Stage III of Lyme's disease is characterized by -

Ans. is 'c' i.e.. Arthritis o Lyme disease is the mostcomon tick-borne disease in western countries and is caused by spirochete B. BurgdorferiEssentials of Diagnsosiso Erythema migrans, a flat or slightly raised red lesion that expands with central clearing.o Headache or stiff neck.o Arthralgias, arthritis, and myalgias: arthritis is often chronic and recurrent.Stage 1 early localized infection# Stage 1 infection is characterized by erythema migrans.# About 1 week after the tick bite (range, 3-30 days, median 7-10 days), flat or slightly raised red lesion appears at the site, which is commonly seen in areas such as the groin, thigh, or axilla.Stage 2. early disseminated infection# Up to 50-60% of patients with erythema migrans are bacteremic.# Within days to weeks of the original infection , secondary skin lesions that are not associated with a tick bite develop in about 50% of patients.# These lesions are similar in appearanc to the primary lesion but are usually smaller.o Malaise, fatigue, fever, headache, neck pain, and generalized achiness are common with the skin lesions.o Cardiac involvment includes myo-pericarditis, with atrial or ventricular arrhythmias and heart block.o Neurologic manifestations include both the central and peripheral nervous systems. The most common central nervous system manifestation is an aseptic meninigitis with mild headache and neck stiffness. The most common peripheral manifestation is a cranial neuropathy; i.e., facialpalsy>.Stage 3, late persistent infection# Stage 3 infection occurs months to years after the initial in fection and again primarily manifests itself as musculoskeletal neurologic, and skin disease.# The classic manifestation of late disease is a monarticular or oigoarticular arthritis most commonly affecting the knee or othe rlarge weight bearing joints.