Lyme disease

Lyme disease is a disease occurring in the northern hemisphere, transmitted by ticks of the genus Ixodes and is caused by spirochetes of the genus Borrelia.

The species of Borrelia which cause Lyme disease belong to a complex of 21 closely related species of Borrelia burgdorferi sensu lato and are Borrelia burgdorferi sensu stricto (North America and partially Europe), Borrelia garinii and Borrelia afzelii (both occurring in Europe and Asia). However, other species of the complex are also discussed, such as Borrelia bissettii and Borrelia valaisiana.

Lyme disease is the most common tick-borne disease in Europe. Up to 65 000 people in Europe are reported to be infected every year. The disease may also occur asymptomatically, but this happens only in about 7% of cases. In other cases, the disease is unpleasant and can have permanent consequences. The disease occurs in three phases.

The first phase is characterized by a red circular spot that spreads laterally. This spot is called erythema migrans and is present in about 70-80% of patients. The presence of the stain may or may not be accompanied by a feverish disease (fever, fatigue, headache).

Within a few weeks, the second phase of the disease occurs. In the second phase, the borrelia leaves the infected skin and begins to spread throughout the bloodstream. Erythema migrans, or a purple nodule called borrelious lymphocytoma, may appear on the skin. 10-15% of people develop so-called neuroborreliosis, which causes acute neurological problems. It can be headache, neck stiffness, light sensitivity, tingling of skin and limbs, memory loss, poor sleep, mood swings. In addition to the nervous system, borrelia often affects the joints, resulting in pain and swelling. The heart may also be affected, where bacteria cause a disturbance of the heart rhythm.

After a few months, the third phase of the disease occurs, which is essentially the progression of the second phase. There are permanent consequences that can lead to disability. For example, loss of momentum, loss of meaning. Chronic inflammation of the nervous system leads to migraines, problems with balance, dizziness, limb weakness, incontinence and back pain. In rare cases, borreliosis may cause psychiatric complaints such as anxiety, depersonification, derealization and psychosis (which can then be misdiagnosed as schizophrenia). In addition, inflammation of the joints and atrophic involvement of the skin of acrodermatitis chronica atrophicans occur.

Borreliosis in the first stage is diagnosed very quickly and accurately by a typical red spot on the skin (erythema migrans). The problem occurs when the patient overlooks the stain or the stain does not form. Borreliosis is sometimes called the Great Imitator because if it is not detected in the first stage, its symptoms correspond to a wide range of different diseases. Therefore, it is often misdiagnosed as arthrosis, fibromyalgia, chronic fatigue syndrome, or lupus. In the laboratory, borreliosis is tested from the patient's blood using a western blot or ELISA method to determine specific anti-borrelia antibodies of the IgM and IgG classes.

To successfully cure borreliosis, appropriate antibiotics should be used as soon as possible after infection. Doxycycline appears to be most suitable for this purpose, but is contraindicated in pregnant and lactating women and young children. As alternatives, amoxycillin or aszythromycin may be used.