How to Know If You Have Lyme Disease?
A tick bite or an unusual skin mark that appears after spending time outdoors can raise understandable concerns about Lyme disease (borreliosis). Dr. Giorgi Kamkamidze, an infectious disease specialist at Neolab Clinic, explains how to recognize the infection, which symptoms should never be ignored, and how Lyme disease is diagnosed.
Early Signs and Symptoms
The first reason to suspect Lyme disease is a history of a tick bite or finding an attached tick on the body. One of the most distinctive early signs is erythema migrans—a characteristic circular red rash that gradually expands over time.
It is known as a "migrating" rash because it slowly spreads outward from the bite site, creating an enlarging ring-like lesion. When this rash appears alongside a confirmed tick bite, it is often enough for a physician to make a clinical diagnosis without waiting for laboratory confirmation.
When Lyme Disease Progresses Without Symptoms
Not everyone with Lyme disease develops the classic rash. In some cases, the tick bite is so small that it goes unnoticed, while others may never develop erythema migrans or may experience an atypical skin reaction.
Without timely diagnosis and treatment, the infection can progress silently. As the disease advances, it may affect several organ systems, including:
- Joints: causing inflammation and Lyme arthritis;
- Nervous system: leading to neurological complications;
- Cardiovascular system: potentially affecting heart function and causing cardiac complications.
Diagnosis and Laboratory Testing
Lyme disease is diagnosed using a serological blood test that detects antibodies against Borrelia bacteria. The test is widely available, and results are usually ready within one business day. In Georgia, the cost typically ranges from 20 to 30 GEL.
When interpreting the results, several important factors should be kept in mind:
- Testing too early may produce a false-negative result: The immune system needs time to produce detectable antibodies. Most clinical guidelines recommend waiting at least three weeks after infection, although antibody development may take even longer in some individuals;
- No test is completely accurate: Even highly reliable laboratory tests can occasionally produce false-negative results;
- Repeat testing may be necessary: If there is strong clinical suspicion—such as a confirmed tick bite or the presence of erythema migrans—a negative initial result should not rule out Lyme disease. In these cases, repeating the test 1–2 weeks later may confirm the diagnosis.
Treatment
One of the biggest challenges in Lyme disease is making the diagnosis, as symptoms may be mild, atypical, or entirely absent. As a result, many infections likely go unrecognized and are never formally diagnosed.
Once Lyme disease is identified, however, treatment is generally straightforward. A physician will prescribe an appropriate course of antibiotic therapy, which is highly effective when started early. Prompt treatment significantly reduces the risk of long-term complications and allows most patients to make a full recovery.
