Lyme disease: a review for primary health care providers

Late spring and summer are the times when tick exposure is the greatest. Lyme disease, a spirochete infection, usually follows a bite from an Ixodes (hard bodied) tick; the symptoms of infection frequently occur between the months of May and August. Classically, Lyme disease begins with a characteristic skin lesion (erythema chronicum migrans) along with flu- or meningitis-like symptoms. If not recognized or if left untreated, Lyme disease may progress with neurologic, cardiac and arthritic manifestations. This disease is endemic to the Northeast, Midwest and Western portions of the United States and is annually increasing in incidence. Health care providers should be knowledgeable about Lyme disease and able to recognize its varied presentations.