ChesterCountyMedicineSummer2020 - 8

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Lyme Disease,

Chameleon of Medicine
BY MIAN A. JAN, M.D., CHAIRMAN, DEPARTMENT OF MEDICINE PENN MEDICINE CHESTER COUNTY HOSPITAL,
AND
MARIA KHAN, AN INTERN AT WEST CHESTER CARDIOLOGY

ue to current situations, people
have resorted to outdoor activities
that include greater contact with
nature, avoiding social crowds. However,
these activities can increase the risk of
getting animal-borne diseases like Lyme
disease. It is often misdiagnosed for
Rheumatoid arthritis because it has a whole
spectrum of symptoms, thus it is compared
with a chameleon.

A basic approach to Lyme
disease
According to the American Journal of
Medicine, Lyme disease or Lyme borreliosis
is a vector-borne disease that is transmitted
to human via bite of an Ixodes tick infected
with the spirochete bacteria, Borrelia
burgdorferi sensu lato. Lyme disease was
first discovered in the year 1975 after the
town of Old Lyme, Connecticut where
many children were misdiagnosed with
Juvenile rheumatoid arthritis. It has been
estimated by the Centers for Disease
Control and Prevention (CDC) that more
than 300,000 new cases arise each year.

Risk factors for this increase include
1) Greater abundance of wildlife hosts
(ticks feed and propagate)
2) Climate changes (increase of seasons
where these ticks are found)

America, Europe, and Asia. Ixodes ticks are
active during early-spring until the midsummer, which is when most people are
diagnosed with Lyme disease

3) Spending time in grassy or wooded
areas
4) Having exposed skin in the wild
5) Not removing ticks promptly or properly

Ticks: Vectors of Lyme Disease
Research showed that bites from deer
ticks infected with the bacterium were
the reason for the outbreak of arthritis.
Ordinary "wood ticks" and "dog ticks"
do not carry the infection. The sensu lato
(sl) complex consists of approximately
20 genospecies, but where not all species
are pathogenic. In North America, B.
burgdorferi is the dominant genospecies
associated with Lyme borreliosis. B.
burgdorferi sl spirochetes are transmitted
via bite of the Ixodes tick, commonly found
throughout temperate regions of North

8 C H E S T E R C O U N T Y M e d i c i n e | S U M M E R / FA L L 2 0 2 0

Symptoms of Lyme Disease
First stage
* This stage consists of a lesion
resembling a "bull's-eye or target"
known as erythema migrans develops.
These lesions may be seen on several
areas such as the thigh, groin, buttock,
and axilla.
* This red macular skin lesion may
enlarge over the course of 1-30 days
depicted in figure 3.
* The rash occurs in two thirds of
patients with Lyme disease and 7 days

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