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What Causes Tick Bites, Fatigue And Lethargy When Diagnosed With Lyme Disease?
Question: In 1997 or 1998 I was bitten by several ticks and I may have had Lyme disease since then. In 1997 I was 60 years old and working as a reporter for thenewspaper the XXXXXXX NJ Star-Ledger and got the tick bites while on assignment. I had been a journalist since I graduated from Univ. of Pennsylvania in 1968. IAfter the tick bites, fatigue and lethargy gradually took over me. I went to a doctor, Dr. Rosenberg at XXXXXXX Medical Hospital in XXXXXXX and I don't remember what he did, but the time I saw him my memory wasn't working right. The fatigue and lethargy gradually made it impossible for me to work, and by mid 1999 I was dismissed from my job. A friend urged me to see a lawyer, who, as I recall, found a federal law called "Americans With Disabilities Act," and my lawyer won a partial settlement for me. But I lost my job and have not worked since. I am still beset with lethargy and I cannot concentrate, and I now have fungus in all of my toes. My present Doctor, XXXXXXX Shulruff in XXXXXXX Fla.,, refused to treat the fungus. it has been seventeen years now, and I am still constantly fatigued and my memory is shot. What should I do.
XXXX:
00 Road XXX XXX
XXXXXX, 00000
email YYYY@YYYY
XXXX:
00 Road XXX XXX
XXXXXX, 00000
email YYYY@YYYY
Brief Answer:
?Late Lyme's disease & Tinea pedis
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
With your history of tick bites on various assignments years back and absence of precise treatment history and now having myriad of symptoms pertaining to nervous system mostly,there is a possibility of Lyme's disease in Late /Stage 3.
Although rare, chronic neurologic involvement may become apparent from months to several years after the onset of infection, sometimes following long periods of latent infection. The most common form of chronic central nervous system involvement is subtle encephalopathy affecting memory & mood.
Or else you might be having Post–Lyme Syndrome (Chronic Lyme Disease),in which small percentage of patients have neuro-cognitive manifestations, or fatigue symptoms for months or years afterward. This syndrome is similar to or indistinguishable from chronic fatigue syndrome .
You should undergo C6 peptide IgGELISA, a second-generation serologic test recommended for late Lyme disease .If the test is not available then Two-step approach in which samples are first tested by enzyme-linked immunosorbent assay (ELISA) and equivocal or positive results are then tested by western blotting, can be undertaken.
Meanwhile you may undergo MRI brain as your predominant complain is memory impairment ,lack of concentration,apart from undue fatigue.
Chronic fungal infection of toes can be treated by oral anti-fungal drugs like fluconazole or Terbinafine. Tinea pedis particularly chronic infection as in your case often requires longer treatment courses and it frequently relapses. However fungal etiology in your case should be confirmed first by direct microscopic examination of skin scrapings with potassium hydroxide (KOH) preparation. or by culture prior to prescribing oral antifungal agents.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
?Late Lyme's disease & Tinea pedis
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
With your history of tick bites on various assignments years back and absence of precise treatment history and now having myriad of symptoms pertaining to nervous system mostly,there is a possibility of Lyme's disease in Late /Stage 3.
Although rare, chronic neurologic involvement may become apparent from months to several years after the onset of infection, sometimes following long periods of latent infection. The most common form of chronic central nervous system involvement is subtle encephalopathy affecting memory & mood.
Or else you might be having Post–Lyme Syndrome (Chronic Lyme Disease),in which small percentage of patients have neuro-cognitive manifestations, or fatigue symptoms for months or years afterward. This syndrome is similar to or indistinguishable from chronic fatigue syndrome .
You should undergo C6 peptide IgGELISA, a second-generation serologic test recommended for late Lyme disease .If the test is not available then Two-step approach in which samples are first tested by enzyme-linked immunosorbent assay (ELISA) and equivocal or positive results are then tested by western blotting, can be undertaken.
Meanwhile you may undergo MRI brain as your predominant complain is memory impairment ,lack of concentration,apart from undue fatigue.
Chronic fungal infection of toes can be treated by oral anti-fungal drugs like fluconazole or Terbinafine. Tinea pedis particularly chronic infection as in your case often requires longer treatment courses and it frequently relapses. However fungal etiology in your case should be confirmed first by direct microscopic examination of skin scrapings with potassium hydroxide (KOH) preparation. or by culture prior to prescribing oral antifungal agents.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
Dear Dr. Biswas,
Thank you for your answer. I have forwarded your letter, along with my original complaint, to Dr. XXXXXXX Shulruff in XXXXXXX who I have been seeing since I settled in XXXXXXX in about 2005, and I intend to contact Dr. Shulruff soon to ask him if anything can be done. Since I was dismissed from my job at a journalist in 1998 my life has been quiet and existing on Social Security is no bed of roses, and I'm working very hard to keep my health up. It's not easy, and now that I'm approaching 80, I'm not very optimistic.
I would appreciate anything that would allow me to renew the bright attention and physical activities I always enjoyed so I could at least enjoy reading without constantly losing my attention.
At this late stage in my life, I was not very optimistic, and of course, not being able to diagnose my problem myself, I had tried to forget it. But then several weeks ago I saw an article on-line that said the constant toe-fungus was a sign that Lyme Disease was still present, and then shortly after that,I saw the article that had your name on it, so I wrote.
Maybe at long last I will get this problem solved and enjoy at least the last few years of what once was a physically active and highly stimulating life.
XXXX
Thank you for your answer. I have forwarded your letter, along with my original complaint, to Dr. XXXXXXX Shulruff in XXXXXXX who I have been seeing since I settled in XXXXXXX in about 2005, and I intend to contact Dr. Shulruff soon to ask him if anything can be done. Since I was dismissed from my job at a journalist in 1998 my life has been quiet and existing on Social Security is no bed of roses, and I'm working very hard to keep my health up. It's not easy, and now that I'm approaching 80, I'm not very optimistic.
I would appreciate anything that would allow me to renew the bright attention and physical activities I always enjoyed so I could at least enjoy reading without constantly losing my attention.
At this late stage in my life, I was not very optimistic, and of course, not being able to diagnose my problem myself, I had tried to forget it. But then several weeks ago I saw an article on-line that said the constant toe-fungus was a sign that Lyme Disease was still present, and then shortly after that,I saw the article that had your name on it, so I wrote.
Maybe at long last I will get this problem solved and enjoy at least the last few years of what once was a physically active and highly stimulating life.
XXXX
Brief Answer:
Chronic Lyme disease & co-infection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Patients with Chronic Lyme disease can also have chronic fungal infections. Chronic immune suppressed Lyme disease patients have multiple opportunistic infections that can include mold and yeast infections. Fungal co-infection can be treated with anti-fungal drugs (oral as well as topical).
At advanced age co-morbidities are common and hence your neurological symptoms mainly of cognitive function may be partly due to age-related changes in brain e.g. cerebral atrophy and one has to live with some limitations and still can enjoy life.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Chronic Lyme disease & co-infection
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Patients with Chronic Lyme disease can also have chronic fungal infections. Chronic immune suppressed Lyme disease patients have multiple opportunistic infections that can include mold and yeast infections. Fungal co-infection can be treated with anti-fungal drugs (oral as well as topical).
At advanced age co-morbidities are common and hence your neurological symptoms mainly of cognitive function may be partly due to age-related changes in brain e.g. cerebral atrophy and one has to live with some limitations and still can enjoy life.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: Get a consultation booked to know more about aging related medical issues. Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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