Return to the "POINTER VIEW"June 22, 2001
Return to the "POINTER VIEW"
June 22, 2001
'Bull's-eye' not always on target
Compiled by Irene Brown
Editor
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It’s not always easy to determine whether or not you’ve been exposed to Lyme disease. In the nymphal stage of a deer tick’s life, it is only the size of the period at the end of this sentence. In fact, many people are not even aware that they’ve been bitten.
Once infected, many people develop a characteristic bull’s-eye rash that is a sure sign of Lyme disease. But, according to the Lyme Alliance Organization, approximately 50 percent of people do not even recall having the bull’s-eye and not all Lyme rashes resemble a bull’s-eye. But, according to medical officials with the Kid’s Health Organization, the appearance of the circular bull’s-eye rash, also known as erythema migrans, is still the most reliable indicator of Lyme disease.
Usually, because the rash is very distinct, a person with the rash can be immediately diagnosed with Lyme disease, and blood tests are not necessary. Because the rash can rapidly disappear, KHO experts said, you may want to take a picture of a suspicious rash on your child if you are unable to see the doctor immediately.
In some cases, the bull's-eye rash never forms. In the absence of the rash, doctors must rely on other symptoms combined with blood tests to diagnose Lyme disease. These tests detect the presence of antibodies of Lyme bacteria in the patient's blood. However, blood tests can give false results if done within a month after initial infection. Specific tests for Lyme disease include enzyme-linked immunosorbent assay (ELISA) and Western blot. Your child's doctor can help to decide whether your child needs a blood test for Lyme disease.
Blood tests are quite helpful in the early disseminated stage, when a patient who has had a recent tick exposure develops symptoms such as an irregular heart rhythm or a nerve palsy. In late stage, blood tests differentiate arthritis caused by Lyme disease from other causes of arthritis.
A misdiagnosis of Lyme disease can be troublesome, KHO experts explained. It may result in failure to recognize a different condition that is causing the symptoms and lead to improper treatment. For example, any form of childhood arthritis can be mistakenly diagnosed and treated as Lyme disease. Not only is there danger of undergoing unnecessary treatment, but prolonged treatment with antibiotics puts the patient at risk for inflammation of the gallbladder and serious gastrointestinal problems.
