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Review
. 2014 May 1;370(18):1724-31.
doi: 10.1056/NEJMcp1314325.

Clinical practice. Lyme disease

Eugene D Shapiro
Review

Clinical practice. Lyme disease

Eugene D Shapiro. N Engl J Med. .

Abstract

A 32-year-old pregnant woman from southeastern Connecticut presents to her physician in July at 26 weeks' gestation because of a skin lesion. She reports she has had fatigue, arthralgia, and headache for 2 days and a rash in her left axilla for 1 day. She lives in a wooded area and works in her garden frequently. Six weeks earlier, she had removed a small tick that was attached behind her right knee. On physical examination, she is afebrile. She has an erythematous, oval macular lesion, 7 to 8 cm in diameter, in her left axilla, with enhanced central erythema; no other abnormalities are noted. How should her case be managed?

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Conflict of interest statement

Dr. Shapiro reports providing medical-record review for law firms for malpractice cases regarding Lyme disease. No other potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Types of Erythema Migrans
Panel A shows a single erythema migrans lesion, Panel B shows vesicular erythema migrans, and Panel C shows multiple erythema migrans lesions.
See this image and copyright information in PMC

Comment in

  • Lyme disease.
    Shapiro ED. Shapiro ED. N Engl J Med. 2014 Aug 14;371(7):684. doi: 10.1056/NEJMc1407264. N Engl J Med. 2014. PMID: 25119621 Free PMC article.
  • Lyme disease.
    Castiglione TF. Castiglione TF. N Engl J Med. 2014 Aug 14;371(7):683. doi: 10.1056/NEJMc1407264. N Engl J Med. 2014. PMID: 25119622 No abstract available.
  • Lyme disease.
    Feder HM Jr. Feder HM Jr. N Engl J Med. 2014 Aug 14;371(7):683-4. doi: 10.1056/NEJMc1407264. N Engl J Med. 2014. PMID: 25119623 No abstract available.

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References

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