I saw a patient today that had two deer tick bites. She went to the emergency room to have one tick removed. She had a rash at the site of the bite and then developed a red 8cm bulls eye type rash in an adjacent area. When she was treated at the emergency room she was given a single dose of Doxycyline for 200mgs. She developed a host of symptoms. She had fatigue, fever, chills, muscle and joint aches. She had painful swollen glands.She had a severe headache and stiff neck. She went to her primary physician. He didn't know what was wrong with her. He ordered a test for Lyme disease which was negative (after three weeks of persistent symptoms) and told her she did not have Lyme disease.
Doctors are programmed that Lyme is not real by IDSA propaganda topical New England Journal editorials. This has caused an unfortunate backlash.
The following information does not come from ILADS. It comes from the County Health Department. Most Lyme infections are caused by nymph forms of the tick, the size of a pin head. Early symptoms include skin rash which may be multiple. Fatigue. Chills and fever. Headache. Muscle and Joint pain. Swollen lymph nodes. The County website/bulletin goes on to say that some people never develop a skin rash and that the symptoms vary. It also states: "Some signs ans symptoms of Lyme disease may not appear until weeks or years after a tick bite. It list symptoms in late Lyme as including numbness, arthritis, memory problems, fatigue which persist after treatment. It states that: "If Lyme is detected and treated early, symptoms are usually mild and easily treated." It skirts around the issue of chronic or Post-Lyme symptoms, but does not take a stance on the issue (chronic Lyme vs Post-Lyme).
This patient had classic sign and symptom of acute Lyme disease, but it was missed. Perhaps headlines in the Washington Post which state that chronic Lyme doesn't exist per the New England Journal get truncated to, "Lyme disease doesn't exist" in the minds of clinicians.
The CDC has made it clear that Lyme is not to be diagnosed based on their laboratory test which was set up for surveillance purposes only. And even the IDSA admits that the antibody tests for Lyme will not turn positive for 4 to 6 weeks after infection. In this patient the negative blood test was completely meaningless.
Forget about the Lyme controversies. Physicians should be adequately informed so that acute Lyme can be diagnosed and treated properly. Early treatment will prevent most patients from subsequently developing chronic Lyme disease.