LYME DISEASE

borreliosis

Etiology
Lyme disease or borreliosis, is

caused by Gram negative spirochetal bacteria from the genus Borrelia, which has at least 37 species, 12 of which are Lyme related, and an unknown number of genomic strains. It is transmitted to humans by the bite of infected ticks. The diagram shows Borrelia burgdorferi which is the causative agent of the Lyme disease.

Symptoms and Diagnosis

The acute phase of Lyme disease infection

is characteristic bulls-eye rash, with accompanied fever, malaise, and musculoskeletal pain (arthraglia or myaglia). Other less common findings include cardiac manifestations, neurologic symptoms, as well as simple altered mental status. Chronic symptoms may include meningoencepalitis. Due to the difficulty in culturing Borrelia bacteria in the laboratory, diagnosis of Lyme disease is typically based on the clinical exam findings and a history of exposure to endemic Lyme areas. Serological tests may be useful but are not diagnostic. Diagnosis of late-stage Lyme disease is often difficult because the disease may imitate many other diseases such as multiple sclerosis, chronic fatigue syndrome, or other autoimmune diseases.

Treatment
Antibiotics are the primary treatment for Lyme disease.

Penicillin was first demonstrated by researchers to be useful against borrellia in the 1950s; today the antibiotics of choice are doxycycline, amoxicillin and ceftriaxone. Macrolide antibiotics are also used. In later stages, the bacteria disseminate throughout the body and may cross the blood-brain barrier, making the infection more difficult to treat. Minocycline is also indicated for neuroborreliosis for its ability to cross the blood-brain barrier.