Erythema Migrans

Authors

Robert B. Nadelman, Division of Infectious Diseases, Department of Medicine, New York Medical College, Skyline Office #2NC20, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA. Electronic address: robert_nadelman@nymc.edu.

Author Type(s)

Faculty

DOI

10.1016/j.idc.2015.02.001

Journal Title

Infectious Disease Clinics of North America

First Page

211

Last Page

39

Document Type

Article

Publication Date

6-1-2015

Abstract

Erythema migrans (EM) is the most common objective manifestation of Borrelia burgdorferi infection. Systemic symptoms are usually present. Most patients do not recall a preceding tick bite. Despite a characteristic appearance, EM is not pathognomonic for Lyme disease and must be distinguished from other similar appearing skin lesions. EM is a clinical diagnosis; serologic and PCR assays are unnecessary. Leukopenia and thrombocytopenia are indicative of either an alternative diagnosis, or coinfection with another tick-borne pathogen. When EM is promptly treated with appropriate antimicrobial agents, the prognosis is excellent. Persons in endemic areas should take measures to prevent tick bites.

Recommended Citation

Nadelman, R. B. (2015). Erythema Migrans. Infectious Disease Clinics of North America, 29 (2), 211-39. https://doi.org/10.1016/j.idc.2015.02.001