title: Lyme borreliosis.
abstract: Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.
authors.affiliation: Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114, USA.|Harvard Medical School, Harvard University, Boston, Massachusetts, USA.
authors.forename: Allen C
authors.initials: AC
authors.lastname: Steere
authors.affiliation: Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Franc
authors.initials: F
authors.lastname: Strle
authors.affiliation: Division of Infectious Diseases, New York Medical College, Valhalla, New York, USA.
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
authors.affiliation: Department of Molecular Biology and Microbiology, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Linden T
authors.initials: LT
authors.lastname: Hu
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Branda
authors.affiliation: Center for Experimental and Molecular Medicine, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Joppe W R
authors.initials: JW
authors.lastname: Hovius
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Mead
mesh_terms: D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D025065:Borrelia burgdorferi / Q000276:immunology / Q000472:pathogenicity; D015748:Borrelia burgdorferi Group / Q000276:immunology / Q000472:pathogenicity; D002444:Cefuroxime / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D004318:Doxycycline / Q000494:pharmacology / Q000627:therapeutic use; D005076:Exanthema / Q000209:etiology; D006801:Humans; D018884:Ixodes / Q000382:microbiology; D008193:Lyme Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D020852:Lyme Neuroborreliosis / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D015047:Zoonoses / Q000209:etiology / Q000382:microbiology; D047090:beta-Lactams / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000658:Amoxicillin; D004318:Doxycycline; D002444:Cefuroxime; C040738:cefuroxime axetil