B13. Lyme Borreliosis

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  • Tick-borne
  • Borrelia burgdorferi
  • Clinical features
    • Stage I – early localized Lyme disease
      • Within 7 – 14 days
      • Erythema migrans
        • Circular, slowly-expanding red ring with central clearing around the bite site
        • Target-like rash
      • Flu-like symptoms
    • Stage II – early disseminated Lyme disease
      • Multiple erythema migrans
      • Migratory arthralgia
      • Early neuroborreliosis
      • Lyme carditis
    • Stage III – late Lyme disease
      • Acrodermatitis chronica atrophicans
        • Inflammation and atrophy of skin of extremities
      • Chronic Lyme arthritis
      • Late neuroborreliosis
  • Diagnosis
    • Clinical diagnosis based on symptoms
    • Serology can be used to confirm
  • Treatment
    • Doxycycline
      • First-line
    • Amoxicillin
      • In pregnant
    • Ceftriaxone
      • If neuroborreliosis or Lyme carditis