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Alternative NamesLyme disease - secondary or stage 2; Stage 2 Lyme disease, Bannwarth syndrome
Definition Return to top
Early disseminated or secondary Lyme disease is an inflammatory disease caused by the bacterium Borrelia burgdorferi.
Causes Return to top
Lyme disease is transmitted through the bite of an infected tick. Secondary Lyme disease develops within days to months after the tick bite. The infection spreads through the lymph system or bloodstream.
Symptoms Return to top
Some patients will remember having a tick bite or symptoms of stage 1 Lyme disease. Some patients with early disseminated or secondary Lyme disease may not have any history of symptoms, tick bites, or skin rashes.
Lyme disease can affect the central nervous system and heart (cardiac system). Symptoms can come and go and may disappear after days, weeks, or months.
Other symptoms that can occur with this disease:
Exams and Tests Return to top
A physical examination may show signs of nervous system (neurological) or heart problems.
Tests that may be done include:
Treatment Return to top
The objective of treatment is to get rid of the infection with antibiotics. The medicines are given for up to 28 days. A second round of antibiotics may be needed. The most commonly used antibiotics are doxycycline, amoxicillin, cefuroxime and ceftriaxone.
Antibiotics given through a vein (intravenous) are needed for patients who develop serious nervous system-related complications or arthritis that does not get better with medicines taken by mouth.
Outlook (Prognosis) Return to top
Symptoms of arthritis may not respond to treatment. Other symptoms should improve with treatment.
Rarely, a person will continue to have symptoms that can sometimes interfere with daily activities. Some people call this post-Lyme disease syndrome. There is no effective treatment for this syndrome.
Possible Complications Return to top
Complications include chronic persistent Lyme disease.
When to Contact a Medical Professional Return to top
Call your health care provider if you develop symptoms of this disorder.
Prevention Return to top
Getting diagnosed early and treating Lyme disease with antibiotics are the most effective ways to prevent secondary Lyme disease.
When walking or hiking in wooded or grassy areas:
Check yourself and your pets frequently during and after your walk or hike. Ticks that carry Lyme disease are so small that they are very hard to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp.
References Return to top
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43:1089-1134.
Bratton RL, Whiteside JW, Hovan MJ, Engle RL, Edwards FD. Diagnosis and treatment of Lyme disease. Mayo Clinic Proc. 2008;83:566-571.
Clark RP, Hu LT. Prevention of Lyme disease and other tick-borne infections. Infect Dis Clin North Am. 2008;22:381-396.Update Date: 3/17/2009 Updated by: Jatin M. Vyas, PHD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.