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Lyme Disease Self Assessment

Question 1

A 32-year-old woman from New Jersey is evaluated because of a 3-day history of a slowly expanding lesion on her left thigh that is not painful or itching. The patient removed a tick from the site of the lesion approximately 3 weeks ago. She has documented allergies to doxycycline, sulfa drugs, and codeine.

On physical examination, she has a 10-cm ovoid erythematous lesion with no central clearing on her thigh. Examination is otherwise unremarkable. An antibody assay for Borrelia burgdorferi is negative.

Which of the following is most appropriate for treating this patient at this time?

(A) Defer treatment pending the results of a repeat B. burgdorferi assay in 6 weeks
(B) Administer amoxicillin for 21 days
(C) Administer doxycycline for 21 days
(D) Administer azithromycin for 21 days

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