Borrelia Burgdoferi ( Lyme disease): most common in north east and upper midwest. it is the most common tick borne infection in the US and Europe. Propt removal of tick decreases the chance of contraction.
Clinical manifestation: early localized (erythema migraines, constitutional symptoms), early disseminated ( multiple EM lesions, AV block, CN palsies, meningitis, radiculopathy, peripheral neuropathy) late disease (months- years: arthritis, neurologic manifestation) important to recognize lesions on darker skin!
Post Lyme disease syndrome: "chronic Lyme disease". headaches, fatigue, arthralgia and really a spectrum of illness. most improve 6 months-year. antibiotic treatment not beneficial as there is no active infection.
Diagnosis: clinical grounds alone with early disease; early disseminated and later we want clinical syndrome and serologic testing.
Treatment: Doxycycoine 10-28 days.
** must consider coinfecion with anaplama or babesia