DR Medhat MRCP

Lyme disease (Borreliosis) :
B. Borrelia
- Is an emerging infectious disease caused by at least three species of bacteria
belonging to the genus Borrelia transmitted via tick bite.
Borrelia burgdorferi sensu stricto : in USA
Borrelia afzelii and Borrelia garinii : IN Europe.
• Clinical features :
Early features :
o Erythema chronicum migrans (small papule often at site of the tick bite
(BuII`s eye rash)
which develops into a larger annular lesion
with central clearing, occurs in 70% of pts).
o Systemic symptoms: fever ,headache ,malaise, arthralgia
Later features :
1) CVS: heart block, myocarditis.
2) Neurological : cranial nerve palsies, meningitis.
3) Pauci-arthritis (i.e 2-4 Joints affected).
• Investigations : antibodies to Borrelia burgdorferi
• TTT : 1) Doxycyclin : if early disease
2) Ceftriaxone : if disseminated disease.
Jarisch-Herxheimer reaction is sometimes seen after initiating therapy:
- fever, rash, tachycardia after first dose of antibiotic (more commonly seen in
syphilis, another spirochaetal disease).
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