Mr. Martin's Lyme disease
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

As with all medicine, diagnosis rests with clinical suspicion. History and physical are the critical elements. 

The laboratory may be helpful in confirming Lyme disease, but getting a good history is by far most important.

  • IgG anti-Borrelia antibodies can help, but won't be detectable for 4 to 6 weeks
  • Enzyme-linked immunoabsorbent assay (ELISA) is available but it is not well standardized. False positives are not uncommon. Must be confirmed by Western Blot.
  • Cultures are impractical. Difficult and must biopsy the skin lesion. Procedure is not widely available.
  • Hey, what do you know, we're back to a good history and physical.
    
Great, so what do we do about treatment?                  Back
 

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