Lyme disease physical examination
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Lyme disease Microchapters |
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Lyme disease physical examination On the Web |
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American Roentgen Ray Society Images of Lyme disease physical examination |
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Risk calculators and risk factors for Lyme disease physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
The physical examination of Lyme disease is necessary for the diagnosis. Erythema migrans and fever are commonly seen on physical examination in early disease. Disseminated disease is characterized by multiple erythema migrans, neurological and musculoskeletal symptoms.
Physical Examination
Appearance of the patient
Patients are usually well appearing in early stages; may appear fatigue. As the disease progresses patient may appear ill.
Vital signs
- Fever (in 15% of patients)
- Tachycardia
- Abnormal pulse
Skin
- Erythema migrans (Target like lesions) - Present at the site of tick bite. Single or multiple depending on stage of disease.
HEENT
- Headache
- Regional Lymphadenopathy
- Facial deviation
- Dry eyes
- Drooling of saliva
- Sore throat
- Vision changes
- Tender neck flexion
Cardiovascular
- Tachycardia
- Palpitations
- Shortness of breath
- Chest pain
Neurological
- Dizziness
- Neck stiffness
- Numbness and tingling in extermities
- Ataxia
- Memory disturbances
- Altered mental status
Muscukoskeletal
- Arthralgias - Commonly involving knee, may be migratory
- Arthritis
- Myalgia
- Joint tenderness
- Joint swelling
Images
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Common bullseye rash pattern associated with Lyme Disease.
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Characteristic "bulls-eye"-like rash caused by Lyme disease.
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Erythema Chronicum Migrans
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![Right posterior shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/images/c/c8/Borrelia07.jpeg)
Right posterior shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]
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![Left lateral buttock of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/images/b/b4/Borrelia08.jpeg)
Left lateral buttock of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]
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![Right hip and waist region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/images/2/2a/Borrelia10.jpeg)
Right hip and waist region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]
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![Posterior knee with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by the bacterium, Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/images/1/1c/Borrelia11.jpeg)
Posterior knee with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by the bacterium, Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]
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![Medial aspect of the right calf of a patient who’d presented with what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/images/f/fa/Borrelia14.jpeg)
Medial aspect of the right calf of a patient who’d presented with what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]
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![Posterior right shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/images/6/61/Borrelia15.jpeg)
Posterior right shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]
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![This Lyme disease patient presented with the signs and symptoms indicative of arthritic changes to his right knee due to a Borrelia burgdorferi bacterial infection. From Public Health Image Library (PHIL). [1]](/images/c/c8/Borrelia17.jpeg)
This Lyme disease patient presented with the signs and symptoms indicative of arthritic changes to his right knee due to a Borrelia burgdorferi bacterial infection. From Public Health Image Library (PHIL). [1]
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![Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]](/images/4/40/Borrelia31.jpeg)
Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]
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![Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]](/images/6/69/Borrelia32.jpeg)
Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]
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![Facial palsy caused by an infection by the bacterial spirochete Borrelia burgdorferi. Patient was subsequently diagnosed with Lyme disease. From Public Health Image Library (PHIL). [1]](/images/6/6c/Borrelia36.png)
Facial palsy caused by an infection by the bacterial spirochete Borrelia burgdorferi. Patient was subsequently diagnosed with Lyme disease. From Public Health Image Library (PHIL). [1]
![Right posterior shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia07.jpeg)
![Left lateral buttock of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia08.jpeg)
![Right hip and waist region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia10.jpeg)
![Posterior knee with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by the bacterium, Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia11.jpeg)
![Medial aspect of the right calf of a patient who’d presented with what was diagnosed as Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia14.jpeg)
![Posterior right shoulder region of a patient who’d presented with the erythema migrans (EM) rash characteristic of what was diagnosed as Lyme disease, caused by Borrelia burgdorferi. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia15.jpeg)
![This Lyme disease patient presented with the signs and symptoms indicative of arthritic changes to his right knee due to a Borrelia burgdorferi bacterial infection. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia17.jpeg)
![Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia31.jpeg)
![Pathognomonic erythematous rash in the pattern of a “bull’s-eye”. Patient subsequently contracted Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia32.jpeg)
![Facial palsy caused by an infection by the bacterial spirochete Borrelia burgdorferi. Patient was subsequently diagnosed with Lyme disease. From Public Health Image Library (PHIL). [1]](/index.php/File:Borrelia36.png)