A CASE OF A LYME DISEASE IN THE SECOND TRIMESTER OF PREGNANCY
Date Issued
2025-09
Author(s)
Anamarija Shpishikj Pushevska
Pranvera Izairi
Arta Islami Zulfiu
Bekim Dika
Iskra Martinovska
Abstract
Introduction: Lyme disease is the most common tick-borne disease in North America
and Europe and it is caused by spirochetal bacteria Borelia burgdorferi. Early
symptoms of infection include a characteristic rash (erythema migrans), fever,
headache and lethargy. If untreated, the disease may affect the heart, nervous
system and joints. Regardless of whether maternal exposure to B. burgdorferi occurs
before conception or during pregnancy, it does not appear to be associated with fetal
death, prematurity or risk of congenital malformations. Even documented infection
of the placenta with B. burgdorferi has not been linked to adverse pregnancy
outcomes. Also, there have been no reported cases of transmission of B. burgdorferi
via breast milk. Antibiotics used during pregnancy are amoxicillin or cephalosporins,
14-21 days. Case report: A 24-year-old primigravida, at 23 weeks of gestation,
reported that 3 weeks earlier she had been bitten by a tick that had not been
removed by a surgeon. A change appeared as a red ring of about 10 cm in the gluteal
region on the right, as well as joint pain, without fever. She was examined by an
infectious disease specialist. Serological tests were performed and a high titer of IgG
and IgM antibodies for Borelia burgdorferi sensu lato were detected. Antibiotic
therapy Amp. Ceftriaxone 2gr/day was administered for 14 days, which prevented
further complications in mother or fetus. Conclusion: With this case, we want to
point out that Lyme borreliosis is present, that a tick bite is serious and requires an
examination by a surgeon and an infectious disease specialist, in order to properly
remove the tick and prevent the occurrence of this disease, which is possible even
during pregnancy. It is also important to be aware of its symptoms, in order to start
antibiotic therapy before more serious complications arise.
and Europe and it is caused by spirochetal bacteria Borelia burgdorferi. Early
symptoms of infection include a characteristic rash (erythema migrans), fever,
headache and lethargy. If untreated, the disease may affect the heart, nervous
system and joints. Regardless of whether maternal exposure to B. burgdorferi occurs
before conception or during pregnancy, it does not appear to be associated with fetal
death, prematurity or risk of congenital malformations. Even documented infection
of the placenta with B. burgdorferi has not been linked to adverse pregnancy
outcomes. Also, there have been no reported cases of transmission of B. burgdorferi
via breast milk. Antibiotics used during pregnancy are amoxicillin or cephalosporins,
14-21 days. Case report: A 24-year-old primigravida, at 23 weeks of gestation,
reported that 3 weeks earlier she had been bitten by a tick that had not been
removed by a surgeon. A change appeared as a red ring of about 10 cm in the gluteal
region on the right, as well as joint pain, without fever. She was examined by an
infectious disease specialist. Serological tests were performed and a high titer of IgG
and IgM antibodies for Borelia burgdorferi sensu lato were detected. Antibiotic
therapy Amp. Ceftriaxone 2gr/day was administered for 14 days, which prevented
further complications in mother or fetus. Conclusion: With this case, we want to
point out that Lyme borreliosis is present, that a tick bite is serious and requires an
examination by a surgeon and an infectious disease specialist, in order to properly
remove the tick and prevent the occurrence of this disease, which is possible even
during pregnancy. It is also important to be aware of its symptoms, in order to start
antibiotic therapy before more serious complications arise.
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