The effects of Lyme disease are permanent

Lyme disease: what are the symptoms?

Borreliosis mainly affects the skin, the nervous system and the joints. If there is any reddening around the puncture site that spreads in a ring, you should definitely see a doctor

Lyme disease can affect several organs and varies from person to person. The infection with Borrelia is most common on the skin, but the nervous system and joints and, rarely, the heart can also be affected. The various complaints can appear individually, at the same time or one after the other.

At least days to several weeks pass between the tick bite and the first signs of the disease. In rare cases, when the Borrelia persists in the body, symptoms appear months to years after the infection.

Severe courses of Lyme borreliosis are rare. Only every third or fourth infected person develops symptoms at all.

Ring-shaped skin inflammation (wandering redness, erythema migrans)

The characteristic sign of Lyme borreliosis is the typical skin inflammation: a circular, sharply defined reddening forms around the tick bite, which spreads in a ring until it is at least five centimeters in diameter. Because it spreads in this characteristic form, it is also called wandering blush (Erythema migrans).

The reddening develops a few days to weeks after the tick bite and its classic form can usually be recognized by the doctor at first glance. The non-specific reaction to the tick bite that occurs immediately after the bite is to be distinguished. This often slightly swollen reddening usually does not exceed three to four centimeters and disappears on its own within a few days.

Wandering redness is the most common symptom of Lyme disease and occurs in 80 to 90 out of 100 people. Since it can be very inconspicuous and causes only minor symptoms, for example it does not itch, it can easily be overlooked.

Skin changes in connection with a tick bite should always be the reason for a doctor's visit. Even if the redness looks different than the classic wandering redness or does not migrate, a Borrelia infection can be behind it. In some of the Lyme disease patients, round or oval reddening occurs in several places on the skin at the same time (multiple erythemata migrantia).

General feeling of illness

Within the first few weeks after a tick bite, flu-like symptoms such as fatigue, joint pain, muscle pain, high temperature or night sweats can also indicate Lyme disease. They can occur together with or independently of the wandering blush and be a sign that Borrelia is spreading in the blood in the body.

Blue-red skin lumps (Borrelia lymphocytoma)

A rarer sign of Lyme disease is a usually single blue-red lump in the skin. The so-called Borrelia lymphocytoma arises as a reaction to the bacteria through the accumulation of certain cells of the body's defenses (lymphocytes) in the skin. The painless, soft nodules can appear anywhere on the body, but are mainly found on the ear, on the nipples or in the genital area, more rarely on the nose. They appear in the first few weeks after infection and are more common in children than adults. About seven in one hundred children and two in one hundred adults with Lyme disease have Borrelia lymphocytoma.

Nerve pain and neurological symptoms (neuroborreliosis)

Borrelia infect the nervous system in 3 to 15 out of a hundred sufferers. The most common signs of neuroborreliosis are burning and stabbing pains that occur primarily at night. The nerve pain is often belt-shaped, can change location, and typically does not respond well to pain medication. Inflammatory nerve irritation can lead to numbness, visual and hearing impairments. Paralysis also occurs, especially of the facial nerves, arms and legs. Other neurological symptoms are also possible. Strokes caused by involvement of the cerebral vessels are extremely rare.

In children, neuroborreliosis most often manifests itself with a sudden paralysis of the facial nerve (facial paralysis) or severe headache, possibly with stiff neck, photophobia, nausea, vomiting or fatigue, due to meningitis (lymphocytic meningitis).

Weeks or months can pass between the tick bite and the occurrence of neuroborreliosis. Some of those affected have previously observed a wandering reddening. The neurological symptoms can also occur at the same time as the wandering reddening or without any noticeable skin changes.

Inflammation of the heart (carditis)

Borrelia infestation rarely leads to inflammation of the heart (carditis), which can be particularly noticeable in cardiac arrhythmias.

Late Lyme disease: chronic inflammation of the joints, skin and nervous system

If Lyme disease is not treated with antibiotics, the pathogens can persist in the body and cause symptoms after months or years. The late stages of Lyme disease are rare and mainly affect the joints, skin and nervous system. Typically, single or a few large joints - most often the knee joints, less often the ankle and elbow joints - become inflamed with typically massive swelling (Lyme arthritis). The discomfort can persist or occur in episodes.

The skin sometimes changes, especially on the arms and legs. It swells first and then thins and turns bluish in color. Often there are signs of nerve damage such as numbness, tingling, burning or increased sensitivity to pain. This so-called acrodermatitis chronica atrophicans mainly affects women of advanced age.

Chronic brain and spinal cord inflammation is also a possible late symptom of Lyme disease. Signs of late neuroborreliosis are diverse, spastic paralysis with gait disorders and bladder disorders often occur.

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