Expert: Carol - 11/23/2006

Question
On November 12 I was in the woods collecting  firewood with my husband.  It was a raw day and I was covered up with coat and gloves.  That night I noticed what looked like a bite  on one arm, below the elbow.  There was a definite center, almost like a chunk had been bitten out.  Because I'd been so well covered up I thought first of spider, rather than tick.  Within a week that original spot had expanded to form a cluster of tiny blisters nearly, the circle nearly inch across, and the entire area red, hot, swollen and VERY itchy.  Isolated individual spots had erupted on other places on that arm, as well as a few on my chest and abdomen.  Those spots have not yet spread out to form a circle like the original bite, or whatever it is, did, but they too are intensely itchy.  I was puzzled, wondering if  instead of a bite, the rash was a result of poison ivy or eczema or even scabies, so on Nov. 20 I saw a doctor at the Tunkhannock Geisinger clinic.  He said not to worry, it was definitely just poison ivy and go home and apply hydrocortisone cream.  I used the cream as well as Gold Bond for the itching, but nothing really helped.  Two days later, on Nov. 22, the original bite/circular rash looked like a bullseye, with the bite mark at the center, whitish, surrounded by an almost red area and a ridge, then a circle that was pale, greenish, and then red again.  This time I began thinking Lyme Disease and made another appointment at the Geisinger clinic for that day.  I saw a different doctor who said he thought I had shingles or possibly tissue necrosis (or something like that--I've forgotten the term he used) from some kind of insect bite.  He seemed to lean toward shingles (I've never had shingles, or poison ivy, either, before in my life, so I don't have any past experience to help me self-diagnose), which sounded unpleasant, and then he decided it might be a bite of some sort after all.  If it was a bite, it might be infected, so he was considering prescribing an antibiotic for the infection.  I had deliberately not mentioned Lyme disease because doctors don't like patients to suggest a diagnosis, but he hadn't seemed at all impressed by my perfect bullseye so I said meekly, "Is there a risk of Lyme disease?"  He said that we would never know what kind of insect  had bitten me, if any, but of course it could have been a deer tick.  Then he said, "Well, how much do you want?"  I had no idea what he meant so he explained that he could go ahead and write the prescription for a limited antibiotic, or he could prescribe Doxycycline for 21 days and that would cover everything, including Lyme disease.   I opted for the Doxycycline.  I still wonder if what I have is shingles, poison ivy, or either a spider or tick bite, or possibly, a combination  of two or more of the above.  Shingles can be triggered by stress, and November 12 was a particularly stressful day.  Shingles is supposed to be painful, but can sometimes be itchy instead.  The pain or itching doesn't respond well to creams, and this does not respond to creams.  Poison ivy can form a round cluster of blisters, though not normally in a bullseye pattern.  A tick bite does not normally itch the way this rash itches.  A spider bite is unpredictable, but it could conceivably cause something like a bullseye rash.  My question is, if this is a tick bite, is it possible that the rash is a separate condition (shingles or poison ivy) which has coincidentally circled the bite, and also popped up in individual blisters on other parts of my body?  Is there anyway a doctor could determine WHAT is causing my symptoms?  It seems to me my options, as presented to me by two different doctors, cover a broad spectrum: shingles, poison ivy, or a nasty bug bite.  Thanks.

Answer
Hi, Esther....

Sorry for your unfortunate experience--you certainly have a lot going on here.

I read your question a couple of times to be sure I connected all the dots.

Although I can't say for certain what mysterious creature caused your bite, I'll tell you what I think.

Regarding shingles...I and my mother have both had them and they normally involve neuropathic pain requiring some type of prescription painkiller such as Percocet along with an anti-viral medication.  I've never heard of anyone having shingles on his/her arm.  They occur on one side of the trunk or face. In my opinion, I doubt if it's shingles.

Doesn't really sound like poison either, particularly since it's not responding to the anti-itch creams. They usually settle that down pretty quickly.

Now, I'll evangelize a little about Lyme disease. These are facts and not my opinions and they are, also, things that most doctors do not know and/or refuse to believe.

You conceivably could have been bitten by a spider and contracted Lyme disease because any bloodsucking insect can carry the bacteria--this includes mosquitoes, fleas, etc.  Perhaps this is why the bite apprears to be a spider bite.  That's what it sounds like to me.

The bullseye rash is definitely indicative of Lyme infection.  If you still have it, get a picture of it IMMEDIATELY and any other lesions on your body.  Lyme can cause mysterious rashes and they are frequently misdiagnosed as eczema, ringworm, etc.  Doctors just don't know a whole lot about it, take it from me. My diagnosis was missed by 14 various doctors and 'ologists.  I'm the one that figured it all out.

Whenever Lyme disease is mentioned, there is an instant prejudice when it comes to doctors.  They don't believe it needs to be treated with long-term antibiotics (which it absolutely does).  They don't believe that one can have it and still have a negative rest result.  They don't know anything about the co-infections that can occur with it nor do they know all of the bizarre symptoms it can cause.

Having said all this, I believe you need to find a Lyme specialist.  You need to be evaluated for Lyme and its co-infections asap.  Their symptoms can overlap with Lyme and they do not all respond to the same antibiotics.  The longer it goes untreated, the more difficult it is to treat, particularly once it penetrates the central nervous system, such as what happened with myself.

The treatment guidelines for Lyme are in dire need of being overhauled because 21 days of doxy is not enough to eradicate this bacteria.  But, they are the guidelines doctors must follow and the patients are suffering for it.  Lyme specialists believe in treating with two high-powered antibiotics over a longer period of time and there is some controversy over this.  Lyme is much more rampant than people realize so eventually mainstream medicine will wake up and update the treatment guidelines and learn to recognize its symptoms.

To find a Lyme specialist, go to www.LymeNet.org and register. Click on Flash Discussion and then Seeking A Doctor. Post there with your city and state. Due to privacy issues and harrassment from mainstream medicine, drs' names are not posted on the site.  You will see LLMD a lot on the site and that stands for Lyme-literate MD.

You may also try posting your question on that site under General Support and see what kind of feedback you get from those folks.  That site is actually where I self-diagnosed.

One more thing, Lyme can be transmitted among people living in the same household. I know of scores of families where mom, dad and all the kids have it. They have experimented with animals and it has proven this theory.  After all, Lyme is a bacteria.  That's actually how I believe I got it---from my husband.  He had Lyme and Babesiosis and I just had Lyme.   Just telling you so you'll know.  Be vigilant for symptoms in any other family members.

Bottom line...see a Lyme specialist.  It's your only recourse if you want to be properly tested, diagnosed and treated for Lyme and its co-infections.  

Sign me been there, done that!

Hope I've helped you out.  If you need more help from me you can email me directly.  mineandours@hotmail.com

Sure hope you get some answers.

Carol