Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- eritema migratório
- sintomas constitucionais
Other diagnostic factors
- paralisia facial
- artrite ou artralgia
- linfadenopatia regional
- rigidez de nuca
- linfocitoma da cútis
- acrodermatite crônica atrofiante
- bloqueio atrioventricular (AV) ou miopericardite
- radiculoneuropatia
- encefalomielite, neuropatia periférica, encefalopatia
Risk factors
- exposição a carrapatos infectados
- atividades em ambientes externos
- duração da mordida do carrapato
Diagnostic tests
1st tests to order
- imunoensaio enzimático ou ensaio de imunofluorescência
Tests to consider
- IgM e IgG específicas para Lyme (ensaio de immunoblotting)
- cultura de biópsia da pele
- reação em cadeia da polimerase
- eletrocardiograma (ECG)
Treatment algorithm
alto risco de picada de carrapato conhecido
eritema migratório
comprometimento cardíaco
doença neurológica
artrite
artrite recorrente ou persistente
Contributors
Authors
Janak Koirala, MD, MPH, FACP, FIDSA

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.
Acknowledgements
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
Raymond J. Dattwyler, MD
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.
Ionita Catalina, MD
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.
Graham Fry, MB, FRCSI, DTM&H
Lecturer in Tropical Medicine
University College Dublin
Medical Director
Tropical Medical Bureau
Ireland
Disclosures
GF declares that he has no competing interests.
Andras Lakos, MD, PhD
Physician
Centre for Tick-Borne Diseases
Budapest
Hungary
Disclosures
AL is an author of a reference cited in this topic.
Differentials
- Reação inflamatória local à picada de carrapato
- Alergia a mordida de carrapato
- Celulite
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - Lyme disease
- 2020 guidelines for the prevention, diagnosis and treatment of Lyme disease
More GuidelinesPatient information
Lyme disease
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