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SYMPTOMS
A history of environmental exposure (such as camping in an endemic area) is significant. Flu-like symptoms often accompany the rash. Common symptoms of systemic disease include headache, fatigue, chills and arthralgias. Neck stiffness or photophobia may reflect meningitis. Common ocular symptoms include blurred or double vision, pain and photophobia.
SIGNS
Lyme disease is renowned for its protean clinical manifestations. Its progression is described in three stages, although all may co-exist.
? Stage 1: A pathognomonic, localised skin rash (Erythema migrans) develops. Erythema migrans consists of single large erythematous skin lesion, often with a pale or indurated centre ('bull's-eye'), that may expand over several days. Conjunctivitis or periorbital oedema may occur
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