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Previous Volume 337:357-364 July 31, 1997 Number 5

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Lyme disease, which is caused by the tick-transmitted spirochete Borrelia burgdorferi,¹ usually begins with an expanding skin lesion, erythema migrans, accompanied by malaise and fatigue, fever, headache, stiff neck, and myalgias or arthralgias.^2,3 Weeks later, some patients have objective neurologic signs, such as meningitis, cranial neuritis, or radiculoneuritis,⁴ or cardiac abnormalities, particularly atrial–ventricular block.⁵ Months later, intermittent or chronic episodes of arthritis often develop in untreated patients.⁶ Months to years later, a small percentage of patients have subtle signs of encephalopathy (memory deficit, irritability, or somnolence), or polyneuropathy characterized by spinal radicular pain or distal paresthesias.^7,8,9,10

The recommended treatment for . . . [Full Text of this Article]

Methods

Basic Model

Decision Tree

Summary of the Data

            Oral Doxycycline

            Intravenous Ceftriaxone

            Quality of Life

            Costs

Results

Base-Case Analysis

Sensitivity Analyses

            Efficacy of Intravenous Ceftriaxone

            Complications of Intravenous Ceftriaxone

            Quality of Life with Intravenous Ceftriaxone

            Quality of Life for Patients with Neuroborreliosis

Discussion

Source Information

From the Divisions of Clinical Decision Making (M.H.E., S.G.P.) and Rheumatology (A.C.S., R.A.K.), Department of Medicine, New England Medical Center, Boston.

Address reprint requests to Dr. Eckman at the Division of Clinical Decision Making, Box 302, New England Medical Center, 750 Washington St., Boston, MA 02111.

References

Appendix

This article has been cited by other articles:

• Wormser, G. P. (2006). Clinical practice. Early Lyme disease.. NEJM 354: 2794-2801 [Full Text]  
• Steere, A. C. (2001). Lyme Disease. NEJM 345: 115-125 [Full Text]  
• Faul, J. L., Doyle, R. L., Kao, P. N., Ruoss, S. J. (1999). Tick-Borne Pulmonary Disease: Update on Diagnosis and Management. Chest 116: 222-230 [Abstract] [Full Text]