Q: I had Rocky Mountain spotted fever when I was 10. We lived on a farm in the country. The doctor treated me for measles for two weeks before he gave up and sent me to see a specialist. I almost died. However, after being in the hospital for a week, I came out fine. I am now 64, my knees are bad, no cartilage left, and they make popping sounds when I walk. My older sister thinks the bad knees are the result of me having the RMSF and that Lyme disease is causing the knee problem. I have never been told that I had Lyme disease but is it possible that could have caused this knee problem? I have four siblings and none of them have the bad knees so now I am wondering. Total knee replacement is in the future for me but without medical insurance, I have to wait another year until after I turn 65.
A: Rocky Mountain spotted fever is a tick borne disease caused by a bacterium known as rickettsil (rickettsii). It is transmitted to humans through the bite of the infected American dog tick, the Rocky Mountain wood tick and the brown dog tick.
Symptoms typically begin anywhere from 2 to 14 days following the bite and can include fever and vomiting that can be attributed to countless other causes. Muscle and abdominal pain, headaches, loss of appetite and a possible rash may follow. The rash that appears in about 90% of all cases is generally absent during the first few days following the bite or may never develop at all. RMSF can be severe and even fatal if not treated within the first week symptoms present. Severe infection may require hospitalization and may be associated with long-term health problems.
The best test for diagnosis of RMSF is known as indirect immunoflourescence assay (IFA) with R. rickettsii antigen accomplished on two paired serum samples. The first should be taken as soon as possible once the disorder is suspected; the second up to a month later. Typically, the first sample will be negative, while the second, if positive, will reveal a significant increase in specific antibodies. Treatment with doxycycline is ideally begun within the first five days of symptoms and continued for up to 14 days.
Lyme disease is caused by the bacterium Borrelia burgdorferi. The disease is carried primarily by deer ticks and spread with the help of the white-footed deer mouse. Bacteria enters a person’s skin through the bite of the infected tick that the CDC says in most cases must be attached for 36 to 48 hours. There is disagreement on this view, since some physicians feel if a tick simply attaches to a human, the disease can be spread.
Symptoms begin with a rash or bulls eye ring in up to 80% of infected individuals with fever, fatigue, and body aches. The rash may be present anywhere on the body, not necessarily in the area where the tick bit. Because the skin of a human is so sensitive, a simple bite may reveal a red lesion that itches profusely. This isn’t necessarily an indication of Lyme disease but does represent a reaction to the saliva of the tick itself. Left untreated, Lyme disease can lead to chronic joint inflammation, particularly of the knee, heart irregularities, facial palsy and more can result.
Treatment for early-stage Lyme is with doxycycline, generally for up to 21 days. Some physicians may choose to prescribe for longer periods, combine two medications, or have other views. When the disease attacks the central nervous system, IV antibiotics may be prescribed for a period of up to a month. Because many individuals today prefer their health care be provided by a naturopath, they should be warned against chromacine, a/k/a bismacine in its injectable form or as treatment for Lyme because of the potential for bismuth poisoning that can lead to heart and kidney failure.
Because there has been a 54 year gap between your tick bite and your bad knees, I cannot determine if there is a correlation; however, if you have unanswered questions, I recommend you have repeat lab work done. Once an individual is diagnosed with Lyme, the marker remains. A health care professional can determine if your tick borne condition is contributory, if there are remnants of the RMSF, or if you have unrelated arthritis.
