Which stage of Lyme disease is erythema migrans associated with?

• A. Early
• B. Acute disseminated infection
• C. Late
• D. Chronic

Answer: (A)

Erythema migrans signals the early localized phase of Lyme disease. It typically appears days to weeks after a tick bite as an expanding red rash at the bite site, often with central clearing. This lesion reflects local infection before Borrelia burgdorferi has spread through the body. If untreated, the infection can progress to early disseminated disease with features like additional EM lesions, facial nerve palsy, meningitis, or carditis, and later to late disseminated manifestations such as arthritis and neurologic symptoms. Chronic Lyme disease is not a formal separate stage in the classic progression. So, erythema migrans is best associated with the early phase.