Lyrne borreliosis is a worldwide, multistage, and multb
system disease caused by borrelial spirochetes, which
are transmitted by Ixodes ticks. It is focally endemic
in temperature climates of the northern hemisphere.
Primary erythema migrans occurs at the site of inoculation.
Secondary erythema migrans occurs at sites of
hematogenous dissemination. Variations in genospecies
account for variations in presentation, including
borrelial lymphocytoma. Disseminated disease
includes constitutional signs and symptoms,
intermittent oligoarticular arthritis, meningitis, cranial
neuritis, radiculoneuropathy, encephalopathy,
atrioventricular block, and myopericarditis.
Late persistent disease includes acrodermatitis
chronica atrophlcans, chronic arthritis, neurological
impairment, and fatigue. There can be difficulties
with both clinical and laboratory diagnosis.
First-line oral therapies for early uncomplicated
disease are doxycycline and amoxicillin. First-line
intravenous therapy for complicated or resistant
disease is ceffriaxone. Prevention includes avoiding
tick habitats, dressing sensibly, judicious use
of repellants, and early removal of imbedded
ticks. Vaccination is indicated only for frequent or
prolonged exposure to tick-infested habitat.