TY - CHAP M1 - Book, Section TI - Chapter 48. Lyme Disease A1 - Bockenstedt, Linda K. A2 - Imboden, John B. A2 - Hellmann, David B. A2 - Stone, John H. PY - 2013 T2 - CURRENT Diagnosis & Treatment: Rheumatology, 3e AB - Lyme disease should be considered in individuals who have a reasonable risk of exposure to Borrelia burgdorferi-infected ticks and who have the characteristic complex of signs and symptoms.Classic clinical features occur in stages: Early localized disease (3–30 days after tick bite): a single hallmark skin lesion erythema migrans (EM), occasionally associated with fever, malaise, headache, arthralgias, and myalgias; less commonly, these latter symptoms can occur in the absence of EM.Early disseminated disease (weeks to months after tick bite): multiple EM lesions and associated fever, migratory arthralgias, and myalgias; acute pauciarticular arthritis; carditis manifested primarily as atrioventricular (AV) nodal block; neurologic features, including cranial nerve (especially facial nerve) palsies, lymphocytic meningitis, and radiculoneuropathies.Late disease (several months to years after tick bite): primarily neurologic features, especially peripheral neuropathies and chronic mild encephalopathy; arthritis, including monoarticular and migratory pauciarticular arthritis.Supporting serologic evidence of exposure to B burgdorferi is present in most cases but can be absent in early infection. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=57274250 ER -