Fast Five Quiz: Can You Identify and Treat Lyme Disease?

Russell W. Steele, MD


July 15, 2015

Physical findings in patients with early disseminated disease are as follows:

  • Erythema migrans, single or multiple lesions

  • Headache

  • Fever

  • Tender adenopathy (regional or generalized)

  • Conjunctivitis (uncommon, never prominent)

  • Carditis (usually manifests as heart block)

  • Meningismus as a sign of aseptic meningitis

  • Cranioneuropathy, especially cranial nerve VII and Bell palsy (peripheral seventh nerve palsy with decreased unilateral function, including the forehead)

In patients with late disease, the typical physical finding is arthritis. Arthritis is located mostly in large joints, especially the knee. Warmth, swelling from effusion, and limited range of motion help distinguish arthritis from simple arthralgia.

For more on the signs and symptoms of Lyme disease, read here.


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