Lyme Disease

  • Michael T. Osterholm
  • Kristine L. MacDonald
  • Craig W. Hedberg


Lyme disease is a tickborne multisystem illness caused by the spirochete Borrelia burgdorferi.The clinical manifestations of illness are divided into three stages (Table 1). Stage I is predominantly characterized by erythema chronicum migrans (EM), a skin rash that classically begins as a single macule that expands to an annular lesion, frequently with subsequent secondary annular lesions. The occurrence of EM is often associated with minor constitutional symptoms. Stage II is characterized by neurologic involvement (particularly meningoencephalitis) or cardiovascular involvement (endocarditis, endomyocarditis, vasculitis, or fibrinous pericarditis), usually beginning several weeks after the appearance of EM. Stage III is characterized by recurrent migratory arthritis, primarily of the large joints, which occurs several weeks to 2 years after infection. Myositis, fasciitis, and peripheral neuropathies can also be associated with stage III Lyme disease. Patients may develop EM without further sequelae, or they may present with stage II or stage III disease without recalling prior EM or a tick bite. In some instances, Lyme disease can be severely debilitating without appropriate antimicrobial therapy; therefore, accurate diagnosis and treatment are critical to the clinical management and the public health control of this illness.


Lyme Disease Borrelia Burgdorferi Tick Bite Tick Vector Lyme Arthritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Suggested Reading

  1. Lyme Disease and Related Disorders, Ann. N.Y. Acad. Sci. 539(1988).Google Scholar
  2. Proceedings of the First International Symposium on Lyme Disease, Yale J. Biol. Med. 54(4) (1984).Google Scholar
  3. Proceedings of the Second International Symposium on Lyme Disease and Related Disorders, Zentralbl. Bakteriol. Mikrobiol. Hyg. A. Google Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Michael T. Osterholm
    • 1
  • Kristine L. MacDonald
    • 1
  • Craig W. Hedberg
    • 1
  1. 1.Acute Disease Epidemiology SectionMinnesota Department of HealthMinneapolisUSA

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