Lyme disease

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Última revisão: 26 Mar 2025

Última atualização: 07 Feb 2025

Lyme disease is an infectious disease transmitted to humans through the bite of infected ticks.

Erythema migrans develops at the site of tick bite usually within 1 to 2 weeks and is a pathognomic feature.

Constitutional symptoms such as fever, headache, myalgias, fatigue, and arthralgias may occur.

Complications of Lyme disease may be neurologic, cardiac, or musculoskeletal.

Mainstay of treatment is antibiotic therapy.

There is currently no vaccine; prevention is centered around reducing exposure to ticks.

Definição

Lyme disease is a zoonotic infection caused by a spirochete of genus Borrelia, which is transmitted to humans by ticks. Zoonotic diseases are transmitted between vertebrate animals and humans. Animals serve as the primary reservoir of Borrelia. Ticks become infected by feeding on an infected animal. The most common initial manifestation is a typical skin lesion known as erythema migrans. Later manifestations may include arthritis, or central nervous system or cardiac involvement.

História e exame físico

Principais fatores diagnósticos

erythema migrans
constitutional symptoms

Detalhes completos

Outros fatores diagnósticos

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

Detalhes completos

Fatores de risco

exposure to infected ticks
outdoor activities
tick bite duration

Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

enzyme immunoassay or immunofluorescence assay

Detalhes completos

Investigações a serem consideradas

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

Detalhes completos

Algoritmo de tratamento

Inicial

known high risk tick bite

AGUDA

erythema migrans

cardiac involvement

neurologic disease

arthritis

CONTÍNUA

recurrent or persistent arthritis

Colaboradores

Autores

Janak Koirala, MD, MPH, FACP, FIDSA

Professor of Medicine and Infectious Diseases

Division of Infectious Diseases

Southern Illinois University School of Medicine

Springfield

Declarações

JK declares that he has no competing interests.

Agradecimentos

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

Declarações

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

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

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.

Diagnósticos diferenciais
- Local inflammatory reaction to tick bite
- Tickbite allergy
- Cellulitis
Mais Diagnósticos diferenciais
Diretrizes
- CDC Yellow Book: health information for international travel - Lyme disease
- 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease
Mais Diretrizes
Folhetos informativos para os pacientes
Lyme disease
Mais Folhetos informativos para os pacientes
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Lyme disease

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

Outros fatores diagnósticos

Fatores de risco

Investigações diagnósticas

Primeiras investigações a serem solicitadas

Investigações a serem consideradas

Algoritmo de tratamento

known high risk tick bite

erythema migrans

cardiac involvement

neurologic disease

arthritis

recurrent or persistent arthritis

Colaboradores

Autores

Janak Koirala, MD, MPH, FACP, FIDSA

Declarações

Agradecimentos

Declarações

Revisores

Raymond J. Dattwyler, MD

Declarações

Ionita Catalina, MD

Declarações

Graham Fry, MB, FRCSI, DTM&H

Declarações

Andras Lakos, MD, PhD

Declarações

Diagnósticos diferenciais

Diretrizes

Folhetos informativos para os pacientes

Log in or subscribe to access all of BMJ Best Practice

Log in or subscribe to access all of BMJ Best Practice

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