Lyme disease is the most common tick-borne disease in the US that can present in three different stages. Diagnosis is through a combination of a thorough history, review of systems, physical exam, as well as a two-tier serologic testing. Former Pediatric resident, Dr. James Davis, joins Associate Professor of Pediatrics, Dr. Susan Goldberg, to discuss the evaluation and management of Lyme Disease in the pediatric population. After listening to this podcast, learners should be able to: Recognize common presenting signs and symptoms of Early Localized, Early Disseminated, and Late Lyme disease from a patient history and physical examination Determine whether a patient meets clinical diagnostic criteria and, if not, which lab tests are appropriate for diagnosis of Lyme disease Appropriately prescribe the correct antibiotic choice and duration for patients, depending on variation of Lyme disease and accompanying symptoms Accurately and effectively instruct patients in prevention strategies for tick bites and Lyme disease Special thanks to Dr. Ingrid Camelo, Dr. Rebecca Yang and Dr. Jacob Eichenberger who peer reviewed today’s episode. FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11411  References: Rodino KG, Theel ES, Pritt BS. Tick-Borne Diseases in the United States. Clin Chem. 2020 Apr 1;66(4):537-548. doi: 10.1093/clinchem/hvaa040. PMID: 32232463. Lantos PM, Rumbaugh J, Bockenstedt LK, Falck-Ytter YT, Aguero-Rosenfeld ME, Auwaerter PG, Baldwin K, Bannuru RR, Belani KK, Bowie WR, Branda JA, Clifford DB, DiMario FJ, Halperin JJ, Krause PJ, Lavergne V, Liang MH, Meissner HC, Nigrovic LE, Nocton JJJ, Osani MC, Pruitt AA, Rips J, Rosenfeld LE, Savoy ML, Sood SK, Steere AC, Strle F, Sundel R, Tsao J, Vaysbrot EE, Wormser GP, Zemel LS. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. Clin Infect Dis. 2021 Jan 23;72(1):e1-e48. doi: 10.1093/cid/ciaa1215. PMID: 33417672. Eddens T, Kaplan DJ, Anderson AJM, Nowalk AJ, Campfield BT. Insights From the Geographic Spread of the Lyme Disease Epidemic. Clin Infect Dis. 2019 Jan 18;68(3):426-434. doi: 10.1093/cid/ciy510. PMID: 29920580; PMCID: PMC6336907. Sundheim KM, Levas MN, Balamuth F, Thompson AD, Neville DN, Garro AC, Kharbanda AB, Monuteaux MC, Nigrovic LE. Seasonality of Acute Lyme Disease in Children. Trop Med Infect Dis. 2021 Nov 9;6(4):196. doi: 10.3390/tropicalmed6040196. PMID: 34842846; PMCID: PMC8628899. 2021. "Lyme Disease (Lyme Borreliosis, Borrelia burgdorferi sensu lato Infection)", Red Book: 2021–2024 Report of the Committee on Infectious Diseases, Committee on Infectious Diseases, American Academy of Pediatrics, David W. Kimberlin, MD, FAAP, Elizabeth D. Barnett, MD, FAAP, Ruth Lynfield, MD, FAAP, Mark H. Sawyer, MD, FAAP Bax CE, Clark AK, Oboite M, Treat JR. A case of disseminated Lyme disease in a child with skin of color. Pediatr Dermatol. 2021 Nov;38 Suppl 2:140-141. doi: 10.1111/pde.14770. Epub 2021 Sep 13. PMID: 34515362. Lipsett SC, Nigrovic LE. Diagnosis of Lyme disease in the pediatric acute care setting. Curr Opin Pediatr. 2016 Jun;28(3):287-93. doi: 10.1097/MOP.0000000000000339. PMID: 27138805. Shapiro ED. Borrelia burgdorferi (Lyme disease). Pediatr Rev. 2014 Dec;35(12):500-9. doi: 10.1542/pir.35-12-500. PMID: 25452659; PMCID: PMC5029759. Meissner HC, Steere AC. Management of Pediatric Lyme Disease: Updates From 2020 Lyme Guidelines. Pediatrics. 2022 Mar 1;149(3):e2021054980. doi: 10.1542/peds.2021-054980. PMID: 35229121. Bolourchi M, Silver ES, Liberman L. Advanced Heart Block in Children with Lyme Disease. Pediatr Cardiol. 2019 Mar;40(3):513-517. doi: 10.1007/s00246-018-2003-8. Epub 2018 Oct 31. PMID: 30377753. Chason ME, Monaghan M, Wang J, Cheng Y, DeBiasi RL. Symptom Resolution in Pediatric Patients With Lym