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Lyme borreliosis (LB) is a complex, multisystem disease caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by the bite of an infected ixodid tick. Lyme disease (LD), the syndrome occurring early in the course, is characterized by erythema migrans (EM), a local infection at the site of the tick bite. If untreated, the infection disseminates hematogenously to many different sites. Late Lyme borreliosis may manifest as involvement of the joints, nervous system, and/or heart. Chronic cutaneous LB is manifested by acrodermatitis chronica atrophicans.


After inoculation into the skin as the tick feeds, spirochetes replicate and migrate outward, producing the EM lesion, and invade vessels, spreading hematogenously to other organs. The spirochete has a particular trophism for tissues of the skin, nervous system, and joints. The organism persists in affected tissues during all stages of the illness. The immune response to the spirochete dovelops gradually. Specific IgM antibody peak between the third and sixth weeks after disease onset. The specific IgG response develops gradually over months. Proinflammatory cytokines, tumor necrosis factor-α, and interleukin 1 β are produced m affected tissues.


*Bull's eye rash after a tick bit
*Rashes that are homogeneously red are seen more frequently

The symptoms of Lyme disease are fever, malaise, fatigue, headache, muscle and joint aches in large joints, sore throat, sinus infection

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