posted
I've read posts here talking about being stage 1 or stage 2 lyme, what is this and where can I read about the stages?
Thanks!
-------------------- When you reach your "wits-end" remember this: "Peace I leave with you, my peace I give you. I do not give as the world gives. Do not let your hearts be troubled and do not be afraid." John 14:27 Posts: 397 | From Loudoun County Virginia | Registered: Mar 2007
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Beverly
Frequent Contributor (5K+ posts)
Member # 1271
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Hi EWT1638,
This is an older post by pacbird, but it explains the stages very well. I hope this helps.
Here's one explanation of the Stages of Lyme:
Stage 1 / Localized Infection The most common clinical manifestation of Lyme disease is the rash, erythema migrans, formerly called erythema chronicum migrans (Figs. 6-9). The rash typically occurs 7-10 days after the tick bite and is present in 60-80 percent of patients with Lyme disease. Because over half of the patients with Lyme disease do not remember a tick bite, absence of a history of a tick bite does not exclude the diagnosis.
The rash typically has an erythematous annular border that gradually expands and has partial central clearing (Fig. 6, 7). The rash can occur anywhere on the body, is typically warm to the touch, and is occasionally pruritic. The median diameter of the rash is 15 cm. Over time the central portion of the rash may become necrotic or vesicular (Fig. 8). The rash usually resolves within 3 to 4 weeks; if antibiotic treatment is given, the rash usually fades by 1 week. Borrelia burgdorferi has been isolated from the outer rim of the skin lesion at this stage.
During this patients may also have flu-like symptoms, regional lymphadenopathy, and other non-specific complaints.
Stage 2 / Disseminated Infection Several weeks after the tick bite, hematogenous spread of the spirochete may occur. Although all regions of the body may be affected, the skin, nervous system, and joints are most commonly involved. Stage 2 skin lesions occur in about 40 percent of patients.
These annular lesions are multiple, smaller than primary erythema migrans lesions, and are less migratory (Fig. 9).
Central nervous system involvement at this stage occurs in less than 20 percent of patients and begins weeks to months after the initial tick bite. Neurologic manifestations include acute meningitis, cranial nerve abnormalities, and peripheral neuropathy. Cerebrospinal fluid obtained from patients with meningitis typically reveals a lymphocytic pleocytosis with an average white cell count of 100 cells per cubic millimeter.
Unilateral or bilateral facial nerve palsy (Bell's palsy) is the most frequent cranial nerve abnormality. Peripheral neuritis may be motor, sensory or mixed; electromyographic results often suggest axonal nerve demyelination. Intermittent migratory musculoskeletal pain or arthralgias may begin at this stage. Arthritis is generally more predominant in Stage 3 disease.
Cardiac involvement occurs in less than 10 percent of patients, but is the most threatening acute complication of Lyme disease. Atrioventricular block is the most common cardiac manifestation and can progress sequentially from first to second to third degree. Progression beyond first degree heart block is more likely if the patient's PR interval is longer than 0.30 seconds. Heart block gradually resolves spontaneously, but temporary pacemakers may be indicated.
Stage 3 / Chronic Infection Although late manifestations of Lyme disease are often caused by persistent infection with B. burgdorferi, chronic symptoms in some patients may have an autoimmune mechanism. For this reason, stage 3 disease presents major diagnostic and therapeutic challenges to the clinician. Months after the initial infection, patients may develop intermittent attacks of monoarticular or oligoarticular arthritis, most commonly in the knees and shoulders.
In contrast to subjective migratory arthralgias typical in earlier stages, patients show objective joint involvement at this stage. Steere carefully studied untreated patients with erythema migrans and found that approximately one-half developed intermittent attacks of arthritis, but only 11 percent developed chronic synovitis, and less than 5 percent had erosive joint destruction.
Steere also discovered that chronic Lyme arthritis may have an autoimmune component; patients with HLA-DR4 often did not respond to multiple courses of antibiotics. Nevertheless, even persons with sustained arthritis rarely have active joint inflammation for longer than several years.
The spectrum of nervous system abnormalities with chronic Lyme disease is broad. Distinct syndromes include: encephalopathy, polyneuropathy, and encephalomyelitis. These manifestations occur months to years after the initial illness, and are variable from patient to patient. Subacute encephalopathy is the most common chronic neurological syndrome and is manifested by disturbances in mood, sleep, and memory.
Polyneuropathy is generally manifested by sensory disturbances including spinal pain, radicular pain, or distal paresthesias.
Axonal polyneuropathy maybe confirmed by electromyography. Rarely, patients may have a leukoencephalitis that mimics multiple sclerosis or dementia. Patients with late Lyme disease may also complain of severe fatigue. Chronic neurologic involvement may persist for 10 years or longer.
A small subset of patients develops acrodermatitis chronica atrophicans. This uncommon chronic skin lesion has been observed predominately in European patients and often develops at a previous site of erythema migrans; it is characterized by skin swelling and a bluish-red discoloration. Additionally, atrophy of the skin may develop and mimic cutaneous scleroderma. Isolation of B. burgdorferi from acrodermatitis chronica atrophicans skin lesions has provided strong support for the presence of persistent infection.
This monograph was produced for the World Wide Web by the Northwest Center for Public Health Practice in cooperation with the Washington State Department of Health. It was adapted from the original print version. See bibliography for acknowledgements
Posts: 6638 | From Michigan | Registered: Jun 2001
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posted
Thank you Beverly. Now I know that I am stage 3, having been misdiagnosed/undiagnosed for years.
-------------------- When you reach your "wits-end" remember this: "Peace I leave with you, my peace I give you. I do not give as the world gives. Do not let your hearts be troubled and do not be afraid." John 14:27 Posts: 397 | From Loudoun County Virginia | Registered: Mar 2007
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Beverly
Frequent Contributor (5K+ posts)
Member # 1271
posted
Your very welcome, I am glad it helped. Posts: 6638 | From Michigan | Registered: Jun 2001
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CaliforniaLyme
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Member # 7136
posted
Stage 1 can be the flu for a few days- or mono-!!
Stage 2 is fibromyalgia, CFS, "a case of bad mono", etc
Stage 3 is MS, ALzheimers, ALS, Parkinsons, Gullain-Barre, a progressive neurological syndrome somehting that can kill you-
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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