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Lyme disease

Last reviewed: 13 Sep 2025
Last updated: 07 Feb 2025

Summary

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • erythema migrans
  • constitutional symptoms
Todos los datos

Otros factores de diagnóstico

  • facial palsy
  • arthritis or arthralgia
  • regional lymphadenopathy
  • stiff neck
  • lymphocytoma cutis
  • acrodermatitis chronica atrophicans
  • atrioventricular (AV) block or myopericarditis
  • radiculoneuropathy
  • encephalomyelitis, peripheral neuropathy, encephalopathy
Todos los datos

Factores de riesgo

  • exposure to infected ticks
  • outdoor activities
  • tick bite duration
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • enzyme immunoassay or immunofluorescence assay
Todos los datos

Pruebas diagnósticas que deben considerarse

  • Lyme-specific IgM and IgG (immunoblot assays)
  • skin biopsy culture
  • polymerase chain reaction (PCR)
  • ECG
Todos los datos

Algoritmo de tratamiento

Inicial

known high risk tick bite

Agudo

erythema migrans

cardiac involvement

neurologic disease

arthritis

En curso

recurrent or persistent arthritis

Colaboradores

Autores

Janak Koirala, MD, MPH, FACP, FIDSA
Janak Koirala

Professor of Medicine and Infectious Diseases

Division of Infectious Diseases

Southern Illinois University School of Medicine

Springfield

IL

Divulgaciones

JK declares that he has no competing interests.

Agradecimientos

Dr Janak Koirala would like to gratefully acknowledge Dr Tin Han Htwe and Dr Cristian A. Spiel, previous contributors to this topic.

Divulgaciones

THH and CAS declare that they have no competing interests.

Revisores

Raymond J. Dattwyler, MD

Professor of Medicine and Microbiology/Immunology

Chief of Allergy, Immunology and Rheumatology

New York Medical College

Valhalla

NY

Declarações

RJD declares that he has no competing interests.

Ionita Catalina, MD

Assistant Professor of Neurology and Neurosurgery

SUNY at Buffalo

Stroke/Neurocritical Care

Millard Fillmore Gates Hospital - Kaleida Stroke Center

Buffalo

NY

Declarações

IC declares that she has no competing interests.

Graham Fry, MB, FRCSI, DTM&H

Lecturer in Tropical Medicine

University College Dublin

Medical Director

Tropical Medical Bureau

Ireland

Declarações

GF declares that he has no competing interests.

Andras Lakos, MD, PhD

Physician

Centre for Tick-Borne Diseases

Budapest

Hungary

Declarações

AL is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical practice guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-48.Texto completo  Resumo

Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - Lyme disease. May 2023 [internet publication].Texto completo

Mead P, Petersen J, Hinckley A. Updated CDC recommendation for serologic diagnosis of lyme disease. MMWR Morb Mortal Wkly Rep. 2019 Aug 16;68(32):703.Texto completo  Resumo

Mygland A, Ljøstad U, Fingerle V, et al; European Federation of Neurological Societies. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol. 2010 Jan;17(1):8-16;e1-4.Texto completo  Resumo

National Institute for Health and Care Excellence. Lyme disease. Oct 2018 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Lyme disease images
  • Diagnósticos diferenciais

    • Local inflammatory reaction to tick bite
    • Tickbite allergy
    • Cellulitis
    Mais Diagnósticos diferenciais
  • Guidelines

    • CDC Yellow Book: health information for international travel - Lyme disease
    • 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease
    Mais Guidelines
  • Patient information

    Lyme disease

    More Patient information
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