Lyme Disease

Lyme disease (Lyme borreliosis) is a zoonosis caused by Borrelia burgdorferi. Early sign: erythema migrans; later multi-system/multi-organ involvement of skin/heart/nerve/joints. First clustered in children in Lyme, Connecticut (1975).

Common Symptoms

Macule; conduction block; ataxia; diarrhea; bone pain; myalgia; abdominal pain; periorbital edema

Causes and Pathogenesis

Burgdorferi & Barbour (1982) identified B. burgdorferi—a loosely coiled left-handed spirochete 10-40 × 0.2-0.3 µm with 3-7 coils, longest/narrowest Borrelia. Lives in tick midgut diverticula; tick bite refluxes spirochetes from salivary glands/midgut into dermis then hematogenous. Bacteremia is brief/low-titer but multi-organ disease—multifactorial. Adhesins DbpA/B bind decorin/collagenous ECM; LPS-like activity; outer-membrane proteins OspA/B/C drive virulence; host cytokines worsen inflammation. Stage 1 (days): ECM with perivascular plasma cell/lymphocyte infiltrate; systemic symptoms/hepatosplenomegaly. Stage 2 (dissemination): CNS (cranial nerves, esp. facial/oculomotor/abducens) and heart. Stage 3 (months): joints (proliferative erosive synovitis), skin (atrophic/acrodermatitis chronica atrophicans-like), CNS (progressive encephalomyelitis/axonal demyelination).

Treatment

Drug therapy, supportive therapy

Preventive Measures

(1) Reservoirs: rodent control; treat infected livestock/pets. (2) Ixodes tick eradication; clear weeds; insecticide. (3) Personal protection: avoid grass/laundry in tick season; tuck clothing; remove ticks within 24 h; antibiotics for bites. Recombinant OspA vaccine effective/safe (booster at month 1 and 12); domestic vaccine in development.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.