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Early diagnosis of Lyme borreliosis. Do not look only for erythema migrans.

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Although the typical erythema migrans is a relatively easy-to-recognize manifestation of
Lyme borreliosis, it is by no means the sole cutaneous manifestation of infection with borreliae. In particular the early stages of the
disease, with their paucity of symptoms or wide variability of the clinical symptomatology, often present a diagnostic challenge. This means that in the event of unclear unspecific cutaneous lesions indicating, for example, erysipelas or urticaria,
Lyme borreliosis should also receive differential diagnostic consideration. Culture of the organism, DNA-based confirmation of B. burgdorferi or, where indicated, a serological investigation can confirm the diagnosis at an early stage. The treatment of choice compromises an antibiotic administered for an adequate duration and at an adequate dose, e.g. doxycycline 2 x 100 mg over three weeks). If treatment is initiated in a local or disseminated early stage, healing rates of more than 85% can be achieved.

MMW Fortschr Med. 2002 May 30;144(22):24-8. English Abstract

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