Patient can have Flu like illness initially or present with late complications like Meningitis, radiculopathy, AV Block etc
Hospitalist:
Erythema Migrans (>5cms, lasts 2 weeks and expands) and Spirochetemia happen in first month
IgM and IgG peak by approx. in one month and IgM goes down in 6 months but IgG remains for long time
Late Musculoskeletal and Neurological disease after 3-4 months
Arthritis usually involves 100% knee jt.
2 Step approach: 1. ELISA antibody test, if positive,
2. Western Blot test-Ig G requires 5 bands out of 10 and IgM requires 2 bands out of 3
Treatment: If patient has tick bite, give One dose of Doxycycline 200mg PO for prophylaxis
For Erythema Migrans, Doxycycline for 2-3wks
