The Medical Letter on Drugs and Therapeutics
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1209
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Treatment of Lyme Disease

Lyme disease in North America is caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by Ixodes scapularis or pacificus ticks. These ticks may also carry other pathogens; coinfection with Babesia microti or Anaplasma phagocytophilum (formerly Ehrlichia) has been reported.1 In 2001 and 2002, 12 states (CT, DE, ME, MD, MA, MI, NH, NJ, NY, PA, RI, WI) reported about 95% of all the Lyme disease in the US, but cases occurred in all states except HI, MT and OK.2 Most Lyme disease in North America occurs between May and September.

THE DISEASE — About 70-80% of patients infected by B. burgdorferi develop the characteristic skin lesion, erythema migrans, which occurs at the site of the tick bite 3 to 30 days after the tick has detached.3 Fever, headache, malaise, arthralgias ... more      

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