A 23-year-old man from Massachusetts with a history of well-controlled type 1 diabetes mellitus presents with a rash (see Figure).
He is taking insulin for his diabetes but is on no other medications.
He does not recall any tick bites, but he does like to be outdoors. He acknowledges that the outdoor area outdoors he enjoys most is infested with ticks. He is afebrile and does not have any other symptoms or findings on physical examination.
Which of the following is an appropriate next step in this patient’s care?
- Enzyme-linked immunosorbent assay and confirmatory Western blot
- Doxycycline for 10 to 14 days, or amoxicillin or cefuroxime for 14 days
- Doxycycline for 7-14 days
- Amoxicillin for 28 days
This question appears in Med-Challenger Internal Medicine Review with CME
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