Rheumatic diseases presenting as sports-related injuries. Sports Med, 38 11 , Cameron DJ. Consequences of treatment delay in Lyme disease. J Eval Clin Pract, 13 3 , What Is Lyme Disease? Lyme disease is a bacterial infection typically transmitted through the bite of an infected tick.
Lyme disease has been associated with numerous neurologic, rheumatologic and psychiatric manifestations. However, the full range of symptoms needed to recognize the disease may not be apparent to a physician during a routine examination. Ticks are tiny parasites that feed on the blood of their hosts humans and animals in order to survive and advance to the next life cycle stage. Most ticks have four stages: egg, larva, nymph and adult. The larva and nymph need a blood meal to move to the next stage.
Ticks are extremely small, with the nymph the size of a pinhead. Daniel Cameron, MD, MPH, is a nationally recognized leader for his expertise in the diagnosis and treatment of Lyme disease and other tick-borne illnesses.
For more than 34 years, he has been treating adolescents and adults suffering from Lyme disease. View All Interviews. Kisco, NY Tel: Fax: Call for your appointment today Mt. Kisco, New York. About Lyme Disease. Misdiagnosing Lyme disease References Misdiagnosing Lyme disease Misdiagnosing Lyme disease The Great Imitator The Borrelia burgdorferi Bb spirochete is an evasive organism which can penetrate virtually any organ or system in the body, including the brain and central nervous system, joints, muscles and heart.
Introduction Dr. Many, but not all, people with B. Without prompt treatment, the bacterium can migrate from the bite area to other areas of the body, in particular the nervous system, heart, and joints. This can lead to a range of persistent symptoms, including fatigue, night sweats, stiff neck, headache, disrupted sleep, and depression.
These symptoms can last for months or years. Some studies estimate that 10 to 20 percent of people still experience symptoms even after treatment with standard antibiotics. In a study in Frontiers in Medicine, Aucott and his colleagues found that people with well-documented PTLDS had higher levels of depression — along with fatigue, pain, and poor sleep quality — than healthy participants.
Although major depression is less common in people with PTLDS, those with moderate to severe depression have a greater risk for suicidal thoughts. However, one study found that people with PTLDS have more difficulty with memory-related tasks compared to people with major depression. And these memory problems can occur alongside language and attention difficulties.
So, do people with Lyme disease have depression because they have a chronic illness, or because of changes to their brain caused by the disease? In particular, researchers have been looking at inflammation caused by infection with B. This protein is a marker for brain inflammation. Although the results will need to be replicated in larger studies, they fit with other research linking chronic inflammation with depression.
For Allie Cashel , president and co-founder of Suffering the Silence , an online community for people living with chronic illness and disability, the link between the long-term symptoms of Lyme disease — or any chronic illness — and mental health makes sense. People who are bitten by a tick may not even realize it. Or they may not develop the characteristic Lyme rash. When they do, their doctor may make a diagnosis of another condition, like depression or anxiety. While this can provide the clarity of having a definite condition, it may not bring relief of their symptoms.
If there were a reliable test for Lyme disease, these problems would probably go away. The lack of a clear diagnosis can leave people with PTLDS in limbo, constantly at a loss to explain why they feel so exhausted all the time.
It is well documented that the consequent overdiagnosis of Lyme disease leads to unnecessary antibiotic prescriptions for patients who do not have the infection. This large study by Kobayashi and colleagues from a highly endemic area elucidates the clinical characteristics of a representative population referred to an ID office. It is not surprising that almost three-quarters of the 1, patients categorically did not have Lyme disease.
The longer the symptom duration, the less likely it was the patient had Lyme disease. Yet the vast majority of these patients had received antibiotics. The authors remind us that about a fifth of all U. This translates into a very large population who may have a medically unexplained diagnosis. This study also reinforces previous knowledge that misinterpretation of immunoblot results leads to an incorrect diagnosis of Lyme disease.
A novel finding is that additionally, patients with these symptoms are being incorrectly diagnosed as having co-infections. Several take-home messages from this study can be used to educate physicians and patients. This education is needed not only to curb antibiotic use in persons without infections, but to avoid labeling persons with persistent symptoms as having a chronic infection.
This could be lifesaving. Immunoblot results should be interpreted carefully and only using current recommendations. A positive immunoglobulin M immunoblot can be used only to support a diagnosis of early Lyme disease, and only in conjunction with relevant clinical findings. A belief is now trending that tick-borne coinfections are common and that they contribute to chronicity of symptoms.
In fact, coinfections are not common, and the broad testing panels available should be used very judiciously. Perspective from Sunil K.
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