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Lyme Disease

Felix B. Chang Cruz, MD, FAAMA, ABIHM Reviewed 06/2020
 


BASICS

Lyme disease is caused by the bacterium Borrelia burgdorferi

DESCRIPTION

  • A multisystem infection caused by Borrelia spirochetes, transmitted primarily by ixodid ticks

    • Ixodes scapularis (deer tic...

DIAGNOSIS

HISTORY

  • History of a tick bite followed by EM and/or illness (fever, fatigue, headache, myalgias). Only about 1/3 of patients recall tick bite.

  • Round, flat or raised, erythematous bulls-eye le...

TREATMENT

GENERAL MEASURES

Early and disseminated Lyme disease can usually be treated as an outpatient, except when complicated by carditis or meningitis (requires parenteral antibiotics). 

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Based on the severity of symptoms, patients with Lyme carditis, neurologic syndromes, or arthritis may require prolonged follow-up. 

DIET

No restr...

REFERENCES

1
Schwartz AM, Hinckley AF, Mead PS, et al. MMWR surveillance for Lyme disease—United States, 2008–2015. MMWR Surveill Summ.  2017;66(22):1–12.
2
Marques A, Telford SRIII, Turk SP, et al....

ADDITIONAL READING

CODES

ICD10

  • A69.20 Lyme disease, unspecified

  • A69.23 Arthritis due to Lyme disease

  • A69.21 Meningitis due to Lyme disease

  • A69.22 Other neurologic disorders in Lyme disease

  • A69.29 Other conditions associated ...

CLINICAL PEARLS

  • The presence of EM following a tick bite in an endemic area is an indication for empiric antibiotic treatment for presumptive Lyme disease.

  • Ticks must be attached for at least 36 to 48 ...

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