Lyme Disease Misdiagnosed as a Brown Recluse Spider Bite

Excerpt

To the editor: Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi (1). The condition is usually heralded by the appearance of the characteristic skin lesion, erythema chronicum migrans (2), and expands within days to form an erythematous patch or annular lesion. The initial skin eruption is often followed by the development of secondary lesions and is accompanied by malaise and fatigue, fever, myalgias, arthralgias, headache, stiff neck, and lymphadenopathy. Difficulties arise when erythema chronicum migrans presents in an atypical fashion. In the past 2 years we have seen two patients initially diagnosed as having had brown