Erythema chronicum migrans in the United States

Four cases of erythema chronicum migrans occurred within a one-month period in southeastern Connecticut. The syndrome may include advancing erythematous rash stemming from an apparent insect bite, hyperesthesias, myalgias, malaise, fever, lymphadenopathy, and, rarely, meningitis. Treatment with penicillin, the tetracycline, or, in our experience, erythromycin usually results in prompt resolution.