Make the Dx: Solution to 'Bugging out'

By MDLinx staff
Published April 11, 2024

Key Takeaways

Can you make the diagnosis? Click here to review the case and check your answer below.

For the first patient, the telltale rash gives it away: it’s Lyme disease. But what happens if there weren’t a rash, as is the case in 25% of patients? 

Lyme disease is a multisystem disease that can be difficult to diagnose. First, symptoms are generalized, including dizziness, headaches, and body pain. Second, not everybody has erythema migrans, the annular rash that is pathognomonic for the disease. Third, current diagnostic tests don’t always flag Lyme disease early because antibodies can take time to rise to detectable levels.

Lyme disease is caused by bacteria called Borrelia burgdorferi, passed through the bite of an infected deer tick.

Risk factors for Lyme include doing outside activities, such as gardening or hiking, in an area where Lyme occurs.

Lyme disease has been recorded in nearly all US states, but is most common in the Northeast, upper Midwest, and northwestern states. Because this disease affects multiple organ systems, it is of interest to various specialists.

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