Disease Stages

Stage Time after infection S/S
Early, localized (cutaneous) disease 7-14 dys (up to 30 dy) flu-like illness, * (target-like lesion) → spontaneously over a 4-week w/t tm
*Symptoms appearing after to EM dy - mon headache, fatigue, malaise, LAD, migratory arthralgias and myalgias, Bell’s palsy, aseptic meningitis, mononeuritis multiplex, heart block, myocarditis, mid neck stiffness
Later (extracutaneous) disease mon - yrs acrodermatitis chronic atrophicans, panniculitis, recurrent mono/oligoarthritis of large joints, subacute encephalomyelitis, polyneuropathy, dementia -> dx clinically and with serology +/- CSF

Treatment

https://cps.ca/en/documents/position/lyme-disease-children

Symptom// Options Doxycycline Amoxicillin
X (10 dy) X (14 dy)
Isolated X (14 dy)
X (28 dy) X (28 dy) X (14 - 28 dy) → Recurrent or Persistent
or X (14–21 dy) X (14–21 dy) X (14 – 21 dy)
X (14 dy) X (14 dy)