Lyme arthritis first was described in the United States in 1977 after a report of a cluster of children with arthritis living in Old Lyme, Connecticut. In the subsequent 45 years, Lyme disease has come to be recognized as an infectious disease that if left untreated may involve multiple organ systems, including the skin, joints, heart, and nervous system, and is referred to as Lyme borreliosis. The Infectious Diseases Society of America issued guidelines for the management of Lyme disease based on a systematic review of the scientific literature in 2000 and 2006.2,3  The American Academy of Neurology issued guidelines in 2007 for the treatment of nervous system Lyme disease. Practice guidelines were affirmed in 2010. The current guidelines were published in 2020 by a panel representing the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology, using the...

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