Clinical spectrum of Lyme disease

  • Jesus Alberto Cardenas-de la Garza
  • Estephania De la Cruz-Valadez
  • Jorge Ocampo-Candiani
  • Oliverio WelshEmail author


Lyme disease (borreliosis) is one of the most common vector-borne diseases worldwide. Its incidence and geographic expansion has been steadily increasing in the last decades. Lyme disease is caused by Borrelia burgdorferi sensu lato, a heterogeneous group of which three genospecies have been systematically associated to Lyme disease: B. burgdorferi sensu stricto Borrelia afzelii and Borrelia garinii. Geographical distribution and clinical manifestations vary according to the species involved. Lyme disease clinical manifestations may be divided into three stages. Early localized stage is characterized by erythema migrans in the tick bite site. Early disseminated stage may present multiple erythema migrans lesions, borrelial lymphocytoma, lyme neuroborreliosis, carditis, or arthritis. The late disseminated stage manifests with acordermatitis chronica atrophicans, lyme arthritis, and neurological symptoms. Diagnosis is challenging due to the varied clinical manifestations it may present and usually involves a two-step serological approach. In the current review, we present a thorough revision of the clinical manifestations Lyme disease may present. Additionally, history, microbiology, diagnosis, post-treatment Lyme disease syndrome, treatment, and prognosis are discussed.


Lyme disease Borrelia burgdorferi Tick-borne diseases Ixodes Erythema migrans Lyme neuroborreliosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained for iconographies.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Jesus Alberto Cardenas-de la Garza
    • 1
  • Estephania De la Cruz-Valadez
    • 1
  • Jorge Ocampo-Candiani
    • 1
  • Oliverio Welsh
    • 1
    Email author
  1. 1.University Hospital “Dr. Jose Eleuterio Gonzalez”, Department of DermatologyUniversidad Autonoma de Nuevo LeonMonterreyMexico

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