Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- erythema migrans
- constitutional symptoms
Other diagnostic factors
- facial palsy
- arthritis or arthralgia
- regional lymphadenopathy
- stiff neck
- lymphocytoma cutis
- acrodermatitis chronica atrophicans
- atrioventricular (AV) block or myopericarditis
- radiculoneuropathy
- encephalomyelitis, peripheral neuropathy, encephalopathy
Diagnostic investigations
1st investigations to order
- enzyme immunoassay or immunofluorescence assay
Investigations to consider
- Lyme-specific IgM and IgG (immunoblot assays)
- skin biopsy culture
- polymerase chain reaction (PCR)
- ECG
Treatment algorithm
Contributors
Authors
Professor of Medicine and Infectious Diseases
Division of Infectious Diseases
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JK declares that he has no competing interests.
Dr Janak Koirala would like to gratefully acknowledge Dr Tin Han Htwe and Dr Cristian A. Spiel, previous contributors to this topic.
Disclosures
THH and CAS declare that they have no competing interests.
Peer reviewers
Professor of Medicine and Microbiology/Immunology
Chief of Allergy, Immunology and Rheumatology
New York Medical College
Valhalla
NY
Disclosures
RJD declares that he has no competing interests.
Assistant Professor of Neurology and Neurosurgery
SUNY at Buffalo
Stroke/Neurocritical Care
Millard Fillmore Gates Hospital - Kaleida Stroke Center
Buffalo
NY
Disclosures
IC declares that she has no competing interests.
Lecturer in Tropical Medicine
University College Dublin
Medical Director
Tropical Medical Bureau
Ireland
Disclosures
GF declares that he has no competing interests.
Physician
Centre for Tick-Borne Diseases
Budapest
Hungary
Disclosures
AL is an author of a reference cited in this topic.
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