to clinical symptoms.
Infection
In the first days, it is almost impossible to notice the symptoms of Lyme disease (borreliosis) - at first the incubation period lasts. Its duration in rare cases is only two days, in some cases up to a month. On average, the pathogen takes two weeks. The clinical picture varies from case to case, some patients have no symptoms at all.
It is customary to distinguish three main stages. The division is rather conditional, not all experts in the field of medicine agree with it. It is not at all necessary that each patient will have all three stages at different periods of the disease. There are cases of manifestation strictly in the form of a chronicle. This forces us to be especially attentive to patients who have applied with arthritis, polyneuropathy and a number of other conditions potentially associated with borreliosis. To clarify the diagnosis, you will first have to order tests to rule out Lyme disease. Symptoms, consequences of tick-borne borreliosis should be known first of all by doctors in order to make the correct diagnosis for the patient.
About stages and forms
Erythema migrans appears at an early stage of borreliosis. This is one reddish spot, localized in the place where the tick bit. Some patients experience multiplespots. Gradually centrifugal growth occurs. The diameter after a few weeks can reach 20 cm, and in some patients the size of the formation is even larger. The more erythema, the more pronounced regression in the center. A clear trace is possible in the center of the focus.
The area is more often localized on the trunk, legs, arms, less often on the face. Along the edges, a rupture of the erythema border is possible, the strip becomes like a garland. Perhaps the intersection of the chest, neck. It is erythema that is the key sign of borreliosis, which makes it possible to suspect which diagnosis should be made. The area is hot to the touch, responds with pain, itches and burns. Erythema is more often in the form of an oval or a circle, but incorrect formation is possible.
In some patients, erythema persists for months, in others it disappears after a couple of days. With etiotropic treatment, regression is observed after a week of the therapeutic course. Perhaps the complete disappearance of damage, there is a possibility of skin peeling, pigmentation of the focus. The bite point is marked with a crust.
May have child foci. Often, borreliosis is accompanied by general poisoning, the temperature rises. Headache, shivering, feverish, sleepy.
Second stage
Usually this period falls on 4-5 weeks after infection. In some cases, it is observed in the second week, sometimes - only on the 21st. Borreliosis manifests itself as meningitis, neuritis, impaired functionality of the heart and blood vessels. A syndrome similar in manifestations to the flu is possible - a headache, fever, the patient is weak. On the skinlesions are more often secondary annular, their size is up to 5 cm. A rash is possible on the palms, there is a possibility of skin lymphocytoma.
Up to half of patients suffer from facial neuritis. Every third person has moderate symptoms of encephalitis. Possible damage to the nervous system responsible for eye movement, hearing. With borreliosis, peripheral NS suffers. A fairly typical manifestation is Bannwart's syndrome, in which the nerve roots are damaged, meningitis develops.
Neurological disorders often resolve themselves in a month, but the risk of recurrence is high. There are cases when, with Lyme disease, it was precisely such lesions that were the only signs, and erythema did not appear, as well as signs of infectious processes in the body.
About 8% of patients in the 5th week are faced with impaired cardiac function. The heart hurts, it is reduced intermittently. Inflammatory processes in cardiac tissues are possible. Such symptoms can disturb a month and a half. The entire second stage of borreliosis is accompanied by weakness and painful sensations localized in muscle, joint, and bone tissues.
Late chronic form
In the third stage, the joints suffer. Usually the stage begins two months after infection, sometimes later - a year or two. Large joints are more commonly affected, possibly only on one side, although there is a possibility of symmetrical polyarthritis. Arthritis occurs with relapses, destructive processes affect cartilage, bones, the disease is chronic.
Borreliosis in the form of a chronicle is remissions followed by relapses. Permanentrelapses. Of the manifestations, the most pronounced is arthritis. Changes characteristic of chronic inflammatory processes are not uncommon: cartilage becomes thinner and disappears, degenerates. Possible skin lesions, benign lymphocytomas, painful when touched.
At a late stage, Lyme disease can be accompanied by chronic acrodermatitis. In the area of \u200b\u200bdiseased areas, the skin atrophies, in appearance they become similar to tissue paper. The duration of progress is months and years. Neuroborreliosis is observed. Encephalomyelitis, characteristic of the disease, is similar in manifestations to multiple sclerosis. Possible memory impairment, sleep impairment, speech disorder.
What to do?
If the disease proceeds at an average level, hospitalization is necessary, followed by the choice of a strategy to combat Lyme disease. Treatment of borreliosis is possible in an infectious diseases hospital. With a mild form of the disease, treatment at home is allowed. Assign complex antimicrobial therapy. The choice of specific drugs, regimen, dosage - at the discretion of the doctor. The doctor analyzes the severity of the course of the disease, the features of a particular case.
Persons who have been bitten and recovered from the disease are registered at the dispensary for at least two years in order to control the consequences of tick-borne borreliosis (Lyme disease). Clinical examination involves a visit to a therapist, an infectious disease specialist. After 3, 6, 12, 24 months, full-fledged clinical studies are needed, based on the results of which it is possiblereferral to a cardiologist, neurologist or other highly specialized doctors.
Especially attentive attitude should be to pregnant women with Lyme disease. Prevention of borreliosis currently does not involve the use of specific means due to the lack of such. The negative effect of the pathogen on the embryo has been proven, especially strong at the beginning of gestation. In each individual case, it is decided on an individual basis as far as possible and reasonable to keep the pregnancy.
How to warn?
So far it has not been possible to develop a vaccine that would eliminate infection with borreliosis. The best method of ensuring he alth is to minimize the risk of a tick bite. Individual protective measures must be observed. Doctors, responsible persons with the population carry out explanatory work, designed to convey the danger of tick bites and ways to prevent them. As soon as a tick is noticed on the body, it is necessary to immediately remove the parasite. The causative agents of borreliosis live in the intestinal tract, so it takes some time to penetrate into human blood. The probability of infection is greater, the longer the parasite is on the human body.
The use of antibiotics after a tick bite to prevent Lyme disease is currently open. It is believed that a course of antimicrobial drugs in the first days after a tick bite can somewhat reduce the risk of illness, but the choice of drugs is at the discretion of the doctor. To minimize negative consequences,you should immediately contact the clinic for professional help after detecting a tick bite.
Knowing the early signs is especially important in the absence of specific prevention for Lyme disease. The consequences of borreliosis, detected in time, are minimal if the patient is prescribed the correct treatment with antibacterial drugs.
What does it lead to?
The consequences of Lyme disease (borreliosis) are more to be feared if the patient has not received adequate treatment. In the predominant percentage, the prognosis for infection is positive. If the disease has progressed to the third, most severe stage, has become chronic, the condition worsens over time. Possible skin degenerative processes, deformations in the areas of localization of infectious foci. If left untreated, there is a risk of disability or death.
Without adequate assistance, there is a possibility of impaired functionality of the hearing and vision system, possible memory loss and dementia, severe heart disorders, muscle paralysis. There are cases when borreliosis without treatment led to multiple arthritis and was the cause of the appearance of benign neoplasms. Those are more often localized near the point of the tick bite.
The disease belongs to the class of infectious, at the primary stage it is cured quite easily. It is much more difficult to achieve a cure at a late stage - it is in this case that the chance of negative consequences is especially high. To minimize risks, after going out into nature, it is necessary to carefully examine the entire body for bites.
Important nuances
After hospitalization of the patient and confirmation of the diagnosis with borreliosis, the doctor prescribes complex therapy. It is necessary to simultaneously destroy the pathogen and restore the functionality of tissues and organs damaged by it. To select antibiotic therapy, it is first necessary to conduct tests in order to detect sensitivity to various substances. Requires pathogenetic treatment. The course is prescribed, taking into account the main symptoms, complications inherent in the patient.
At the first stage, curing borreliosis is easy, and the risk of consequences for the nervous system, joints, and heart is minimal. The most commonly used tetracycline, amoxicillin. The duration of the course varies from 20 to 30 days. If the disease is severe, antibiotics are given by injection.
It is possible to use cephalosporins or medicines containing erythromycin. The drug "Sumamed" has proven itself well.
If borreliosis is accompanied by arthritis, non-hormonal anti-inflammatory, analgesics and physiotherapy are prescribed. To lower the chance of an allergic reaction, antihistamines are indicated. To restore the body's strength at the stage of recovery, the patient is prescribed vitamin complexes, immunotherapy.
