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Lyme Disease 088.81



Lyme Disease ICD-9

  • 088.81 Lyme Disease

Lyme Disease Etiology / Epidemiology / Natural History

  • Caused by the spirochete Borrelia burgdorferi which is carried by the deer tick Ixodes dammini as well as other ticks.
  • Most prevalent in the Northeast, upper Midwest and far West.

Lyme Disease Anatomy

Lyme Disease Clinical Evaluation

  • Erythema migrans: classic skin lesion with erythema expanding from the site of a tick bite.
  • Variable constitutional, flulike symptoms.
  • Athralgia (80%): most commonly the knee.
  • Cardivascular symptoms (4-8%): cardiac conduction block
  • Neurologic symptoms (15%): Bell's palsy, cranial nerve palsy
  • Chronic stage = recurrent arthralgias, fatigue, polyradiculopathy, encephalopathy (inability to concentrate, memory loss).

Lyme Disease Xray / Diagnositc Tests

  • Blood test for Borrelia titer

Lyme Disease Classification / Treatment

  • If tick is removed within 24 hours the risk of Lyme disease is minimal. Ticks are best removed with gentle teasing with fine tweesers.
  • Doxycycline 100mg PO BID for 10-30 days
  • Amoxicillin 500mg PO TID; 30mg/kg/day for peds.

Lyme Disease Associated Injuries / Differential Diagnosis

  • Arthritis
  • Fibromyalgia
  • Rheumatic fever
  • Idiopathic Bell's palsy
  • Meningitis
  • Multiple sclerosis
  • Peripheral neuritis
  • Reiter syndrome (iritis, urethritis)

Lyme Disease Complications

  • recurrent arthralgias
  • fatigue
  • polyradiculopathy
  • encephalopathy

Lyme Disease Follow-up Care

Lyme Disease Review References

  • Griffin LY, Essentials of Musculoskeletal Care 3rd edition, AAOS, 2005


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