Table 1. Clinical features of North American Lyme disease

Findings

 

Constitutional

Skin

Nervous System

Cardiac

Rheumatologic

Stage I

Fever, malaise, and regional lymphadenopathy

with or without arthralgia/arthritis

Erythema migrans with a more acute onset,

less central clearing, rapid enlargement, and multiple foci uncommon

--

--

--

Stage II

--

Multiple erythema migrans

Headache, neck stiffness, and meningisimus with or without cranial neuropathy

Atrioventricular block and myocarditis

Severe asymmetric, oligoarticular

joint inflammation

Stage III

--

Rare

Paresthesias, radiculopathy, sleep disturbance,

and cognitive deficits such as impaired memory and impaired concentration

None

Occasional treatment-resistant arthritis