Lyme disease, also known as borreliosis, is a controversial condition that is caused by the bacteria Borrelia burgdorferi, with infection being via a tick-borne vector.
Controversy around Lyme disease centers on chronic infection with some 3 doubting its existence. There are some terms that help differentiate these patients with non-specific symptoms of fatigue, myalgia and arthralgia, from those with acute infection 3:
- post-Lyme disease symptoms: symptoms for <6 months
- post-Lyme disease syndrome: disabling symptoms lasting for >6 months
Lyme disease is endemic in some areas of North America and Europe.
Three disease stages have been proposed manifesting after the tick bite 2:
- stage 1: flu-like illness and enlarging skin lesion (erythema migrains) (2-30 days)
- stage 2: cardiac and neurological symptoms (1-4 months)
- stage 3: arthritis and neurological symptoms (many years)
Lyme disease has nonspecific symptoms with multisystemic involvement 1,2:
Lyme disease caused by the bacteria Borrelia burgdorferi and is transmitted by the bite of the ticks Ixodes scapularis and Ixodes pacificus.
Disease manifestations can be multisystem and non-specific includes 1,2,4:
- cutaneous: erythema migrans
- CNS: peripheral neuropathy, radiculoneuropathy, myelopathy, encephalitis, meningitis
- cardiac: myopericarditis, cardiac arrhythmia
- musculoskeletal: Lyme arthritis
Treatment and prognosis
Treatment is based with antibiotics depending on the stage of the disease and its severity 1. There is no evidence that long-term antibiotic therapy is appropriate for patients with post-Lyme disease symptoms or syndrome 4.