Lyme disease: etiology, pathogenesis, clinical courses, diagnostics and treatment

__________________________________________________________________________________________ Lyme disease (LD) is caused by Borrelia burgdorferi, transferred by infected ticks Ixodus ricinus. LD occurs endemically in Europe, America and Northern regions of Asia. In Poland, LD is the most frequent tick borne disease, which causes serious epidemiological problems. The main health hazard of LD occurs on the forested areas of Podlasie, Maritime province, the West Poland lake district, and Carpathians. The highest incidence 114.0 per 100 000 was registered in Podlaskie province. The infectious cycle of Borrelia burgdorferi includes: nymph moulds to adult, eggs laid by female, eggs hatch to larva, larva feeds on first host, fully fed larva drops to ground, larva moulds to nymph, nymph attaches to and feeds on the second host. LD is a chronic disease attacking many organs, including the skin, heart, brain and joints. LD is divided into three stages based on clinical symptoms: I limited infection (Erythema migrans and Borrelia lymphoma), II disseminated infection (numerous erythema migrans, early neuroborreliosis, joint inflammation, Lyme carditis), III late borreliosis (chronic atrophic limbs inflammation, late neuroborreliosis, chronic joint inflammation). At present, the best diagnostic method for LD is a laborand time consuming two-stage serological method. First-line antibiotics in the treatment of Lyme disease are doxycycline, amoxicillin, cefuroxime axetil, ceftriaxone, cefotaxime, and penicillin G. The best method of avoiding Borrelia burgdorferi infection is to avoid biting from ticks carrying spirochetes. Early removal of ticks, protects against spirochaetal infection.