Lyme disease
Lyme disease is caused by the spirochaete Borrelia burgdorferi and is spread by ticks
Features
Investigation
Management
Features
- early: erythema chronicum migrans + systemic features (fever, arthralgia)
- CVS: heart block, myocarditis
- neuro: cranial nerve palsies, meningitis
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Lyme disease rash, target lesion of erythema migrans
Investigation
- serology: antibodies to Borrelia burgdorferi
Management
- doxycycline if early disease. Amoxicillin is an alternative if doxycycline is contraindicated (e.g. pregnancy)
- ceftriaxone if disseminated disease
- Jarisch-Herxheimer reaction is sometimes seen after initiating therapy: fever, rash, tachycardia after first dose of antibiotic (more commonly seen in syphilis, another spirochaetal disease)