Which is an early disseminated manifestation of Lyme disease?

Which is an early disseminated manifestation of Lyme disease?

• A. Erythema migrans
• B. Facial nerve palsy
• C. Maculopapular rash
• D. Cough

Answer: (B)

Lyme disease progresses from an early localized stage to an early disseminated stage, where the infection spreads through the bloodstream to involve multiple organ systems. In this disseminated phase, nervous system involvement is common, with cranial neuropathies, especially facial nerve palsy, frequently seen. This presents as sudden weakness or paralysis of facial muscles and can affect one or both sides. Erythema migrans is the hallmark of the initial localized infection at the bite site, not a disseminated manifestation. A maculopapular rash and a cough do not characterize the early disseminated neurologic involvement seen in Lyme disease. Therefore, facial nerve palsy best represents an early disseminated manifestation.

Lyme disease progresses from an early localized stage to an early disseminated stage, where the infection spreads through the bloodstream to involve multiple organ systems. In this disseminated phase, nervous system involvement is common, with cranial neuropathies, especially facial nerve palsy, frequently seen. This presents as sudden weakness or paralysis of facial muscles and can affect one or both sides. Erythema migrans is the hallmark of the initial localized infection at the bite site, not a disseminated manifestation. A maculopapular rash and a cough do not characterize the early disseminated neurologic involvement seen in Lyme disease. Therefore, facial nerve palsy best represents an early disseminated manifestation.