Chronic Lyme disease: misdiagnosis and antibiotic treatment

A tick bite can cause Lyme disease. In the worst case, years later, side effects threaten. But the disease is often misdiagnosed and treated.

Fatigue, joint pain and throbbing head. If you make the unreasonable and ask Dr. Google diagnosed this disease surprisingly often: chronic Lyme disease. More and more people are suffering from long lists of symptoms on the Internet – the disease has become a fad. However, the diagnosis is controversial, the German medical journal even described it as a product of the imagination.

Lyme disease can be caused by a tick bite. Like Tick Encephalitis (TCE), it is one of the tick-borne diseases. While two to three percent of ticks in endemic areas carry TBE, pathogens of Borreliosis are found in about 30 percent of ticks in Switzerland.

Lyme disease, among others, can be recognized as redness of the skin around the puncture site, called Wanderröte. It occurs on average seven to ten days after the sting. If you go to the doctor on time, the disease can be treated with antibiotics.

How to protect yourself from ticks

The Zeckenliga recommends the following preventive measures:

  • Wear closed clothing and shoes in hazardous areas.
  • Put socks / stockings on the pants.
  • As an extra measure, use an insect repellent. However, this only takes a short time and is not reliable enough when used alone.
  • Take a shower after an outdoor shower and rub the skin well. Systematically scan the body for ticks, especially at preferred bite sites: pubic area, inner thigh, navel and surrounding area, under the chest, armpits, shoulders, neck and neck, hairline behind the ears, in the popliteal pit and hollow. Pay special attention to small larvae and nymphs: they are very small, light brown and can easily be neglected, as they almost look like freckles.
  • Remove ticks from their clothes after an outdoor break (eg with rolli clothes). Hang clothes to dry, because in wet clothes, ticks can survive for hours.
  • When hiking and playing, avoid bushes and shrubs along the strips. Avoid walking in tall grass and bushes.
  • Be careful when lying in the woods, meadows, parks and gardens.

Bad side effects

This can be problematic if one does not notice the redness of the skin or if it does not develop despite the disease, which is the case in about half of the patients. Then, Lyme disease can progress, bacteria attack the central nervous system, large joints can become inflamed and rarely the heart is affected. But these late effects are very rare and affect only a few percent of sufferers.

Nevertheless, patients with symptoms such as fatigue or joint pain consult a doctor and ask them to check their blood for a possible Borrelia infection, explains the infectologist, senior physician at the University Hospital Basel, Aurélien Martinez. "There are doctors who do not follow the guidelines and look for antibodies in the blood for Lyme disease, although this is not clinically necessary."

This blood test then often turns out positive, confirming the internet-based self-diagnosis of many patients, who then often required therapy. "Lyme disease has become a stimulant for many people who are contagious," said Martinez.

What is Lyme Disease?

Lyme disease is the most common disease transmitted by ticks. It is estimated that in Switzerland, 3,000 to 5,000 people suffer from it each year.

In the early stage, general symptoms such as fatigue, fever and headaches are observed. Later, various symptoms of meningitis, intense pain and heart problems may appear.

Facial palsy is relatively common in the late stages of Lyme disease.

Non-significant blood test

Because a positive blood test is of little importance. Indeed, about 10 to 30% of Swiss have antibodies in the blood against Borrelia bacteria. However, not even one in ten is suffering from acute Lyme disease – the antibodies come from an earlier Borrelia infection and often completely healed. To detect if the symptoms are late effects of Lyme disease, the blood test is not crucial, but a differential diagnosis in which other causes of symptoms are excluded step by step.

Nevertheless, some doctors in Switzerland diagnose chronic borreliosis in cases of diffuse symptoms and treat them for a long time with antibiotics, explains Martinez. Patients take these medications, which often have significant side effects, and then months or even years. The use of antibiotics for Lyme disease for more than four weeks, advises the Swiss Society of Infectious Diseases. Aurélien Martinez agrees: "There is no scientific evidence that patients benefit from such treatment," he said.

More information on higgs – the magazine for those who want to know.

Three injections against tick bites

Ticks are usually smaller than a matchstick. Dipped in the blood, they are more than ten millimeters. (Archives)


Ticks are usually smaller than a matchstick. Dipped in the blood, they are more than ten millimeters. (Archives)

271 Swiss suffered in 2017 from a tick bite and a meningitis. The only vaccine available is safe protection against this dangerous disease. The Federal Office of Public Health (FOPH) recommends it urgently.

Read here.