Lyme disease: etiology, epidemiology, diagnostics and treatment

Greta Reikertaitė1, Ilona Šakuro1

1 Lithuanian University of Health Sciences Medical Academy Faculty of medicine, Kaunas, Lithuania


Lyme disease, also known as borreliosis, is the most common disease transmitted by vectors (ticks) in the temperate zone of the northern hemisphere. This tick-borne infection was first discovered in the 20th century, and due to environmental factors favorable to ticks, Lyme disease infection or other tick-borne diseases are becoming more common. In humans, borellosis is spread by infected ticks of the genus Ixodes when they feed on blood. Ixodes ricinus mites are the most common in Europe. The causative agent of Lyme disease (borreliosis), Borrelia burgdorferi, is gram-negative spirochetes. A person becomes infected with Lyme disease when an infected tick injects saliva (containing Borrelia) into a wound while sucking blood. Infection usually occurs 48 to 72 hours after the tick bites. When borreliosis occurs, about 80 percent of people experience a pathognomonic sign of this disease – migrating erythema (concentric redness in the skin, at the site of tick bite), erythema is about 5 cm in diameter, prone to increase. Also during the month, the patient experiences flu-like symptoms – fever, bone-breaking feeling, muscle aches, general fatigue, swollen lymph nodes. Later, if left untreated, about a month after the onset of erythema, damage to the neurological system can occur – early neuroborellosis: lymphocytic meningoradiculitis with radiculitis pain, paresis, cranial neuritis (usually n.facial paresis). Lyme disease also causes damage and inflammation of the musculoskeletal system, heart, skin and eyes. Clinical detection of migratory erythema at an early stage is sufficient to support the diagnosis of borreliosis, followed by detection of IgM and IgG antibodies against Borrelia by ELISA and Western Blot. Lyme disease is treated with antibiotics, and the specific treatment depends on the patient’s health condition, age and stage of the disease. After treatment, about 5 percent of people who have had Lyme disease still experience muscle, joint pain or fatigue. This disease severely impairs the physical and emotional as well as mental health of a person with the progression or failure of the necessary treatment. According to the activity of ticks, Lithuania is considered to be a zone of high endemicity, therefore it is important to know and update the knowledge about diseases caused by ticks, especially in spring, when ticks are highly active. In this article, we reviewed the latest scientific literature on the  etiology, epidemiology, symptoms, pathogenesis, diagnosis, and treatment of Lyme disease.

Keywords: Lyme disease, borreliosis, erythema migrans, neuroborellosis, acrodermatitis.