26-year-old man comes to the physician with a 2-day history of multiple symptoms, including rash on his trunk, headache, fatigue, malaise,
myalgias, and fever. The rash, which is not associated with pain, itching, or burning, has expanded over the last 2 days. The patient went on a
camping trip in Vermont 2 weeks ago and recalls a tick bite at that time. His temperature is 38.9°C (102°F), blood pressure is 120/80 mm Hg,
pulse is 98/min, and respirations are 16/min. The large single macule on his trunk is erythematous with central clearing. The rest of the
examination is unremarkable. What is the most appropriate next step in management of this patient?
- QA Bacterial blood cultures
- 0 B. Intravenous ceftriaxone
- 0 C . Oral doxycycline
- 0 D. Reassurance and close follow-up
- 0 E. Serology for Lyme disease
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