title: Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia.
abstract: 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.
authors.affiliation: Department of Microbiology, Infectious and Emerging Diseases, Blacksburg, VA, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Palmieri
authors.affiliation: Department of Microbiology, Infectious and Emerging Diseases, Blacksburg, VA, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: King
authors.affiliation: Department of Microbiology, Infectious and Emerging Diseases, Blacksburg, VA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Case
authors.affiliation: Department of Pathology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA.
authors.forename: Arben
authors.initials: A
authors.lastname: Santo
keywords: ELISA; Lyme disease; Western blotting; arthritis; chronic Lyme disease (CLD); erythema migrans; ixodid ticks; post-treatment Lyme disease syndrome (PTLDS)