Lyme disease

Background

• Arthritic manifestations can occur weeks, months, or years after stage I infection

Clinical Features

• Monarticular or oligoarticular asymmetric joint involvement (large joints most commonly)
  • Migratory pattern may occur

Treatment

Prophylaxis

Tick Bite Propylaxis = Doxycycline 200mg PO x 1

High Risk

1. Tick on for >48 hrs
2. Engorged tick
3. Endenic area (east coast)

^Old vaccine has little to no efficacy after 1 year