Final answer:
The clinical case definition of Lyme disease includes the presence of erythema migrans, at least one late-manifesting sign of disease and antibody to Borrelia burgdorferi, and positive serologic evidence. Diagnosis is informed by a combination of clinical signs, such as the bull's-eye rash, musculoskeletal or neurological symptoms, epidemiological factors, and serological tests like the enzyme immunoassay (EIA).
Step-by-step explanation:
Clinical Case Definition of Lyme Disease
The clinical case definition of Lyme disease includes D. All of the above: A. The presence of erythema migrans, B. At least one objective, late-manifesting sign of musculoskeletal, neurologic, or cardiovascular disease and antibody to Borrelia burgdorferi, and C. Positive serologic evidence. Lyme disease symptoms may present in three stages: early localized, early disseminated, and late stage.
The early localized stage often shows a characteristic bull's-eye rash, erythema migrans, which may be warm to the touch. Flu-like symptoms such as malaise, headache, fever, and muscle stiffness are also common. The early disseminated stage includes symptoms like severe headache, neck stiffness, facial paralysis, arthritis, and carditis. Late-stage manifestations can be severe, with chronic inflammation causing arthritis, meningitis, encephalitis, and altered mental states, and may be fatal if untreated. Serological tests like enzyme immunoassay (EIA) can detect antibodies to B. burgdorferi and assist in diagnosis.
Lyme disease is the most commonly reported vectorborne illness in the US, with B. burgdorferi transmitted by the bite of Ixodes ticks. Diagnosis can be challenging due to mild initial symptoms that resemble other diseases and the fact that antibody production may take up to two months post-infection to be detectable. However, a combination of clinical signs, epidemiological factors, and serological testing typically inform a presumptive diagnosis.