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Int Med Case Rep J. 2013 Dec 5;6:99-105. doi: 10.2147/IMCRJ.S51240. eCollection 2013.

Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia.

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Department of Microbiology, Infectious and Emerging Diseases, Blacksburg, VA, USA.
Department of Pathology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA.


A 50-year-old woman from Pulaski, Virginia, presented to a local clinic with headaches, fever, generalized joint pain, excessive thirst and fluid intake, and a progressing rash on her back. On physical examination, she had a large circular red rash on her back with a bull's-eye appearance, 16 × 18 cm in diameter. Serologic tests confirmed a diagnosis of Lyme disease. The patient could recall a walk through the woods 3 weeks prior, although she never noticed a tick on her body. Following a prolonged course of antibiotics, this case report presents a patient with ongoing symptoms consistent with post-treatment Lyme disease.


ELISA; Lyme disease; Western blotting; arthritis; chronic Lyme disease (CLD); erythema migrans; ixodid ticks; post-treatment Lyme disease syndrome (PTLDS)

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