On June 1, a 32-Year-Old Hiker Was Bitten by a Tick

question 34

Essay

On June 1, a 32-year-old hiker was bitten by a tick. After one week, he noticed an erythrematous ring at the location of the bite. Four weeks later, a physician found a large, macular, centrifugally spreading ring. During the next month, it expanded to 35 cm and faded. Over the next 2.5 years, the man experienced recurrent inflammation of a knee. Identify the periods of incubation, prodromal, illness, and decline. What is the etiology? What caused the symptoms? What treatment should have been administered in July? What treatment should be administered two years later?

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