title: [Frequency of the clinical manifestations of Lyme borreliosis in Spain].
abstract: BACKGROUND
  There are differences in the clinical manifestations of Lyme borreliosis (LB) in different parts of the world. The aim of this work was to analyze its clinical manifestations in Spain.
  
  
  METHODS
  We evaluated by ELISA and IFI the sera of 1,500 patients with clinical suspicion of LB between January 1987 to February 1993. Spanish criteria of LB (amplified CDC criteria of LB for epidemiological purpuse) were used. Clinical and serological data were evaluated with the patients' physicians and other etiologies were reasonably excluded in accepted cases of LB.
  
  
  RESULTS
  Sixty-four patients of 138 with a positive serology (46%) met the LB criteria. Neurological manifestations were presented by 40 patients (62.5%) (in control group 23%, p < 0.05) cutaneous lesions by 20 patients (31%), articular manifestations by 18 patients (28%) (in control groups 56%; p < 0.05) and cardiac manifestations in two. Cutaneous manifestations included 17 erythema migrans, 2 acrodermatitis chronica atrophicans and 1 lymphocytoma). Artritis was present in 18 cases. Neurological manifestations included 16 cases of meningitis (2 with encephalitis), 11 of craneal neuropathy and 25 of peripheral neuropathy (13 of polyneuropathy). Cardiac manifestations acepted was 2 atrioventricular blockade. We detected 21% of false positive serology and in 33% of the positive cases, the LB criteria was not met.
  
  
  CONCLUSIONS
  The low percentage of cutaneous manifestations is probably due to the fact that this series consist predominantly of hospital patients. In Spain, as in the rest Europe the predominant manifestations are neurological, however artritis are not infrequent manifestations.
authors.affiliation: Unidad de Enfermedades Infecciosas, Universidad de Alcalá de Henares, Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Guerrero
authors.forename: R
authors.initials: R
authors.lastname: Escudero
authors.forename: P
authors.initials: P
authors.lastname: Martí-Belda
authors.forename: C
authors.initials: C
authors.lastname: Quereda
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000209:etiology; D015748:Borrelia burgdorferi Group; D002648:Child; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D017678:Sex Distribution; D012874:Skin Diseases, Infectious / Q000453:epidemiology / Q000209:etiology; D013030:Spain / Q000453:epidemiology
vernacular_title: Frecuencia de las manifestaciones clínicas de la borreliosis de Lyme en España.