Lyme disease symptoms signs course diagnosis treatment lyme disease

Lyme disease is a term used to describe infectious diseases caused by Borrelia bacteria. The bacteria primarily transmitted by ticks can cause a variety of symptoms in the human organism, which makes the diagnosis of Lyme disease difficult.

ICD-10: A69.2 Lyme disease Medical contact points: Family doctor, general practitioner

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Lyme disease is always suspected when the symptoms listed below occur – or. more than three of them. They include a persistent tiredness, languor and exhaustion – without being justified by any physical exertion. There may also be severe pain in the joints, back pain, and neck pain that resolves without treatment.

Headache is another common symptom. These are usually diffuse, sometimes ring- or cap-shaped severe pains. Pain in the hair roots when combing is also characteristic. Tongue pain and pharyngeal pain, which often occur on one side, are also possible symptoms.

Recurrent and persistent sinusitis with swelling of the mucous membranes can occur, as can swollen lymph nodes in the neck, groin and armpits.

If you have constant muscle pain or soreness without any explanation by particular exertion, you should also think of Lyme disease.

Pain symptoms

– Tendon pain, especially in the Achilles tendon – Pain in one arm or leg (Bannwarth syndrome) – Tennis or golf elbow – Pain in the sole of the foot (especially in the morning) – Pain in the ribs, associated with reduced breathing volume and a feeling of tightness in the chest – Burning pain and numbness of the skin – Sudden stabbing pain

Symptoms in the area of the eyes

– eye dysfunction – eye muscle pain – double vision – pupil disturbances – eyelid weakness – eye inflammation – burning eyes – foreign body sensations

Sensory disturbances

– functional disorders such as sudden hearing loss – dizziness – tinnitus – impaired sense of taste and smell – changes in temperature sensation – sweating – alternating hot flashes as in menopause (also in men) – burning face (without fever) – sexual disorders such as loss of libido – erectile dysfunction – aching breasts – menstrual disorders – urological disorders – frequent urination – incontinence – groin pains

Metabolic symptoms

– flatulence – stomach pain – bloating – lack of appetite – diarrhea – constipation – intolerance to certain foods or food components – hyperacidity – metabolic disorders – elevated cholesterol levels – thyroid disorders such as hypothyroidism – so-called Hashimoto's thyroiditis

Neurological symptoms

– irritations of the nerves of the brain – facial paresis (especially in the early stages), d.h. a facial paralysis – muscle twitching of different regions

Mental& Psychological symptoms

– disorders of the serotonin balance – anxiety – irritability – aggression – mood swings – sleep disorders – nightmares – in children ADHD – quarrelsomeness – compulsive behavior – apparitions – psychoses – manic-depressive episodes – disorders of short-term memory – distractibility – concentration disorders – reduced learning ability – disorientation – severe memory loss as in Alzheimer's disease – delusions

Other symptoms

– wandering redness – lymphocytoma – cigarette paper skin (this in the presence of acrodermatitis chronica atrophicans) – diffuse hair loss – nail changes such as grooves and brittleness – nocturnal palpitations without being preceded by exertion – sharp increase in diastolic blood prere value to more than 90 mm Hg

Course of the disease

The good news is that an intact immune system usually keeps the pathogen in check without any problems, so the bite is completely inconsequential. However, it can survive in the host body. If immune deficiency occurs at some point, cause the disease to break out. It is obvious that in such cases the connection is difficult to establish.

Unfortunately, the layman has almost no chance when it comes to assessing the later stages of the disease and to linking chronic symptoms, some of which are extremely distressing, with an insect bite that occurred a long time ago.

The disease typically progresses in 3 stages:

– In the first stage, redness appears at the site of the tick bite, which – in the 2. The first stage is accompanied by fever, headache, muscle pain and swelling of the lymph nodes. Occasionally there are cardiac arrhythmias, failures of the nervous system as well as brain involvement. – In the 3. In the second stage, joint inflammation occurs, especially at the knee and finger joints as well as at the toe and wrist joints, or involvement of the brain and meninges.

What to do?

If you notice a tick bite, you are well advised to remove the tick as soon as possible, as the pathogens can only pass into the host body after several hours of sucking

If it has finally come to this, the majority of those affected develop the so-called wandering redness (lat. erythema migrans). This is one of the few sure indications of infection.

If the disease breaks out, it can cause a variety of symptoms in the long term. This is referred to as a multisystemic disease that progresses in three successive stages.

If several of the above symptoms occur, a doctor should be consulted.

What does the doctor do?

The doctor will take some blood in order to be able to determine or exclude a Lyme disease on the basis of a laboratory analysis.

Since the symptoms are quite unspecific and cover the whole spectrum of clinical symptoms, further examinations may be necessary to make a clear diagnosis.

Even if Lyme disease is diagnosed, the symptoms can be caused by an additionally understood, other disease. In order not to miss any necessary therapy, all suspected diagnoses will be investigated.


The earlier the disease is detected, the better are the chances of recovery. Antibiotics such as tetracycline or amoxycillin are used for treatment. Lyme disease is spread worldwide. Is the most common tick-borne disease in Europe.

While an effective vaccine against the rarer disease TBE is available, there is no vaccine against Lyme disease. Since about 35% of ticks are infected with Borrelia (screw bacteria), approx. 3-6 % of the affected persons.

Small rodents, birds, deer and deer infested with ticks serve as reservoirs for the pathogens. After a tick bite, the time to onset of the disease can vary greatly. Symptoms often appear only after several weeks.

Causes& Emergence

Lyme disease is transmitted by ticks
Photo: D. Kucharski K. Kucharska | Shutterstock

Lyme disease is transmitted by tick bites from infected ticks. Especially in the summer months, ticks sit in the grasses and lie in wait for their hosts (humans, dogs, cats and other mammals). The tick prefers to seek out warm, moist and dark areas of the body.

Since tick saliva has an anti-inflammatory effect, many people and animals do not notice the tick bite until the tick is clearly visible and covered with blood on the body.

The longer the tick remains attached to the body, the greater the risk of Lyme disease infection for the host. The tick should be removed immediately after discovery with special tick hooks or tick cards.

How dangerous is Lyme disease? The disease is especially dangerous during pregnancy. For people who are already in poor health. The manifold symptomatology makes it difficult to make statements beyond that.

In many cases Lyme disease runs undetected and symptomless. In individual cases, it can even trigger life-threatening symptoms.

If there is a suspicion of infection with Borrelia after a tick bite, this should be followed up in any case to prevent possible spread and reduce the risk of complications.


When staying or walking in the woods for a long time, it is recommended to wear closed light-colored clothing as well as closed shoes as protection against ticks. After spending time in nature, the body should be checked for ticks and, if possible, change clothes.

If a tick is discovered, it must be removed as soon as possible. The tick must not be squeezed, but should be removed with a tick removal card or forceps. After successful removal of the tick, the bite site must be cleaned. disinfected and the wound must be observed for a few days. Home remedies such as oil, glue or wax should be avoided.

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