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Related Experiment Videos

[Multilocular large erythemas and fever].

K Jeker1, R Weber, G Schulthess

  • 1Departement Innere Medizin, Medizinische Poliklinik und Abteilung Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich.

Praxis
|December 7, 2005
PubMed
Summary

Multilocular erythema migrans, a rare presentation of Lyme disease in Europe, can be mistaken for other conditions. Early diagnosis and treatment with doxycycline are crucial for resolving these Borrelia burgdorferi infections.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Medical Microbiology

Background:

  • Lyme disease, caused by Borrelia burgdorferi, is a tick-borne illness with diverse clinical manifestations.
  • Erythema migrans is the hallmark skin lesion of early Lyme disease.
  • Geographic variations in Borrelia species influence the presentation of erythema migrans.

Observation:

  • A 44-year-old man presented with multiple, large, reddish skin lesions with central paling three months after returning from Sri Lanka.
  • Differential diagnoses considered included erysipelas and tinea corporis, but clinical features and diagnostic tests pointed towards Lyme disease.
  • The patient exhibited a rare multilocular form of erythema migrans.

Findings:

  • Serum IgM antibodies against Borrelia burgdorferi were detected.

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  • The patient was diagnosed with multilocular erythema migrans.
  • Treatment with doxycycline (200 mg daily for 10 days) resulted in complete resolution of skin lesions within days.

    • Implications:

    • Multilocular erythema migrans, though uncommon in Europe, requires prompt recognition and treatment to prevent potential early hematogenic dissemination.
    • Understanding the varied presentations of Lyme disease, including multilocular erythema migrans, is essential for accurate diagnosis and management.
    • Infection with different Borrelia burgdorferi strains, particularly in America, may be associated with a higher prevalence of multilocular erythema migrans and systemic symptoms.