The Medical Letter on Drugs and Therapeutics
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1342
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Treatment of Lyme Disease

Most cases of Lyme disease in the US occur between May and September in the Northeastern, Mid-Atlantic and North Central states.

THE DISEASE — Lyme disease in North America is caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by Ixodes scapularis or I. pacificus ticks.1 At least 70-80% of patients infected by B. burgdorferi have the characteristic skin lesion, erythema migrans, which occurs at the site of the tick bite 3-30 days after the tick has detached and expands over days to weeks. The skin lesion may have a bull’s-eye appearance or may be erythematous without central clearing. Fever, headache, malaise, arthralgia or myalgia usually accompany early disease. Multiple (secondary) skin lesions occur in about 15% of patients as a result of spirochetemia. Erythema migrans may go unnoticed because it usually causes little pruritus or ... more      

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