How can Lyme disease be managed in a 33-year-old woman?

Question

Hello doctor,

I am a 33-year-old female. I have Lyme disease. I had the bullseye-shaped rash from a bite, and I did not notice it until I developed a rash on my arms and face. I also have swelling on both my eyelids. My symptoms are tiredness, back pain, severe pain in the heels of my feet, some kidney pain, and rashes all over my body. It has probably been three weeks since I started having these symptoms. I do not have any history of Lyme disease. But I had Rocky Mountain spotted fever (RMSF) when I was nine years old.

Should I schedule an appointment with my PCP (primary care physician) or go to the ER (emergency room)?

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Given your symptoms and history, here is what I recommend:

Why are your symptoms concerning?

The bullseye-shaped rash is a classic sign of Lyme disease, and a three-week duration means early disseminated Lyme disease is possible. Symptoms such as fatigue, widespread rash, eyelid swelling, heel pain, and kidney pain can indicate that the infection is spreading or causing complications. Since Lyme can affect multiple organ systems, timely diagnosis and treatment are important to prevent long-term issues.

What to do now?

You should schedule an urgent appointment with your primary care physician (PCP) as soon as possible. They can evaluate your symptoms, perform blood tests (like ELISA, also known as enzyme-linked immunosorbent assay, and Western blot for Lyme), and start treatment. If you experience severe symptoms such as high fever, difficulty breathing, severe swelling, signs of kidney failure (decreased urination, swelling in legs), or neurological symptoms (weakness, numbness, confusion), then you should go directly to the ER (emergency room). Otherwise, going to the ER (emergency room) may not be necessary, but do not delay seeing your doctor.

Treatment:

Early Lyme disease is treated with a course of oral antibiotics (usually Doxycycline). If complications or organ involvement are present, intravenous antibiotics may be required.

Urgent PCP (primary care physician) appointment within a day or two. Watch for worsening or severe symptoms and then go to ER (emergency room). Get started on antibiotics promptly if Lyme disease is confirmed or strongly suspected.

I hope this answers your query.

Let me know if I need to assist you further.

Thank you.