Lyme disease (Lyme disease)The multiform Lyme disease can be described as a multisystem disease. The skin, central nervous system, joints and heart are particularly affected. Scientists usually divide the course of the disease into stages I to III, in medical practice, however, the less rigid division into acute (stage I and II) and chronic stage (corresponds to stage III) is often preferred.
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It should be noted that each sign of the disease can occur in isolation, but also in different combinations with skipping of a stage over years.
Spontaneous healing is possible especially in the first two stages of the disease. Having had Lyme disease does not imply immunity to re-infection after a tick bite.
In many cases, a typical reddish-bluish discoloration of the skin (erythema migrans) occurs at the site of the bite within 3 days to several weeks after the tick bite. This discoloration spreads in a ring and can reach a diameter of 5 to 20 centimeters. In the center, the puncture site can be seen, around which the redness usually fades away. Erythema migrans, or wandering redness, may also appear in one or more other parts of the body, indicating that the bacterium has spread throughout the body.
Erythema migrans must be distinguished from a local harmless skin discoloration as a direct consequence of the tick bite. The latter generally lacks the lightening in the center. It remains limited to the actual bite site with a size of one to two centimeters. The appearance of the migratory redness can vary greatly, so that every skin change in connection with a tick bite should always be shown to a pediatrician and adolescent doctor.
Some patients also suffer from general infection symptoms such as fever, muscle pain, joint pain, headaches, conjunctivitis, sweating, swelling of the lymph nodes, fatigue and gastrointestinal complaints, which may persist through all stages or occur for the first time. In case of flu-like symptoms after a tick bite, the child should therefore be examined by a pediatrician and adolescent doctor without fail.
Weeks to six months after the tick bite, burning nerve pain with disturbances of sensory perception and paralysis occur close to the erythema migrans (Bannwart syndrome); consequences of inflammation of the nerve roots and loss of the cranial nerves with the exception of the olfactory nerve. Impaired vision or hearing as well as inflammation of the heart can also occur with Lyme disease. This is the typical disease pattern in adults.
The infestation of the nervous system (neuroborreliosis), on the other hand, is manifested in 90% of children in a mostly unilateral facial nerve paralysis (facial paresis). In this case, the children cannot close the eye on the affected side, cannot frown on one side and cannot whistle, as one corner of the mouth hangs down limply. Much rarer is meningitis, which causes a variety of symptoms such as fever, vomiting and severe headaches.
Children and adolescents in particular occasionally develop a small, firm, benign, blue-red skin tumor (Borrelia lymphocytoma), which occurs mainly on the earlobes, the nipples and in the genital area, where it remains for weeks to months.
Relatively rare are heart diseases, such as z.B. Heart muscle and pericardial inflammation, inflammation of the eye or muscles.
Six months to years after the tick bite, about 5% of adults and children may develop joint involvement (Lyme arthritis), which is associated with permanent or intermittent pain and swelling, mainly in the knee and ankle joints. Moreover, chronic skin lesions are known to occur, although they are extremely rare in children. In acrodermatitis chronica atrophicans Herxheimer, the affected skin on the distal limbs and extensor sides of the feet, legs, arms and hands initially becomes extremely thin, hairless and altered in its pigmentation (similar to parchment paper), before severe thickening occurs in the final stage. The disorder goes with pain or. itching along with them.
Almost always the peripheral nervous system is damaged in the affected skin areas. In connection with the appearing insensations one speaks of an arthropathy or polyneuropathy. Very rarely, there is permanent inflammation of brain. spinal cord (encephalomyelitis) with partial or complete paralysis of the legs or. Arms. Possible late effects are also speech or coordination disorders and epileptic seizures.