Brief Answer:
It is possible but did he get serological testing done?

Detailed Answer:
Good afternoon. Germany is listed as a country where Lyme has been reported and confirmed so the simple answer to your question is YES....it certainly is POSSIBLE he was infected with Lyme Disease. Did he develop anything such a what is referred to as ERYTHEMA MIGRANS...this would be a "moving" red rash from the point of being bitten. You didn't describe it so I don't know.

You must remember one thing.....there are many TICK BORNE diseases in the world. I run into the notion a lot in my patients that when bitten by a tick and they get sick that's Lyme disease...because....well, that's all it can be if you're "bit by a tick, right doc?" And the answer is NO.....many types of tick borne diseases. It is always a nice thing if the tick itself can be captured and maintained for actual testing. That would be the best....but if the suspicion is Lyme disease then, the serologic test of choice would be the WESTERN BLOT test. Having said that....no test is 100% accurate in identifying a specific tick borne disease...or even any type of tick borne disease.

In other words, the diagnosis by and large remains a clinical one and even tests that are done on a person known to have the disease can turn out negative. Nevertheless, I'd still recommend getting them done if available since depending upon the infectious type the treatment could change.

Here is a checklist of items that the CDC recognizes can highly aid in the diagnosis of Lyme Disease:

LYME BORRELIOSIS DIAGNOSTIC CRITERIA
RELATIVE VALUE
Tick exposure in an endemic region- 1

Historical facts & evolution of- 2
symptoms consistent with Lyme

Systemic signs & symptoms consistent with Lyme infection (other potential diagnoses excluded):
Single system, e.g., monoarthritis- 1
Two or more systems e.g., monoarthritis- 2
and facial palsy

Erythema migrans, physician confirmed- 7

Acrodermatitis Chronica Atrophicans, biopsy confirmed- 7

Seropositivity- 3

Seroconversion on paired sera- 4

Tissue microscopy, silver stain- 3

Tissue microscopy, monoclonal immunofluorescence- 4

Culture positivity- 4

B. burgdorferi antigen recovery- 4

B. burgdorferi DNA/RNA recovery- 4

DIAGNOSIS
Lyme Borreliosis Highly Likely- 7 or above
Lyme Borreliosis Possible- 5 or 6
Lyme Borreliosis Unlikely- 4 or below


In the way you've presented things (and I admit you may not have included everything possible in your short blurb) I would score your husband MAYBE with a 4 but that would be stretching to include fever and overall body aches as part of the symptoms of Lyme. Therefore, based upon the above criteria it would seem that Lyme's would be UNLIKELY. If, however, you can get him tested and anything turns out positive to add to the score then, that could sway things.

In terms of treatment duration...assuming he was caught in the early stage of anything then, a treatment course of 4-6 weeks is the minimum standard. If antibiotics were not started until he would've considered to be in later stages then, you're looking at a treatment regimen of 4-6 months.

If you're back in the States then, I would recommend he be seen by an Infectious Disease specialist to get the particulars sorted out and to make sure that he is on the best regimen possible for the most likely infectious problem he could have.

For your edification I've included a link to a very bood website for the Lyme Disease Association which I think you'll find informative:

http://www.lymediseaseassociation.org/index.php/about-lyme/medical/treatment-guidelines


I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with written feedback?

Also, if there are no other questions or comments, I'd appreciate it greatly if you would CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


The query has required a total of 45 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Treatment of Lyme is not a sprint but marathon

Detailed Answer:
Thank you for your question. I think you'll want to let his physician know of your concerns with his ongoing fevers as well...especially if they are very high..., however, as I stated at the end of the last answer I gave you- the minimum time of treatment in suspected Lyme disease (if caught in the early stages even) is 4-6 weeks whereas if it is not caught until later in the process...one could be looking at as much as 4-6 months.

Also, the presence of the fever could be a sign as well of the actual "killing" by the antibiotic of the spirochetes. This can sometimes be quite a strong reaction in some individuals and is referred to as a Herxheimer Reaction and should subside as antibiotics are continued. Again, you'll want to be sure that you are working with someone well versed in this sort of problem or at the very least an Infectious Disease specialist who can be sure that the amount and frequency of his antibiotic regimen is dialed in to his specific severity and duration of condition.

If he actually does have Lyme and is under-treated then, he may develop a Chronic form of the illness and you don't want that....by the same token...there is such a thing as OVER-treatment as well....so, just like Goldilocks used to say....we want everything to be "Just right..."

Also, keep in mind that any test that is done whether it be serum, spinal fluid (not really necessary in most cases), urine, biopsy specimens, DNA testing, or immunoassays has a fairly high chance of coming out negative so absence of test results to confirm does not mean he doesn't have the disease. Tick-borne diseases are sometimes very challenging since they are all basically clinical calls...again, another reason you'd like to make sure the doctor you're working with is experienced in recognizing the different tick-borne diseases and how to deal with them from a therapeutic point of view.

Once again, my hope is that I've satisfactorily addressed your questions and would very much be thankful for a HIGH STAR RATING with written feedback if you agree.

Also, if there are no other questions or comments, I'd appreciate it as much if you'd CLOSE THE QUERY so it can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


The query has required a total of 56 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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