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The clinical spectrum and treatment of Lyme disease.

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Lyme disease was recognized as a separate entity because of close geographic clustering of affected children in
Lyme, Connecticut, with what was thought to be juvenile rheumatoid arthritis. It then became apparent that
Lyme disease is a complex, multisystem disorder. The illness usually begins in summer with erythema chronicum migrans and associated symptoms (stage 1). Weeks to months later, some patients develop neurologic or cardiac abnormalities (stage 2), and weeks to years later, many patients develop intermittent attacks of arthritis (stage 3), which may become chronic, with erosion of cartilage and bone. Patients with severe and prolonged illness have an increased frequency of the B-cell alloantigen, DR2. For patients with early
Lyme disease, tetracycline appears to be the most effective drug, then penicillin, and finally erythromycin. High-dose intravenous penicillin is effective for the later stages of the

Yale J Biol Med. 1984 Jul-Aug;57(4):453-61. Research Support, Non-U.S. Gov’t; Research Support, U.S. Gov’t, P.H.S.

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