Early localized disease, occurring a few days to one month after the tick bite* |
Erythema migrans - occurs in approximately 80 percent of patients |
Associated symptoms and signs may include: fatigue, malaise, lethargy, mild headache, mild neck stiffness, myalgias, arthralgias, regional lymphadenopathy |
Early disseminated disease¶, occurring weeks to months after the tick bite*Δ |
Carditis - about 1 percent of patients reported to the CDC◊ |
Manifestations include AV nodal block, mild cardiomyopathy or myopericarditis |
Neurologic disease - occurs in approximately 15 percent of untreated patients◊ |
Manifestations include lymphocytic meningitis, cranial neuropathy (most often facial, can be bilateral), peripheral neuropathy; rarely myelitis or encephalitis |
Musculoskeletal involvement - occurs in approximately 60 percent of untreated patients◊ |
Manifestations include migratory arthralgias |
Skin involvement - multiple erythema migrans lesionsΔ, borrelial lymphocytoma (in Europe) |
Lymphadenopathy - regional or generalized |
Eye involvement§ - conjunctivitis, iritis, choroiditis, vitritis, retinitis |
Liver disease - liver function test abnormalities, hepatitis |
Kidney disease - microhematuria, asymptomatic proteinuria |
Late disease¶, occurring months to years after the tick bite* |
Musculoskeletal symptoms - approximately 60 percent of untreated patients develop intermittent monoarticular or oligoarticular arthritis; approximately 10 percent of untreated patients develop persistent monoarthritis, usually affecting the knee |
Neurologic disease - incidence has not been established |
Peripheral neuropathy or encephalomyelitis (both rare) |
Cutaneous involvement - acrodermatitis chronica atrophicans, morphea/localized scleroderma-like lesions (both described only in Europe) |
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