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What is Lyme Disease- Bulls Eye Rash? Its Signs and symptoms

What is Lyme Disease- Bulls Eye Rash? Its Signs and symptoms

Posted on May 30th, 2023


Lyme disease (Lyme borreliosis) is an infectious vector-borne disease caused by an infected tick bite. The causative agent of this disease is bacteria named Borrelia burgdorferi and Borrelia mayonii. These bacteria transferred through a black-legged tick of the genus Ixodes. When it feeds on diseased deer, mice, or birds, the tick becomes infected.

When the infected tick bites humans, a distinctive red circular rash appears on the skin called ‘Bull’s eye’ or ‘Erythema migrans.’ These rashes are quite different from typical rash occurrences due to other insect bites, mosquito bite, or bee stings.

A tick has to stay on the skin for about 36 to 48 hours to transmit bacteria into the human body. Therefore, when rashes appear after infection, people often can’t recognize them because they don’t remember biting by a tick.

The distinctive rash termed ‘bull’s eye rash or “erythema migrans” appears within three to thirty days after the infected tick bite. However, on average, Lyme disease rashes appear in the first week of infection. Exclusive research by the Centers for Disease Control and Prevention (CDC) estimated that a characteristic rash appears in 70% to 80%. Furthermore, untreated Lyme disease can lead to severe health complications.

Lyme disease was first reported in 1975 in the town of Old Lyme, Connecticut. Currently, it is one of the most frequent reasons for rashes in America and Europe. There are more chances of Lyme disease rashes in people who live in rural or wooded areas. In addition, people who have domestic animals and frequently visit fields have a high chance of being bitten by a tick and Lyme disease rashes.

Signs and symptoms of Lyme disease:

The sign of Lyme disease in children may vary in different community. The early sign of Lyme disease in children is a characteristic circular rash named ‘bull’s eye’ or ‘Erythema migrans.’ However, there are also chances that no rashes appear on the skin after a bite by an infected tick. For instance, some people may be in the last stage of Lyme disease while there are no Lyme disease rashes on the skin (early-stage symptom).

One of the most common signs and symptoms of Lyme disease are mentioned below;

A reddish, flat, and circular rash called ‘bull’s eye rash on the site of the bite.

  • Fever
  • Severe Joint pain
  • Swollen lymph nodes
  • Joint aches
  • Sleep disturbances
  • Lack of concentration
  • Headache
  • Fatigue
  • Other flu-like symptoms

If you experience these symptoms, then immediately seek medical attention. Hence, untreated Lyme disease in children can lead to severe health complications because bacteria spread to other organs also.

Symptoms of Lyme disease in children:

Most commonly, children suffer the same signs and symptoms as adults. However, there may occur some psychological changes due to Lyme disease in children.

  • Anger or aggression
  • Mood swings
  • Depression or anxiety
  • Frequent nightmares

There are chances that these signs are because of some other disease instead of Lyme disease. Therefore, if you spot any of the symptoms discussed above in your child, immediately visit wellness professionals for better treatment.

Post-Lyme disease syndrome:

In some cases, symptoms don’t disappear even after antibiotic treatment. This condition is called post-Lyme disease syndrome. Lyme disease develops into post-Lyme disease syndrome in approximately 10% to 20% of people.

It mainly affects the nervous system and disrupts cognitive skills and mobility. This infection can be recovered by proper treatment, but it takes months or years.

Symptoms of post-Lyme disease syndrome:

Symptoms of post-Lyme disease are similar to the early-stage signs of infection. Includes,

  • Body aches
  • Muscle aches
  • Fatigue
  • Difficulty in sleeping and speech
  • Fever
  • Short-term memory problems
  • Inflammation in the large joints such as the shoulder, knee, etc.

Stages of Lyme disease:

Typically, there are three stages of Lyme disease. Includes,

  1. Early localized
  2. Early disseminated
  3. Late disseminated

Its signs depend on the stage at which the infection has been spread. Additionally, its symptoms vary from person to person. For instance, some people in the last stage don’t even have rashes on their skin.

Early localized stage:

Most often, signs of Lyme disease appear after 3 to 30 days of a tick bite. One of the earliest symptoms of infection is a rash called ‘bull’s eye.’ Furthermore, there may appear multiple rashes on your skin.

The medical term used for these rashes is “Erythema migrans” or EM. The rash usually occurs at the tick bite site, but you can also experience multiple rashes on other sites on your skin.

The characteristic appearance of a bull’s eye rash is a red spot at the center surrounded by a clear area and a red circle at the edge. It may feel warm when you touch the rash. However, these rashes are not itchy and painful.

Symptoms of Lyme disease include,

  • Fever
  • Swollen lymph nodes
  • Sore throat
  • Vision changes

Early disseminated stage:

Early disseminated Lyme disease occurs months after a tick bites you. As its name shows, it is a systemic infection. It occurs when bacteria spread to the other body parts through the bloodstream. You may feel unwell. Additionally, there may appear multiple rashes on different sites on the skin.

Symptoms of early disseminated Lyme disease include,

  • Multiple rashes on the skin
  • Disturbed heartbeat
  • Neurological conditions such as numbness, facial palsy, etc.

Late disseminated stage:

Lyme disease reaches a late disseminated stage when you don’t get treatment in the first two stages. This stage occurs months or years after being bitten by a tick.

Other symptoms include,

  • Arthritis
  • Neurological disorders such as encephalopathy lead to short-term memory loss, sleep disturbances, etc.

What are the causes of Lyme disease?

Lyme disease develops when a tick bites you. The main causative agents of disease are two bacteria called Borrelia burgdorferi and Borrelia mayonii. These bacteria spread rapidly into the blood and reach multiple organs. Therefore, as early signs of infection, the rash appears on the skin called bull’s eye.

An exclusive report by the Centers for Disease Control and Prevention, a black-legged tick transmits the infection in people of specific areas such as Northeastern, Mid-Atlantic, and North Atlantic United States.

How to diagnose Lyme disease?

The fundamental factor in diagnosing Lyme disease is checking for incidents of tick bites in the past. Furthermore, it is also essential to determine whether the patient belongs to a Lyme disease rash endemic area.

Furthermore, wellness professionals or doctors will also do physical examinations to check for any rashes and other symptoms on your body. Additionally, several blood tests will also perform in later stages. No blood tests are usually performed to diagnose infection in the early stages of the disease.

To diagnose Lyme disease, a doctor may perform the following tests:

Enzyme-linked immunosorbent assay:

ELISA test is used to detect antibodies present in the blood produced against bacteria.

Polymerase chain reaction:

A doctor often suggests a PCR test for persistent Lyme arthritis and nervous system problems. Joint fluid and cerebrospinal fluid are taken as a sample for the PCR test. However, the test results of the PCR test on the cerebrospinal fluid aren’t considered authentic due to low sensitivity.

Western blot:

Western blotting is used to confirm the results of the ELISA test by detecting antibodies against respective bacteria.

Risk factors of Lyme disease:

The following areas are declared the most tick bite endemic areas by the Centers for Disease Control and Prevention.

  • Pennsylvania
  • Newyork
  • New Jersey
  • Maine
  • Connecticut
  • Virginia
  • New hemisphere

Hence, tick bites develop Lyme disease, so the people who work outdoors are at high risk of Lyme disease rashes. The other common risk factors of bull’s eye rash are mentioned in the following,

More exposure to grassy areas:

Most ticks are found in grassy or woody areas. Therefore, people who spend most of their time in such areas are at higher risk of infection. Furthermore, children who play on the grounds can also develop Lyme disease. Additionally, adults with outdoor jobs are also at elevated risk of bull’s eye rashes.

Having exposed skin:

Hence, a tick can bite anywhere on your skin as it can easily attach to bare flesh. Thus, avoid wearing shorts and half-sleeves while going outside in woody areas to prevent infection.

Improper or late removal of tick:

After attachment to the skin, it requires 36 or 48 hours to transmit bacteria into the body. Thus, removing the tick immediately or within two days can prevent the development of Lyme disease.

How to prevent Lyme disease rash?

Avoid going outside without need, especially in woody or grassy areas, prevent Lyme disease. Furthermore, you can also lessen disease risk by following some simple precautions. Includes,

Properly cover your body:

It is one of the best ways to prevent Lyme disease. Thus, wear a dress that properly covers your body while going into grassy areas. Try to walk aside from the long bushes.

Use insect repellent:

Ensure to apply insect repellents before going outside in woody areas to prevent tick bites. The most effective insect repellent with 20% or higher DEET concentration. Thus, parents should apply repellent to children carefully. However, don’t use these repellents on children under three years.

Clean your lawn regularly:

Keep your lawn unfriendly to ticks by regularly cutting long and rough grass. Furthermore, mow your lawn and stack the woods in airy or sunny places to discourage tick growth.

Detach the tick immediately when you see it:

A tick takes 36 to 48 hours to transfer bacteria into the human body. Most often, multiple rashes appear within a week of tick bites. Thus, to prevent infection, try to remove ticks as soon as possible. You can use tweezers or any other plucking instrument to remove the tick properly.

How to treat Lyme disease rash?

When a tick bites you, there appear multiple rashes. It looks like a bull’s eye because of its characteristic round shape. These rashes are medically known as ‘Erythema migrants.

Initially, the infection remains localized, and it can be treated by a 10 to 14 days course of oral antibiotics.

Other medications to treat the infection are mentioned below,

  • Antibiotics such as amoxicillin, doxycycline, and cefuroxime are first-line treatments for Lyme disease rash.
  • Amoxicillin and cefuroxime are used to treat mothers who breastfeed.
  • People with cardiac or nervous system complications due to Lyme disease are treated with intravenous antibiotics. However, after recovery, a doctor will switch the IV antibiotic treatment to oral antibiotics. Usually, antibiotic treatment is completed in 14 to 28 days.

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