Lyme Disease

Lyme disease, or Lyme borreliosis, is the most commonly transmitted tick-borne infection in the United States (US) and among the most frequently diagnosed tick-borne infections worldwide. Lyme disease is divided into 3 stages: early localized, early disseminated, and late. Early localized disease is distinguished by the red ring-like expanding rash of erythema migrans at the site of a recent tick bite. Other symptoms experienced at this stage may be malaise, headache, fever, myalgia, and arthralgia. Most patients only experience the symptoms of early localized disease. About 20% of patients develop early disseminated disease, with the most common symptoms being multiple erythema migrans lesions.

Other symptoms of the disseminated stage are flu-like symptoms, lymphadenopathy, arthralgia, myalgia, palsies of the cranial nerves, especially of cranial nerve VII, ophthalmic conditions, and lymphocytic meningitis. Additionally, cardiac manifestations, including conduction abnormalities, myocarditis, or pericarditis, may occur. The most common late-stage manifestation is arthritis, which is usually pauciarticular and affects large joints, especially the knees. Lyme disease is a curable condition if identified and treated appropriately.