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Lyme Arthritis

An Update for Clinical Practice

Long, Katharine Christina MD*; Cohn, Keri Anne MD, MPH, DTM&H

doi: 10.1097/PEC.0000000000001576
CME Review Article

Lyme disease is the most common vector-borne illness in North America, with the majority of cases occurring in the Northeast and upper Midwest. Lyme arthritis is the most prevalent manifestation of late-stage Lyme disease. Lyme arthritis typically presents as a monoarthritis or oligoarthritis in large joints such as the knee. Accompanying positive 2-tier Lyme serologies or polymerase chain reaction from synovial fluid/tissue is considered diagnostic for patients from an endemic area. The mainstay of initial treatment is a prolonged course of oral antibiotics.

*Academic Chief of Emergency Department Education, Valley Children's Hospital, Clovis; and Clinical Instructor (Affiliate) of Emergency Department, Stanford University School of Medicine, Stanford, CA (Long); and

Assistant Professor of Clinical Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; and Director of Pediatric Emergency Medicine–Global Health Fellowship (Cohn), The Children's Hospital of Philadelphia, Philadelphia, PA.

The authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Reprints: Katharine Christina Long, MD, Valley Children's Hospital, Madera, 1830 N Sanders, Clovis, CA 93619 (e-mail:

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