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Jama patient page | lyme disease
The Journal of the American Medical Association INFECTIOUS DISEASES
is an infection caused by a kind of bacteria
(germ) called a spirochete. This bacterium, Borrelia
, is transmitted by the bite of an infected deer tick. It is the most common tick-borne infection in both North America and Europe. Diagnosis is based on a variety of symptoms, physical findings, blood tests, and a
history of exposure to infected ticks. The June 20, 2007, issue of JAMA
includes an article that discusses a rash called erythema migrans
(see below) as a clinical sign that is consistent with a diagnosis of early Lyme disease and other related
FOR MORE INFORMATION
• Erythema migrans (EM)—About 70% to 80% of infected individuals will develop a red
rash at the site of the tick bite. Over a period of days to weeks, the rash grows larger
and the center may fade, creating a “bull’s-eye” or ring appearance. The rash rarely
• Arthritis—About 60% of untreated individuals will go on to develop arthritis.
The joints become swollen and painful, making daily activities burdensome.
• Neurological symptoms—The spread of Lyme disease to the nervous system can
cause Bell palsy
(a facial droop due to muscle paralysis) or a form of meningitis. Later
neurological symptoms may include memory loss, inability to concentrate, and muscle weakness with tingling and numbness in the arms and legs.
• Other symptoms—Less common symptoms include eye inflammation
swelling), fatigue, sleep disturbance, stiff neck, fever, and body aches.
’s Web site at www.jama.com. Many are available in English and
Once the diagnosis has been made, Lyme disease is treated with antibiotics.
Nonsteroidal anti-inflammatory drugs
such as aspirin or ibuprofen are helpful for
Sources: Centers for Disease Control and
Prevention, American Academy of Family
The best way to prevent Lyme disease is to prevent tick bites:
• Use protective clothing—wear long-sleeved shirts and pants.
• Use insect repellents containing DEET or permethrin.
• Apply an acaricide
(a chemical that kills ticks) to your yard in
• Check your skin, your children’s skin, and your pets for ticks
after time spent outdoors. The nymph stage of deer ticks,
the most important source of Lyme disease transmission, is
barely visible (less than 1/16 inch before feeding). You are
not likely to get Lyme disease if the tick has been attached
to your skin for less than 24 to 48 hours.
• Remove plants that attract deer and periodically clean
leaves, brush, tall grasses, and woodpiles from around your house.
• Minimize exposure to wooded areas and shady grasslands
during the spring and summer months.
The JAMA Patient Page is a public service of JAMA
. The information and recommendations
appearing on this page are appropriate in most instances, but they are not a substitute for
medical diagnosis. For specific information concerning your personal medical condition, JAMA
suggests that you consult your physician. This page may be photocopied noncommercial y
by physicians and other health care professionals to share with patients. To purchase bulk
JAMA, June 20, 2007—Vol 297, No. 23
CALIFORNIA STD TREATMENT GUIDELINES TABLE FOR ADULTS & ADOLESCENTS 2012 These guidelines reflect recent updates to the 2010 CDC STD Treatment Guidelines and the Region IX Infertility Clinical Guidelines. The focus is primarily on STDs encountered in of ice practice. These guidelines are intended as a source of clinical guidance; they are not a comprehensive list of all ef ective reg
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