Lyme Disease: Diagnosis and Treatment –

Lyme disease is a serious condition caused by spirochetal bacteria Borrelia burgdorferi sensu lato following a deer tick bite that requires treatment.  The following provides key points regarding diagnosis, treatment, prophylaxis and tick removal.


Early features (3 to 30 days after tick bite) to watch for include:

Erythema migrans
70 to 80% of infected individuals
At site of tick bite approximately day 7 (range 3 to 30 days)
Fever, headache, and fatigue
Joint and muscle aches
Swollen lymph nodes
Late features (days to months after tick bite)

Severe headaches and neck stiffness
Additional Erythema migrans rashes on other areas of the body
Arthritis with severe joint pain and swelling, particularly the knees and other large joints
Facial palsy (cranial neuritis)
Intermittent pain in tendons, muscles, joints, and bones
Heart palpitations or an irregular heart beat (Lyme carditis)
Episodes of dizziness or shortness of breath
Lyme meningitis or encephalitis
Nerve pain (radiculoneuritis)
Problems with short-term memory

Note: The CDC has updated the Lyme laboratory screening algorithm

CDC still recommends the two step approach
Step 1: Serologic testing using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay
Step 2: Follow step one with a western immunoblot assay for specimens yielding positive or equivocal results
— Read on