CC
Elizabeth is a 34-year-old female here today for followup regarding her Lyme diagnoses.
HPI
The patient tells me in some ways things are better. The rash behind her knee is now significantly better. She has seen definite improvement in the redness. It still feels a little as though it is burning when the water runs over it in the shower, but is noticing significant improvement, and she is very pleased with that. She had been seen for cellulitis both here and by her dermatologist Dr. Dinulos. She notices that the itching is also improving there as well. She continues with the doxycycline that was prescribed and she has been off the clindamycin now for about the last half of a week or so. She has not had any panic attacks since she was last seen, but she is still feeling anxious about her diagnosis. She has done a lot of research on the…show more content… It is unclear still, whether this is related to Lyme are not. There is a possibility of this being a strep etiology as well. She has done well with the doxycycline. There is minimal if no redness left behind the left knee, and it is significantly improved compared to prior. She is going to continue with the doxycycline course per Dr. Dinulos. We talked for a long time about the possibility of the Lyme diagnoses. We talked about chronic Lyme, and the current recommendations from the medical literature. At this point, I would have her complete the course of doxycycline. If she decides she wants to discuss this further, I would recommend infectious disease. That, she felt, was not necessary after our discussion today. However, if she changes her mind about that, she will let me know. It appeared that she seemed more comfortable following the visit than she did coming in. She knows to contact me if she changes her mind or feels she needs to discuss this further. In addition, she is planning on retesting the blood work in approximately a month after being off the