RT Book, Section A1 Bissonnette, Bruno A1 Luginbuehl, Igor A1 Engelhardt, Thomas SR Print(0) ID 1164077335 T1 Lyme Disease T2 Syndromes: Rapid Recognition and Perioperative Implications, 2e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259861789 LK accesspediatrics.mhmedical.com/content.aspx?aid=1164077335 RD 2024/10/03 AB It is an infectious disease caused by a spirochete with significant immune response possibly leading to neurologic problems. Most patients consult within 7 days of the initial tick bite. The incubation period varies between 3 and 30 days. The skin lesion is characteristically an annular erythematous lesion greater than 5 cm in diameter that slowly increased in size and is painless and nonpruritic. The skin lesion is called erythema migrans and often appears as a bull’s-eye shape with a large hallow around. The second stage includes the formation of large blisters and purple skin masses. Other clinical features include fatigue, arthralgia, headache, and low-grade fever. With time, cardiovascular manifestations (AV blocks, tachycardia) and potentially severe neurological complications (encephalopathy, aseptic meningitis, cranial neuropathy—especially the facial nerve, and sensorimotor neuropathy) are seen within the first 3 months.