Lyme disease, also known as borreliosis, is a condition caused by the bacteria Borrelia burgdorferi, with infection being via the ixodid tick.
Controversy around Lyme disease centers on chronic infection with some authors 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 :
- 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 :
- stage 1: flu-like illness and enlarging skin lesion (erythema migrans) (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 :
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 nonspecific includes :
- cutaneous: erythema migrans
- CNS: peripheral neuropathy, radiculoneuropathy, myelopathy, encephalitis, meningitis, facial nerve palsy
- cardiac: myopericarditis, cardiac arrhythmia
- musculoskeletal: Lyme arthritis
Intracranial MR imaging findings in patients with Lyme disease are rare . Where present, findings include:
- foci of periventricular / subcortical T2 hyperintensity
- nerve root enhancement
- meningeal enhancement
Treatment and prognosis
Treatment is based with antibiotics depending on the stage of the disease and its severity . There is no evidence that long-term antibiotic therapy is appropriate for patients with post-Lyme disease symptoms or syndrome .
History and etymology
The disease derives its name from the town of Lyme, Connecticut where it was first reported in 1975 .