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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Jul 23, 2018

Lyme disease and tick-borne illness deconstructed by Infectious Diseases expert, Paul E. Sax MD, of episode 78 fame. Oh, Summer Nights. The time for romance between Danny Zuko and good girl Sandy, the time to sit in the backyard around the bonfire, the time for sunset hikes in the woods and mountains…..and don’t forget, it’s also the time for those pesky woodland ticks who’ll go for a ride on you and maybe suck your blood (gross!). Dr. Sax takes us through the essentials of tick-borne illness, with a focus on Lyme Disease: diagnosing it, treating it, identifying possible co-infections, and managing Post-Lyme residual symptoms.  

Our (And Dr. Sax’s) Disclaimer about this episode, and the shownotes: Tick-borne illness is a very serious problem in public health in the US, but management is quite a controversial issue. We’ve done our best with this episode to stay as evidence-based as possible. Moreover, given the limited time we have on air, we have tried to focus on what we think is most clinically relevant.

Full show notes available at

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  • Written by: Shreya P. Trivedi MD, Nora Taranto AB
  • Produced by: Shreya P. Trivedi MD, Nora Taranto AB
  • Editor: Matthew Watto MD
  • Images by:  Hannah R. Abrams
  • Hosts: Shreya P. Trivedi MD, Matthew Watto MD, Paul Williams MD
  • Guest: Paul E. Sax MD

Time Stamps

  • 00:00 Intro
  • 02:17 Disclaimer
  • 03:19 Guest bio
  • 05:17 Getting to know Guest
  • 08:33 Favorite hiking experiences
  • 12:20 Disclaimer of Tick-borne illness
  • 12:28 Clinical case of recent hiking in endemic area with a rash
  • 20:59 Lyme testing limitations
  • 27:38 Patient education to doxycycline
  • 30:16 Case of elderly outdoorsy healthy male with flu-like symptoms in the summer
  • 32:39 Differentiating anaplasmosis and babesiosis
  • 33:17 Workup for patient with possible tick co-infections
  • 39:22  Post-lyme disease residual symptoms
  • 48:02  Case of tick attached to patient
  • 56:19  Outro

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