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Lyme Disease Referral Guidelines

Lyme disease, caused by the spirochete Borrelia burgdorferi sensu lato complex, is transmitted to humans usually from infected mice or white-tailed deer via the bite of the Ixodes species tick. In the United States Lyme disease is found mainly in the northeastern states, the upper Midwest, and northern California. However, climate change is affecting tick distribution and it is likely that Lyme disease will become more common in other geographic regions as well.
Clinical Lyme disease most commonly presents as early localized infection manifest by the rash termed erythema migrans; neurologic disease (Lyme neuroborreliosis) comprising both peripheral (cranial neuritis, radiculoneuritis, plexopathies, and mononeuropathies) and central (meningitis, pseudotumor cerebri, encephalitis, and meningitis) nervous system involvement; carditis (usually heart block, rarely pericarditis or myocarditis); and arthritis (usually marked swelling of one or a few large joints).