Most common tick-borne illness in North America
Endemic in Northeast, Upper Midwest, and northwestern California
Peak April–November; 80–90% in summer months
Onset few days to a month after tick bite (arthropod transmission)
30–50% of patients recall tick bite.
Erythema chronicum migrans (ECM):
20 mL/kg of 0.9% NS IV fluid bolus for dehydration
IV access for neurologic and cardiac involvement
Temporary pacemaker for heart block
Telemetry/ICU admission for carditis
Duration of treatment for later organ involvement will be ≥30 days.
Be aware of coinfections with Anaplasmosis and Babesiosis.
American Academy of Pediatrics: Report of the Committee on Infectious Diseases. 29th ed. Elk Grove, CA: Ill; 2012.
Kowalski TJ, Tata S, Berth W, et al. Antibiotic treatment durat...
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