55 yo F in Lyme endemic area, noted new HA & neck pains, no | Figure 1

55 yo F in Lyme endemic area, noted new HA & neck pains, no fevers, followed by singular lesion on RLE. No ticks noted. In interim 2.5 weeks further lesions appeared. All similar circular, flat, non scaly, non pruritic, non painful lesions on trunk, arms, legs. Some central clearing noted. HA continues. Clearly Lyme most suspicious & now txing w/ doxy. Has anyone seen multiple ECM in Lyme?

Similar cases

Patient presented with muscle aches and the rash shown. Rash present for a week and has been expanding. Dx: #Erythema-migrans #Lyme-disease

this is a 10 day evolving lesion that itches slightly. Unsure of what type of insect bite but denies tick exposure. Now has increased arthralgias and headaches but this is not unusual for pt to have relapses of these sxs.

#Lyme-disease #Erythema-migrans

12 y.o with no history of tick bite in a non Lyme disease area (South America). Painful. What do you think?

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?