Institute for Hygiene and Applied Immunology, Medical University of Vienna, A-1090 Vienna, Austria.
Department of Infectious Diseases, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia.
FEMS Microbiol Rev. 2018 May 1;42(3):233-258. doi: 10.1093/femsre/fux047.
Lyme borreliosis is caused by certain genospecies of the Borrelia burgdorferi sensu lato complex, which are transmitted by hard ticks of the genus Ixodes. The most common clinical manifestation is erythema migrans, an expanding skin redness that usually develops at the site of a tick bite and eventually resolves even without antibiotic treatment. The infecting pathogens can spread to other tissues and organs, resulting in manifestations that can involve the nervous system, joints, heart and skin. Fatal outcome is extremely rare and is due to severe heart involvement; fetal involvement is not reliably ascertained. Laboratory support-mainly by serology-is essential for diagnosis, except in the case of typical erythema migrans. Treatment is usually with antibiotics for 2 to 4 weeks; most patients recover uneventfully. There is no convincing evidence for antibiotic treatment longer than 4 weeks and there is no reliable evidence for survival of borreliae in adequately treated patients. European Lyme borreliosis is a frequent disease with increasing incidence. However, numerous scientifically questionable ideas on its clinical presentation, diagnosis and treatment may confuse physicians and lay people. Since diagnosis of Lyme borreliosis should be based on appropriate clinical signs, solid knowledge of clinical manifestations is essential.
莱姆病是由伯氏疏螺旋体复合体中的某些种引起的，由硬蜱属的硬蜱传播。最常见的临床表现是游走性红斑，即扩展的皮肤红斑，通常在蜱叮咬部位出现，即使没有抗生素治疗，最终也会消退。感染病原体可扩散至其他组织和器官，导致可累及神经系统、关节、心脏和皮肤的表现。致命结局极为罕见，是由于严重的心脏受累；无法可靠确定胎儿受累情况。实验室支持（主要通过血清学）对于诊断至关重要，除了典型的游走性红斑病例。治疗通常采用抗生素治疗 2 至 4 周；大多数患者康复顺利。没有令人信服的证据表明抗生素治疗超过 4 周，也没有可靠的证据表明在充分治疗的患者中伯氏疏螺旋体会存活。欧洲莱姆病是一种常见疾病，发病率呈上升趋势。然而，其临床表现、诊断和治疗方面存在许多有科学争议的观点，可能会使医生和非专业人士感到困惑。由于莱姆病的诊断应基于适当的临床体征，因此对临床表现的扎实了解至关重要。
