LYME DISEASE

What awaits you at Centrokinetic?

Centrokinetic welcomes patients with a complete rheumatology department, a medical branch that deals with diagnosing, treating and rehabilitating patients with non-surgical conditions of the musculoskeletal system. These conditions are usually painful, acute or, most often, chronic, preventing the proper functioning of the musculoskeletal system. They are generally called rheumatism, or rheumatic and musculoskeletal diseases.

Most often, patient evaluation is complex and multidisciplinary, given the systemic, generalized nature of most rheumatological conditions, which is why Centrokinetic has experienced doctors:

• Rheumatologists (click to view the list of doctors)
• Rehabilitation physicians
• Orthopedic doctors
• Radiologists
• Neurologists
• Physician for nutrition and metabolic diseases.

What is Lyme disease?

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi, which can be transmitted to humans through the bite of an infected tick of the species Ixodes scapularis. A tick must remain attached to the human body for at least 36 hours to transmit the infection. Studies show that most people diagnosed with Lyme disease don't remember being bitten by any tick. Lyme disease was first identified in the town of Old Lyme, Connecticut, in 1975. It is currently the most common tick-borne disease in Europe and the United States.

People who live or spend a lot of time in wooded areas are more susceptible to becoming infected, and people with pets that visit green spaces are also at a higher risk of contracting Lyme disease.

Symptoms of Lyme disease

People with Lyme disease can react to it differently, and the symptoms can have varying degrees of severity. Although Lyme disease is usually divided into three stages (early localization, early dissemination and late dissemination), the symptoms can overlap. Some people may also present in an advanced stage of the disease, without having had the symptoms that occur in the initial stage. Some of the most common symptoms of Lyme disease are:

• a circular rash, with a "bull's-eye" appearance
• fatigue
• joint pain and swelling
• muscle pain
• headache
• fever
• lymphadenopathy
• sleep disorders
• difficulty concentrating.

Symptoms of Lyme disease in children

In principle, children experience the same symptoms of Lyme disease as adults. They usually present the following symptoms:

• fatigue
• muscle and joint pain
• fever
• other flu-like symptoms.

These symptoms can appear shortly after infection, or may appear after a few months or even years. Your child may have Lyme disease even if they did not develop the "bull's-eye" rash. According to a recent study, the results showed that approximately 11% of children who had Lyme disease did not have this skin rash.

At Centrokinetic, Dr. Alizzi Khalid will perform a complete clinical examination in order to obtain a fast and accurate diagnosis.

Treatment of Lyme disease

Lyme disease is best treated in its early stages. Treatment in the first stage of the disease is simple and consists of administering oral antibiotics for a period of 10-14 days to eliminate the infection. Medications used to treat Lyme disease include: doxycycline, amoxicillin (which represents the first-line treatment for both adults and children). Amoxicillin is also used to treat pregnant or breastfeeding women.  

Intravenous antibiotics are used for some forms of Lyme disease, including those that affect the central nervous system and the heart. 

After the patient's health improves, Dr. Alizzi Khalid will recommend switching to oral medication. The entire treatment usually lasts between 14 and 28 days.

Lyme arthritis occurs in a late stage of the disease and affects only a small portion of infected people. It is treated with oral antibiotics for a period of 28 days.

If a patient has been treated for Lyme disease with antibiotics, but the symptoms have not gone away, this condition is referred to as post-Lyme disease syndrome or post-treatment Lyme disease syndrome.

Approximately 10-20% of people with Lyme disease have experienced this syndrome, according to a study published in 2016 in the New England Journal of Medicine, with the cause being unknown. 

Post-Lyme syndrome can affect joint mobility and cognitive abilities. Treatment initially focuses on relieving pain and physical discomfort. Most people recover, but in some cases this process can take months or even years.

The symptoms of this post-Lyme syndrome are similar to those that occur in the early stages of the disease. These symptoms can include:

• fatigue
• insomnia
• joint or muscle pain
• swelling of the large joints of the body (knee, shoulder, elbow)
• difficulty concentrating and short-term memory loss
• speech problems.

Is Lyme disease contagious?

There is no evidence to show that Lyme disease is contagious between humans. Also, according to the Centers for Disease Control and Prevention (CDC), pregnant women cannot transmit the disease to the fetus, nor later through breastfeeding.

Lyme disease is an infection caused by a bacterium, which is transmitted by the black-legged (deer) tick. In an infected person, this bacterium is found in body fluids, but no evidence has been found to support the hypothesis that Lyme disease can be transmitted to another person through sneezing, coughing or kissing.

Also, there is no evidence to show that Lyme disease can be transmitted through sexual contact or blood transfusion.

Stages of Lyme disease

Lyme disease has 3 stages:

• Early localization
• Early dissemination
• Late dissemination.

The symptoms a patient has vary depending on the stage of the disease they are in. The course of the disease varies from person to person. In some people, the course of Lyme disease does not go through all 3 stages.

Stage I – Early detection of Lyme disease  

The characteristic symptoms of Lyme disease usually appear one or two weeks after the tick bite. One of the first signs of the disease is the appearance of the "bull's-eye" rash.

The rash appears in the area where the tick attached, having the appearance of a red spot, surrounded by a clear area, with reddish edges. It may be warm to the touch, but without causing any discomfort (pain, itching). The rash gradually fades in most people. 

This rash is called erythema migrans and is presumed to be a characteristic sign of Lyme disease; however, most people have not presented with it.

Some people have a solid red rash, while people with darker skin may have a rash that resembles a bruise. The rash may appear with or without systemic viral or flu-like symptoms.

Other common symptoms present in this stage of Lyme disease are:

• Chills;
• Fever;
• Lymphadenopathy;
• Sore throat;
• Vision disturbances; 
• Fatigue;
• Muscle pain;
• Headache;

Stage II – Early dissemination

Stage II can occur several weeks or even months after the tick bite.

The patient may have an altered general condition, and the rash may also appear in areas other than where the tick attached to the skin.

This stage of the disease is characterized by the occurrence of a systemic infection, which means that the infection has spread throughout the body, including to the organs.

Symptoms include:

• Erythema multiforme
• Heart rhythm disturbances, which can be caused by Lyme carditis
• Neurological manifestations such as: paresthesia, cranial nerve neuropathies, facial palsy and meningitis. 
• Symptoms of stages I and II can overlap.

Stage III – Late dissemination

Late dissemination sets in when the infection has not been treated in stages I and II. Stage III of the disease can occur after a period ranging from a few months to a few years after infection.

This stage is characterized by:

• Arthritis in one or more large joints of the body;
• Brain conditions, such as encephalopathy, which can cause, among other things, short-term memory loss, difficulty concentrating and sleep disturbances;
• Paresthesia in the upper and lower limbs.

Diagnosing Lyme disease

Diagnosing Lyme disease begins with taking the patient's history and medical background, to find out whether they have been bitten by ticks before, or whether they have lived in an area endemic to the disease.

At Centrokinetic, Dr. Alizzi Khalid will perform a complete clinical examination to check for any skin irritation or other symptoms characteristic of Lyme disease.

Blood tests are much more conclusive if performed a few weeks after infection, since antibodies are present in the body by then. Dr. Alizzi Khalid may also prescribe the patient to undergo the following tests:

• The ELISA test, which is used to detect antibodies against the Borrelia burgdorferi bacterium;
• The WESTERN BLOT test, which is used to confirm a possible positive ELISA test. 
• Polymerase chain reaction (PCR) testing is used to evaluate people with persistent Lyme arthritis or with signs indicating nervous system involvement. The test is performed by collecting synovial fluid from the joints or cerebrospinal fluid (CSF). PCR testing based on cerebrospinal fluid is not a routinely recommended method due to low sensitivity. A negative result does not guarantee the absence of the disease in the body. Instead, many individuals may have positive results from the PCR test on synovial fluid if tested before starting antibiotic treatment.

Prevention measures 

The most important preventive measure against Lyme disease is avoiding areas where we could be bitten by ticks. Other prevention measures:

• Wearing long pants and long-sleeved shirts when we are outdoors;
• Periodically cleaning the yard and applying pesticides against ticks.
• Using insect repellent sprays. A solution containing 10% DEET (the active substance with the strongest effect against insects) provides protection for approximately 2 hours. It is recommended not to use a greater amount of solution than indicated, and not to use it on the hands and face of children under 2 years old.
• Eucalyptus essential oil provides the same protection as DEET solutions if similar concentrations are used. It is not recommended for use on children under 3 years old;
• Be vigilant! It is recommended to check your children, pets and yourself for possible tick bites. Even if you have been infected with Lyme disease in the past, that does not mean you cannot become infected again. 
• Remove ticks with tweezers or a special instrument. Grasp the tick as close to the head as possible and pull it out gently. Check the area to make sure it has been completely removed.

See your doctor every time you are bitten by a tick.

Rules to follow

After a person has been treated against Lyme disease with antibiotics, it could take weeks or even months for all symptoms to disappear.

To help the healing process, the patient can take the following actions:

• Eat healthy and avoid foods that have a high sugar content;
• Get enough rest;
• Reduce stress-generating factors;
• Take anti-inflammatory medication whenever necessary to reduce pain and discomfort.

At the Centrokinetic clinic, we offer complex medical rehabilitation programs with a highly experienced team, accredited in: Tecar, dynamic taping, massage, Graston technique, Kinesio Tape, ERGON, flossing band. Our team has completed numerous advanced specialization courses with trainers from Romania and abroad, being certified to perform therapies at the highest level. The experience gained in recent years has meant treating over 250 patients monthly.

Centrokinetic is the place where you will find answers and clear solutions for your mobility problems. The clinic dedicated to bone and joint conditions is divided into the following specialized departments:

• Orthopedics, a department made up of a highly experienced team of orthopedic surgeons, led by Dr. Andrei Ioan Bogdan, senior physician in orthopedics-traumatology, with surgical activity at  the Medlife Orthopedic Hospital, specialized in sports traumatology and in ankle and foot surgery.
• Pediatric orthopedics, where children's sports injuries are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and foot conditions (hallux valgus, hallux rigidus, clubfoot, flat valgus foot, cavus foot).
• Neurology,  which has a state-of-the-art department, where consultations, electroencephalograms (EEG) and electromyograms (EMG) are performed. 
• Medical rehabilitation for adults and children, a department specialized in the recovery of performance athletes, in spinal conditions, and in the recovery of children with neurological and traumatic conditions. Our experience is extremely rich, having treated over 5000 performance athletes.
• Medical imaging, the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal conditions, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.

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