Clinical practice. Lyme disease.
Clinical practice. Lyme disease.
复制标题
DOI：
10.1056/nejmcp1314325
复制
发表时间：
2014-05-01
期刊：
影响因子：
--
通讯作者：
Shapiro ED
中科院分区：
文献类型：
--
作者：
Shapiro ED
一名来自康涅狄格州东南部的32岁孕妇在怀孕26周时因皮肤病变就诊。她报告称，她出现疲劳、关节痛和头痛2天，左腋窝皮疹1天。她住在一个树木繁茂的地区，经常在她的花园里工作。六周前，她取出了一只附着在右膝后面的小蜱虫。体检时，她没有发烧。她在左腋窝有一个椭圆形的黄斑病变，直径7 - 8 cm，中央红斑增强;未发现其他异常。她的案子应该如何处理？
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 noted. How should her case be managed?