The Curbsiders Internal Medicine Podcast #516 Lyme Disease Primer featuring Dr. Sophie Woolston
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Mar 2, 2026 Sophie Woolston, MD — infectious diseases physician and clinician-educator specializing in Lyme and cardiac infectious diseases. She walks through recognizing erythema migrans, stages of Lyme, and limits of serologic testing. Practical talk on treatment choices, tick removal and prevention, post-exposure doxycycline, and when to avoid prolonged antibiotics.
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Use Two-Step Testing And Compare Prior Bands
- Use two-step testing: EIA screening followed by Western blot interpretation (IgM 2/3 bands, IgG ≥5/10) to reduce false positives.
- Review band patterns and compare prior tests to detect new infections.
Doxycycline First Line With Clear Alternatives
- For uncomplicated early Lyme treat with doxycycline (usually 10 days for early disease).
- If doxycycline contraindicated (pregnancy, photosensitivity) use amoxicillin or cefuroxime as alternatives.
Prevent Ticks With Clothing Barriers And Repellents
- Prevent ticks by wearing long clothing, tucking pants into socks, using DEET liberally, and treating clothing with permethrin.
- Do frequent tick checks and shower after outdoor exposure to find ticks before they attach long enough to transmit.