Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 370, Issue 18, Pages 1724-1731Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp1314325
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Funding
- NCATS NIH HHS [KL2 TR000140, UL1 TR000142] Funding Source: Medline
- NCATS NIH HHS [UL1 TR000142, KL2 TR000140] Funding Source: Medline
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A 32-year-old pregnant woman from southeastern Connecticut presents to her physician in July at 26 weeks' gestation because of a skin lesion. She reports she has had fatigue, arthralgia, and headache for 2 days and a rash in her left axilla for 1 day. She lives in a wooded area and works in her garden frequently. Six weeks earlier, she had removed a small tick that was attached behind her right knee. On physical examination, she is afebrile. She has an erythematous, oval macular lesion, 7 to 8 cm in diameter, in her left axilla, with enhanced central erythema; no other abnormalities are needed. How should her case be managed?
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