Symptoms develop 3–10 weeks after a tick bite Stage II ( early disseminated Lyme disease ) Flu‑like symptoms : fever, fatigue, malaise, lethargy, headache, myalgias, and arthralgias.Self-limiting (typically subsides within 3–4 weeks).Usually a slowly expanding red ring around the bite site with central clearing (“ bull's eye rash ”).Symptoms develop within 7–14 days after a tick bite. Peromyscus leucopus, the white‑footed mouse, is the primary reservoir of B.Outdoor enthusiasts (i.e., hikers, hunters, etc.).Outdoor workers (landscapers, farmers, etc.).The incidence of Lyme disease is highest between April and October (especially from June to August).Typically found in forests or fields on tall brush or grass.Ixodes ricinus (castor bean tick) in Europe.Ixodes pacificus (western black-legged tick) in the northwestern US.Various tick species: mainly Ixodes scapularis (deer or black-legged tick) in the northeastern and upper midwestern US.burgdorferi can persist in the body for years. In the US: Borrelia burgdorferi, a microaerophilic spirochete bacteria.Lyme disease is treated with antibiotics the drugs of choice are doxycycline for localized disease and ceftriaxone for disseminated disease. Serological tests (e.g., Western blot enzyme-linked immunosorbent assay) can help support the clinical diagnosis, especially if the presence of EM is not known or questionable. Lyme disease is a clinical diagnosis in patients presenting with EM. In Asia and Europe, further skin manifestations may also occur in stage II ( lymphadenitis cutis benigna) and stage III ( acrodermatitis chronica atrophicans). Stage III (late disease) is characterized by chronic arthritis and CNS involvement ( late neuroborreliosis) with possible progressive encephalomyelitis. In stage II (early disseminated disease), patients may present with neurological symptoms (e.g., facial palsy), migratory arthralgia, and cardiac manifestations (e.g., myocarditis). Stage I (early localized disease) is characterized by erythema migrans (EM), an expanding circular red rash at the site of the tick bite, and may be associated with flu‑like symptoms. Lyme disease (or borreliosis) is a tick-borne infection caused by certain species of the Borreliagenus ( B.
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