Lyme disease: a review.

Lyme disease has protean manifestations. The causative agent is Borrelia burgdorferi, a recently discovered spirochete. The disease has been found on three continents. The initial major clinical feature is a characteristic skin eruption known as erythema chronicum migrans. Subsequent main clinical manifestations are meningopolyneuritis and arthritis. However, clinical expressions of the disease vary widely. Some patients have very mild disease and others develop severe and prolonged illness. Specific laboratory tests for the detection of antibody to the organism are now available. The sensitivity of these tests approaches 100% when the sera are collected from patients having the later clinical manifestations. Penicillin and tetracycline are the therapeutic drugs of choice.