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parts of the body. Less common symptoms include backache, nausea and vomiting, sore throat, swollen lymph nodes, and an enlarged spleen. Although most symptoms may come and go, feelings of illness and fatigue may persist for weeks.

The fire ant sting usually produces immediate pain and a red, swollen area, which disappears within 45 minutes. A blister then forms, rupturing in two to three days, and the area often becomes infected. In some cases, a red, swollen, itchy patch develops instead of a blister. Isolated nerves may become inflamed, and seizures may occur. A bee may leave its stinger in the skin. The stinger should be removed as quickly as possible without concern for the method of removal. An ice cube placed over the sting reduces the pain. A cream containing a combination of an antihistamine, an analgesic, and a corticosteroid is often useful. People who are allergic to stings should always carry a preloaded syringe of epinephrine, which blocks anaphylactic or allergic reactions. People who have had a severe allergic reaction to a bee sting sometimes undergo desensitization, which may help prevent future allergic reactions.

Lyme Disease Usually, Lyme disease occurs in the summer and early fall. Children and young adults who live in wooded areas are most often infected. The bacteria that cause Lyme disease are transmitted by the deer tick (Ixodes), so

Lyme disease (erythema migrans)

named because the adult ticks often feed on the blood of deer. The bacteria that cause Lyme disease are transmitted to people when an infected tick bites and stays attached for one or two days. Brief periods of attachment rarely transmit disease. The early-localized stage typically begins with a large, red spot at the site of the bite, usually on the thigh, buttock, trunk, or armpit. The spot (erythema migrans) typically expands to a diameter of six inches (15 centimeters), often with a central clearing (bull’s eye). About 25 percent of infected people never develop – or at least never notice – any red spot. The symptoms of earlydisseminated Lyme disease begin when the bacteria spread through the body from the initial bite area. In this stage, many people feel ill with fatigue, chills and fever, headaches, stiff neck, and aches in muscles and joints. Nearly half develop more, usually smaller, erythema migrans spots on other

deer tick

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Abnormalities of nerve function develop in about 15 percent of people. The most common problems are headache, stiff neck, involvement of the tissues covering the brain and spinal cord (aseptic meningitis), and weakness on one side of the face (Bell’s palsy); these may persist months before disappearing. Nerve pain and weakness may develop in other

About 25 percent of infected people never develop – or at least never notice – any red spot.

areas and persist longer. Irregular heartbeats (arrhythmias) and inflammation of the sac around the heart (pericarditis) that causes chest pain develop in eight percent of infected people. In untreated Lyme disease, the late stage begins months to years after the initial infection. Arthritis

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