See a doctor if you develop symptoms of Lyme disease; especially if you live in or have visited a high-risk area. Any unusual rash or flulike symptoms should be evaluated by a doctor; especially if you have been in an area considered to be high-risk for Lyme disease. Joint problems, heart palpitations, or neurological symptoms should all be evaluated promptly by a physician as well. Mention any possible tick exposure in recent months.
Most patients with Lyme disease do not need hospitalization unless potentially dangerous heart abnormalities develop. In rare cases, a temporary pacemaker is required.
Your doctor is the best source of information on the drug treatment choices available to you.
Patients with serious heart rhythm problems may need a temporary pacemaker. Pacemakers are electrical devices placed on the chest wall with a wire running into the heart. Usually only a temporary device is needed for the heart rhythm irregularities of Lyme disease.
Patients with persistent arthritis may need surgery on the affected joints. Long-term, severe arthritis that is resistant to treatment with antibiotics and anti-inflammatory medications may need to be treated surgically. Possible procedures include removal of the joint lining (the synovium), which occurs very rarely, or total joint replacement.
Pregnant women and nursing mothers should be treated promptly if Lyme disease is suspected. The consequences of having Lyme disease during pregnancy have not been well-documented; evidence is inconclusive about possible dangers to the fetus. To be safe, pregnant women should be treated promptly with antibiotics if infection is suspected. Doxycycline and tetracycline, however, should not be used during pregnancy, as they can cause discoloration of teeth in the developing baby. Oral erythromycin, azithromycin, or amoxicillin may be substituted, but are less effective.
While there is no evidence that Lyme disease can be transmitted through breast milk from an infected mother, a mother suspected of being infected should stop nursing until she has completed a course of antibiotic therapy. Her baby should also be watched closely and tested for Lyme disease if signs of illness develop.
Lyme disease is usually completely curable, especially when treated in its early stages. The prognosis for Lyme disease is good when treated with antibiotics early in the disease. Patients usually get well rapidly and completely. When treated in later stages, most patients do recover, but it may take longer and can occasionally require another course of oral or intravenous antibiotics. A small percentage of such patients continue to have persisting joint or neurological problems despite extended treatment.
Contact your physician if symptoms do not resolve after antibiotic treatment. Patients with cardiac, neurological, or joint manifestations are likely be followed more closely by their physician to be certain that problems resolve completely.
Take precautions against future infection. A bout with Lyme disease does not protect against reinfection from another tick bite. If you continue to live, work, or visit outdoor areas where ticks live, ask your doctor about whether you would be a good candidate for the Lyme disease vaccine.
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