Borrelia Burgdorferi (lyme)


  • Spriochete
  • Deer tick (Ixodes) borne

Risk Factors

  • Endemic area Northeast, upper mid-West
  • Tick contact x 24-48h


  • Myalgias
  • Arthralgias
  • Fatigue
  • F
  • C
  • Ha
  • Neuropathy
  • Erythema migrans in ~85%, typically occurs at bite site w/in days to 1m
  • Days to mos after bite can have→ heart block
  • CNS involvement w/Bells palsy, meningitis, myalgias and athralgias
  • If untreated, mos to yr later→ inflammatory arthritis, most commonly knees/large joint(s)
  • Can co-infect w/organisms causing babesiosis and anaplasmosis

Physical Exam Findings

  • E migrans→ red papule to macule, often uniformly red but can have central clearing or necrosis
  • Can be asx, painful or puritic
  • Enlarges and can last 1m if untreated