Erythema migrans

Infect Dis Clin North Am. 2015 Jun;29(2):211-39. doi: 10.1016/j.idc.2015.02.001.

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.

Keywords: Borrelia burgdorferi; Erythema migrans; Lyme disease.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Erythema Chronicum Migrans / diagnosis*
  • Erythema Chronicum Migrans / drug therapy
  • Erythema Chronicum Migrans / pathology
  • Humans
  • Lyme Disease / diagnosis
  • Polymerase Chain Reaction
  • Prognosis

Substances

  • Anti-Bacterial Agents