... purposes)Journal of Medical Case ReportsOpen Access Case reportAltered mental status, an unusual manifestation of early disseminated Lyme disease: A case reportShiven B Chabria* and Jock LawrasonAddress: ... Alternatively, there may have beenantecedent erythema migrans and/or systemic complaintsin the early localized phase. Early disseminated Lyme dis-ease can have many central nervous system manifesta-tions. ... New Hampshire, Rhode Island, NewYork, New Jersey, Pennsylvania, Delaware, Maryland,Michigan, and Wisconsin [2]. The clinical manifestationsare usually categorized into early localized, early...