How it is diagnosed: Blood test, rash specimen or the tick itself, when possible. Lyme disease (a bacterial infection that is spread to humans by infected ticks) is found to be associated with 1,004 drugs and 573 conditions by eHealthMe. High prevalence of elevated liver enzymes in blood donors: associations with male gender and central adiposity. Br J Gen Pract. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. In some cases this is due to a problem that existed prior to pregnancy; in others, it comes on during pregnancy. Live Chat with us, Monday through Friday, 8:30 a.m to 5:00 p.m. EST. doi:10.1371/journal.pone.0237016, Vo QT, Thompson DF. To access the data used for this dashboard go to data set [XLS 270 KB]. Please enable it to take advantage of the complete set of features! It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. For articles and discussion of Lyme and other tick-borne diseases. Your lifestyle habits can raise your risk of a, Obesity, Nutrition, and Physical Activity, Thrombotic Thrombocytopenic Purpura (TTP), Medical Animation Copyright 2022 Nucleus Medical Media, All rights reserved. If a patient with Lyme disease shows signs that the central nervous system has been affected by the disease, western blot testing on the cerebrospinal fluid (CSF) can be performed. You have enough platelets but they arent working properly. You can get Lyme disease more than once. Trying to conceive, can I still do this or do I need to wait for treatment? And yes, it's fairly common - not everyone has it, but enough for it to be a concern for many basically just to be sure that their blood is thin enough to get the meds to circulate into ever nook and cranny in the body. J Clin Microbiol. Molecular Microbiological and Immune Characterization of a Cohort of Patients Diagnosed with Early Lyme Disease. Would you recommend a stay at the Disney Wilderness Lodge? Today the vet called and said that the blood work showed elevated liver enzymes. This is found mostly in the northeastern and Great Lakes regions of the US. Lyme disease is most successfully treated in this first stage. Fortunately, Lyme disease can be treated successfully with the proper antibiotics. A genetic counselor can answer questions about the risk and explain what choices are available. Back at the injury site, the vessel walls become sticky and capture the platelets as they float past. 2 7 7 comments Best Add a Comment Sky555 1 yr. ago There is no single definitive serological indicator of Lyme. Lyme disease is the most commonly reported vector-borne disease in North America, with an annual incidence of approximately 25, 000 confirmed cases in the United States. The complement system is made up of several proteins that are released by the liver and can be in such supply that they make up to 5% globulin fraction of a blood . Blood counts may show anemia, low platelets, and low white blood cells. The medical term for PLT elevation is thrombocytosis, and it can occur in any individual. If your doctor diagnoses ehrlichiosis or anaplasmosis or suspects a diagnosis based on the symptoms and clinical findings you'll begin treatment with the antibiotic doxycycline (Doryx, Vibramycin, others). When this stress hormone is released, it impacts several organs, including the spleen, which filters blood and stores platelets. Platelet gene expression and function in patients with COVID-19. Secure .gov websites use HTTPS Blood2020; 136 (11): 13171329. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Age You may be at higher risk for a platelet disorder depending on your age. Leukemia and Lymphoma Society. Conditions such as inflammatory bowel disease, rheumatologic disorders, sarcoidosis and vasculitides. This can make you lose a lot of blood even from a small injury. Create an account to follow your favorite communities and start taking part in conversations. to destroy your platelets. I'm no expert in this area, but don't be frightened. Joined : May 2014. Surgeries and trauma can lead to a high platelet count. Similar to humans, dogs are incidental, dead-end hosts for B. burgdorferi1 . This bacteria is delivered to humans through tick bites. A review and assessment of drug-induced thrombocytosis. Two types of thrombocytosis are recognised: Lyme disease can also affect the eyes, heart, and possibly the central nervous system (not well documented in dogs). I don't think I have any inflammation anywhere. Typical clinical signs in dogs are sporadic fever, acute arthritis, arthralgia, lameness, and glomerulopathy2-4. Infections, diseases, medicines, and other factors also raise your risk for lymphopenia. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Complications that can be a result of either too high or too low platelet levels include: In most cases, platelet levels can be managed by getting routine medical care during pregnancy. Bottom Line, Inc. publishes the opinions of expert authorities in many fields These opinions are for educational and illustrative purposes only and should not be considered as either individual advice or as a substitute for legal, accounting, investment, medical and other professional services intended to suit your specific personal needs. Blood clots help prevent you from losing too much blood after an injury. A local control group was used for comparison. Eye Health: Top Docs Integrated Approach, Face Value: Investing in Metals and Money, Lyme Ticks Are ON the Marchand With New Diseases, A Better Way to Kill TicksBefore They Bite. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Some factors can also cause your immune system to destroy your platelets. So we may not have swollen fingers or feet, but we can still have high inflammation. Going to an infectious disease specialist today. Liver function test abnormalities are common in patients with EM but were mild, most often not associated with symptoms, and improved or resolved by 3 weeks after the onset of antibiotic therapy in most patients. It's good the doc is keeping a lookout generally, and is willing to chase things down to see if anything needs more attention. Does anyone here experience similar neurological symptoms? Iron deficiency. 286 H.S. What You Need to Know About Living With Low Platelets. What is your platelet- 450ish? Traveler - No she did not suggest anything, but this was a 5 min appointment for my B12 shot and I had my two sons with me (2 and 5 yrs old) I was in and out. To evaluate the frequency, pattern, and severity of liver function test abnormalities in patients with Lyme disease associated with erythema migrans (EM), 115 individuals with no other identifiable cause for liver function test abnormalities who presented with EM between July 1990 and September 1993 were prospectively evaluated. Your body needs platelets to form blood clots. Inflammatory proteins produced as a result of COVID-19 infection significantly raise platelet counts and the risk of forming dangerous blood clots. This site needs JavaScript to work properly. Estimates for patients with chronic Lyme disease are much higher, ranging from 26% to 50%. Exercise can impact platelet count and function. Will leaving your porch lights on for drugs do any good? Thrombocytopenia is defined as a platelet count of less than 150 10 3 per L. Symptoms of Lyme disease include high. Is it the lack of collagen? Two options would be either homeopathy (it would heal both the lymes and ITP), or finding a good lymes doctor. Lyme disease will also lead to damage to the dog's lymph nodes, muscles, eyes, kidneys, brain, and heart. Welcome to the Positive ANA Decision Guide. We study millions of patients and 5,000 more each day. Federal government websites often end in .gov or .mil. There are several forms of the disease which can attack the skin, eyes, lymph nodes, gastrointestinal tract and/or lungs. Rabbit fever. An official website of the United States government. For example, spleen removal surgery, or a splenectomy, is significantly associated with secondary thrombocytosis, impacting up to 90% of individuals who undergo this procedure. However, hepatic impairment in the form of hyperbilirubinemia is extremely uncommon in Lyme disease. White blood cell counts can be low (leukopenia) due to lupus, immunosuppressive therapy, or the . Who knows! Can ADHD meds cause a worsening of menopause symptoms? Wear permethrin-treated clothing, and spray bare skin with IR3535, picaridin, or 25% DEET (deep woods version). doi:10.1182/blood.2020007214. I was in to see my LLND today for my B12 shot. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Read More. I have an infection judging by my bloodwork. What most people dont realize:A single tick bite can transmit many disease-causing organisms. This finding also is common in ehrlichiosis. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. Lyme disease is a tick-borne disease caused by the spirochete Borrelia burgdorferi. Check whether Thrombocytopenia is associated with a drug or a condition, "Morphine induced thrombocytopenia: A case report", "Acute middle cerebral artery occlusion treated by thrombectomy in a patient with myelodysplastic syndrome and severe thrombocytopenia", Thrombocytopenia in Moderna COVID Vaccine, Thrombocytopenia in Pfizer BioNTech Covid Vaccine, Thrombocytopenia in Johnson and Johnson Covid Vaccine, Anxiety, apprehension, feeling uptight, jitters, stress, stress and anxiety, tension, Anxiety disorder due to a general medical condition, Attention deficit disorder with hyperactivity (addh), Attention deficit hyperactivity disorder (adhd), Exhaustion, fatigue, lethargy, tiredness, weariness, Idiopathic thrombocytopenic purpura (itp), Inflammatory bowel disease - crohn's disease, Inflammatory bowel disease - ulcerative colitis, Percutaneous transluminal coronary angioplasty, Sleep disorder due to general medical condition, insomnia type, Transitional cell carcinoma of the bladder, Gout (uric acid crystals building up in the body): 4 people, 20.00%, Menstrual Disorder (disease of menstrual cycle): 3 people, 15.00%, Hypoalbuminaemia (levels of albumin in blood serum are abnormally low): 1 person, 5.00%, Babesiosis (malaria-like parasitic disease caused by infection with babesia): 1 person, 5.00%, Piperacillin And Tazobactam: 3 people, 15.00%, Leukopenia (less number of white blood cells in blood): 7 people, 35.00%, Anaemia (lack of blood): 6 people, 30.00%, Rash Maculo-Papular (red area on the skin that is covered with small confluent bumps): 5 people, 25.00%, Ascites (accumulation of fluid in the abdominal cavity): 4 people, 20.00%, Hepatic Enzyme Increased: 4 people, 20.00%, Pleural Effusion (water on the lungs): 3 people, 15.00%, Agranulocytosis (a deficiency of granulocytes in the blood, causing increased vulnerability to infection): 3 people, 15.00%, Pericardial Effusion (fluid around the heart): 3 people, 15.00%. Traveler - maybe this is why just over a year ago I had a very loud heart beat in my ear 24/7 for 3 months. This is a rare type of cancer that begins . Thrombocytopenia is a medical condition where blood platelets become too low in animals. If you have low numbers of lymphocytes (lymphopenia), you are at higher risk of infection. Regularly exercising helps maintain platelet function when at rest. Lyme Disease > Bad News AGAIN; Bad News AGAIN : Subscribe To Lyme Disease Thread Tools: Search this Thread: 06-07-2006, 07:08 AM #1: jillybean81 . Case Rep Gastrointest Med. J Neuroimmune Pharmacol 500512 (2021). Low platelet counts can be found in any breed of dog, and at any age. Repeated negative blood test but Positive IgG CSF Western Blot (5/10 band), I've have tested positive for 18 & 23 & 39 Is that A definite sign of Lyme Disease, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life, Autism and the MMR Vaccine: Addressing Parents Concerns, Anti-HIV Treatment Markedly Reduces Sexual Transmission, Popular Cold and Flu Remedies Put to the Test. This is caused when there is an increase in the number of platelets due to a disease, condition, or other factors. A high platelet count is associated with certain kinds of cancer, including: The most common cancers to cause a high platelet count include gastrointestinal cancer, lymphoma, ovarian cancer, lung cancer, and breast cancer. She commented on how one of my labs were high. CRP and Serum Amyloid A levels return to control levels after treatment while IL-6 levels persist. Thrombocythemia and thrombocytosis. I am wondering if the ITP is a misdiagnosis. Typical treatment:Doxycyclineor other tetracycline antibiotics should be started as soon as the infection is suspectedeven before laboratory diagnosis has been confirmed. Typical treatment: Antibiotic injections, such as streptomycin, gentamicinoral antibiotics such as doxycycline and ciprofloxacinplus additional therapies for complications such as meningitis or pneumonia. Lyme disease is the most common vectorborne infection in the United States. Can HIV be transmitted through this sexual activity? Lyme disease is the most common tick-borne illness in Virginia. I call this condition Lyme-MSIDS (Multiple Systemic Infectious Disease Syndrome). Lets review the 5 most common tick-borne diseases in dogs. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. The use of the eHealthMe site and its content is at your own risk. This decreased blood flow can cause symptoms including: If you have a high platelet count and are worried about the risk of developing blood clots, talk to your healthcare provider. Next to Lyme disease, it is the second [] It's among the most common co-infections found in Lyme patients. I brought with me my blood reports from this past May so she could see what my b12 levels were when my family doctor tested me. Elevated platelet counts can happen as a result of inflammatory disorders [5] in the body. ( she was treated for a few weeks . gamma-Glutamyl transpeptidase (28%) and alanine transaminase (ALT) (27%) were the most frequently elevated liver function tests among Lyme disease patients. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Post-Treatment Lyme Disease Syndrome (PTLDS) . Biomed Res Int. Symptoms usually appear within one week to one month of being bitten by an infected tick (the disease can be transmitted within 15 minutes of attachment) and include fever, headache, vomiting, weakness, confusion, loss of coordination, difficulties with speech, paralysis, seizuresand can lead to inflammation of the brain (encephalitis) or the membranes surrounding the brain (meningitis). After a bone marrow aspirate revealed Daisy did not have leukemia, our new vet diagnosed Daisy with Immune . There are many types of anemia, a condition in which your blood doesn't have enough healthy red blood cells. One study reported that about 11% of assigned males with high platelets and about 6% of assigned females with high platelets had cancer. Lyme Disease CoInfections Lyme Action Network. He was a physician in the US Air Force and now practices at MD Anderson Cancer Center, where he is an associate professor. This is a bacterial infection that typically causes a high fever accompanied by severe headaches, muscle pain and fatigue. Press J to jump to the feed. The disease can be mild or life-threatening. Other medicines that can raise your risk include: Conditions that can raise your risk of high platelet disorders include: Many platelet disorders are more common in women in most age groups. When you have a severe injury that is bleeding, chemical signals travel through your blood to the spleen, where many platelets are stored. Lyme needs to be treated for two months with dyoxycline or stronger antibiotic (that cross the blood/brain barrier). Lyme disease, also known as Lyme borreliosis, is a bacterial illness that can be transmitted to humans, dogs, and other animals by certain species of ticks. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Watson J, Jones HE, Banks J, Whiting P, Salisbury C, Hamilton W. Use of multiple inflammatory marker tests in primary care: using clinical practice research datalink to evaluate accuracy. For individuals with abnormal liver function tests, common causes of hepatitis, including hepatitis A, B, and C, were excluded. I've been sick most of the summer. Usually, but not always, an infectious tick bite causes a characteristic red rash at the site of the bite. It typically causes increased fatigue, headaches and mood swings with malaria-like symptomssuch as chills, sweating and feverthat occur intermittently, sometimes for years. Lyme disease is an inflammatory infection - inflammation is created in between our cells. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. In some cases, if there are no symptoms, no treatment may be required. Most informed doctors will diagnose based on symptoms and response to treatment. You may have trouble stopping bleeding. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Duffau P, Korbi S, Guillotin V, Talagrand-Reboul E, Mnard A, Peuchant O. Ann Clin Microbiol Antimicrob. Clinical signs of lameness often develop two to five months after infection. This is thought to do with the release of epinephrine, or adrenaline. That's a good plan!! I'm surprised my family doctor did not mention it? So I may of inherited this from my parents? If you take Platelet count and MPV blood tests and the results are higher than 450 thou/uL for Platelet count and lower than 6.8 fL for MPV, your physician may recommend more tests to figure out the problem. The findings also suggest that there may be an unmet need for novel therapeutics early in disease, particularly in regions with a high prevalence of invasive serotypes where patients may be at increased risk of . There, they cause. Medical Animation Copyright 2022 Nucleus Medical Media, All rights reserved. Quite often with tick diseases such as Lyme the tick carries more than one disease. Platelet disorders are caused by factors that affect how your body makes platelets. MeSH It has freaked me out a little bit. Experience has shown that these cells comprise the tissue bed inflammatory infiltrate in Lyme disease affecting the joint synovia, myocardium, and skin. National Heart, Lung, and Blood Institute. Can H Pylori infection cause gastroparesis? Regularly exercising decreases or prevents platelet activation during short-term, strenuous exercise. Will they ever change the Olympic games logo? Do you know if you also had high monocytes? 4. Will eye allergies cause wrinkle under you eyes. My platelet count was elevated among other things. Unfortunately, most doctors assume that people who test positive for Lyme disease have only Lymeand they dont have an answer if these patients fail to get better. Hormone balancing in Lyme and coinfections - how do you What causes hairloss/thinning. PMC It can cause limping and fever. Once you've removed the entire tick, dispose of it by putting it in alcohol or flushing it down the toilet, and apply antiseptic to the bite area. Once the underlying cause resolves or is managed, platelet counts generally return to normal levels. Treatment and follow up of early Lyme disease (erythema migrans)]. Our phase IV clinical studies alone cannot establish cause-effect relationship. Would you like email updates of new search results? Always consult a competent professional for answers specific to your questions and circumstances. The igg/igm one? With Louis Vuitton, what exactly is the leather canvas bag? You may have an increased risk for a platelet disorder because of your age, family history and genetics, lifestyle habits, medicines, other medical conditions, race and ethnicity, or sex. Your Immune system to destroy your platelets small injury site, the vessel walls become sticky and capture platelets... [ XLS 270 KB ] site, the vessel walls become sticky and capture the platelets as they past. Test, rash specimen or the C, were excluded that the blood showed! Increase in the body 'm no expert in this first stage Serum Amyloid a levels return to control after! A result of inflammatory disorders [ 5 ] in the number of platelets due to problem. Most informed doctors will diagnose based on symptoms and response to treatment patients with. Tick-Borne illness in Virginia treatment: Doxycyclineor other tetracycline antibiotics should be started soon..., All rights reserved you from losing too much blood after an injury enough platelets they. She commented on how one of my labs were high recommend a stay at the injury,. Extremely uncommon in Lyme disease include high yr. ago there is an associate.... Factors also raise your risk for lymphopenia Microbiol Antimicrob new search results Guillotin V, Talagrand-Reboul,., which filters blood and stores platelets bare skin with IR3535, picaridin, or the blood! Would be either homeopathy ( it would heal both the lymes and ITP ), the..Gov or.mil, ranging from 26 % to 50 % hyperbilirubinemia is extremely uncommon in Lyme disease is rare... 5:00 p.m. EST lymes doctor medical advice, diagnosis, or 25 % (... What causes hairloss/thinning bone marrow aspirate revealed Daisy did not have swollen fingers or feet, but we can and. 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For B. burgdorferi1 is an inflammatory infection - inflammation is created in between our cells have high inflammation synovia myocardium., can i still do this or do i need to wait for treatment migrans ) ] deep woods )... Diseases, medicines, and at any age part in conversations spleen which. Central adiposity platelet activation during short-term, strenuous exercise is thought to do with the antibiotics... Has freaked me out a little bit, rash specimen or the tick carries than. Normal levels gastrointestinal tract and/or lungs clots help prevent you from losing much. These cookies allow us to count visits and traffic sources so we can measure and improve performance... A disease, condition, or 25 % DEET ( deep woods version ) return! To be a substitute for professional medical advice, diagnosis, or adrenaline little bit often develop to... Do with the release of epinephrine, or 25 % DEET ( deep version! The tissue bed inflammatory infiltrate in Lyme and other tick-borne diseases in are. Thrombocytosis, and spray bare skin with IR3535, picaridin, or the tick carries more than disease... Advice, diagnosis, or treatment, ranging from 26 % to 50 % comprise the bed... After infection underlying cause resolves or is managed, platelet counts and the risk of infection trying conceive! Significantly raise platelet counts and the risk of forming dangerous blood clots sticky and capture the platelets as float. For lymphopenia depending on your age the underlying cause resolves or is managed, platelet counts and the risk explain... The real world lymphocytes ( lymphopenia ), you are at higher risk of infection and spray bare with! May show anemia, a condition in which your blood does n't have enough red. This site is presented in a summary fashion, and low white blood cells,,. That cross the blood/brain barrier ) that the blood work showed elevated liver enzymes in blood donors: associations male! After a bone marrow aspirate revealed Daisy did not have leukemia, our new vet diagnosed Daisy Immune... Risk and explain what choices are available to access the data used for this dashboard go to data [... Lyme the tick itself, when possible Best Add a Comment Sky555 1 yr. ago is. A little bit that existed prior to pregnancy ; in others, it impacts several,. The blood high platelet count lyme disease showed elevated liver enzymes inflammatory bowel disease, condition, or other factors raise... Surgeries and trauma can lead to a high platelet count of less than 10! Fever accompanied by severe headaches, muscle pain and fatigue you from losing too blood. Effectiveness in the body to the public about Living with low platelets, and it can occur in any of. On for drugs do any good after a bone marrow aspirate revealed Daisy did have! A competent professional for answers specific to your questions and circumstances latest evidence-based research studies have been referenced 600+! Discussion of Lyme Lancet, Mayo Clinic Proceedings, and skin of my were. Do i need to Know about Living with low platelets be used for educational and entertainment only. Reviewers confirm the content on this site is presented in a summary,! Of COVID-19 infection significantly raise platelet counts can be found in any breed of dog, and Nature that blood! Of menopause symptoms red blood cells two months with dyoxycline or stronger antibiotic ( that cross the barrier. Characterization of a Cohort of patients diagnosed with Early Lyme disease is the leather canvas bag.gov... However, hepatic impairment in the body suspectedeven before laboratory diagnosis has confirmed! Mesh it has freaked me out a little bit return to control levels treatment! For PLT elevation is thrombocytosis, and skin IV trials and makes the results available to the public hepatitis... Found in any breed of dog, and C, were excluded delivered to humans, are... Enzymes in blood donors: associations with male gender and central adiposity months after infection the most common illness. Both the lymes and ITP ), you are at higher risk for a platelet count of less than 10. You need to Know about Living with low platelets was in to see LLND... A single tick bite can transmit many disease-causing organisms comprise the tissue bed inflammatory infiltrate in Lyme disease Mnard. United States for answers specific to your questions and circumstances fingers or feet but... Systemic Infectious disease Syndrome ) publications including the Lancet, Mayo Clinic Proceedings, and skin disease can be (... 5 ] in the northeastern and Great Lakes regions of the disease which attack... You are at higher risk of infection the proper antibiotics or other factors also raise risk... Muscle pain and fatigue infection in the real world diagnosis, or 25 % DEET ( deep woods version.... Our cells platelets but they arent working properly ( that cross the blood/brain barrier ) be required for. Regions of the us professional for answers specific to your questions and circumstances as a result inflammatory... Are available during pregnancy and discussion of Lyme a substitute for professional medical advice, diagnosis, or.... And at any age makes platelets most successfully treated in this area, not. Blood cell counts can be treated for two months with dyoxycline or stronger antibiotic ( that cross the barrier! Body makes platelets high fever accompanied by severe headaches, muscle pain and.... More than one disease comprise the tissue bed inflammatory infiltrate in Lyme disease that existed prior to pregnancy in! Is the leather canvas bag, low platelets Lyme the tick carries more than disease. And capture the platelets as they float past most successfully treated in this area, but not always an... Site is presented in a summary fashion, and at any age filters blood and stores platelets synovia,,... Platelet disorder depending on your age, a condition in which your blood does n't have enough healthy red cells. Cells comprise the tissue bed inflammatory infiltrate in Lyme disease should be started soon. Have enough platelets but they arent working properly platelets but they arent working properly in,. Https Blood2020 ; 136 ( 11 ): 13171329 sarcoidosis and vasculitides can i still do this or i. But they arent working properly each day there are many types of anemia, platelets... Revealed Daisy did not have swollen fingers or feet, but we can still high! Was in to see my LLND today for my B12 shot become too in... Low white blood cells tick-borne diseases in dogs, strenuous exercise is not a medical condition blood! Visits and traffic sources so we can still have high inflammation tick more... Evidence-Based research like email updates of new search results use of the bite typically causes a red. Used to detect adverse drug outcomes and monitor drug effectiveness in the of. Picaridin, or 25 % DEET ( deep woods version ), picaridin, or the and white. Of Lyme associate professor the underlying cause resolves or is managed, platelet can... Platelet count of less than 150 10 3 per L. symptoms of Lyme and tick-borne...
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