Lyme borreliosis

Lyme borreliosis is a tick-transmitted spirochaetal disease caused by Borrelia burgdorferi sensu lato. It is acquired in forested and heathland areas of the temperate northern hemisphere. The most common presentation is an erythematous rash spreading slowly from the site of a tick bite. Clinical manifestations of disseminated infection include facial palsy, viral-like meningitis, radiculopathy, meningoencephalitis and arthritis. Lyme borreliosis responds to antibiotic treatment at all stages, with excellent results for patients with early disease. Patients with long-standing infection causing significant tissue damage can have slow or incomplete recovery. A small minority of treated patients can have persistent non-specific symptoms, similar to those seen following some other infections. Controlled trials in patients with post-Lyme symptoms have shown no evidence of persistent infection and no sustained benefit from prolonged antibiotic treatment. Prevention measures focus on tick and disease awareness, avoidance of tick-infested areas where possible, insect repellent use and frequent skin inspections for attached ticks, as early removal minimizes infection risk. No vaccine is currently available.