Lyme borreliosis
Lyme borreliosis (LB) is a multisystem infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The most frequent clinical manifestations include erythema migrans, meningoplyneuritis, and arthritis. Diagnosis of LB is made on clinical grounds and usually supported by a positive serology. Early diagnosis and treatment almost always leads to a rapid healing of the disease. However, in disseminated manifestations gradual remission of symptoms may take several weeks to months. In rare cases, the pathogen can persist for many years, causing acrodermatitis chronica atrophicans, chronic neuroborreliosis of the central nervous system, or Lyme arthritis. Moreover, the infection may induce a persisting immunopathological response, resulting in ‘antibiotic-resistant’ Lyme arthritis. However, even these chronic manifestations usually slowly regress after thorough antibiotic and symptomatic therapy, although in part with irreversible organ defects.