LYME DISEASE: DIAGNOSTIC CHALLENGE

This work tells about J.B.B. 26, who came to the unit with a diagnosis of tendonitis in wrists and evolved in two months for disabling polyarthritis unresponsive to corticosteroids and immunomodulatory, becoming bedridden. When reporting the rapid evolution of the patient aim is to show the importance of diagnosis in primary care, listening to the patient and their feelings about their illness and how it was important to wake up treatment from the clinical diagnosis of Lyme disease. J.B.B. seeks unity with complaints of pain in wrists for 15 days with evolution to elbows and shoulders. On examination arthritis hands joints and arthralgia of all joints being examined steroids started. Tests with autoimmune and inflammatory response negative markers. It evolved in days with polyarthritis which made it impossible to walk. Initiated fatigue upon exertion. He said then that he had been bitten by tick with migratory erythema and fever. Although symptoms compatible with Lyme disease the disease was denied by the rheumatology and infectious diseases services. By becoming bedridden with pain and fatigue negotiate the start of empirical treatment for Lyme at home with ceftriaxone and hydroxychloroquine. In four days of antibiotic therapy he resumed walking. In 10 days improves complete arthritis; Today, 45 days after the treatment the patient is no pain, no fatigue, returning to your daily routine. Apply the steps of medicine focused on the person in this case was key to its resolution.