Steere A C, Malawista S E, Bartenhagen N H, Spieler P N, Newman J H, Rahn D W, Hutchinson G J, Green J, Snydman D R, Taylor E
Yale J Biol Med. 1984 Jul-Aug;57(4):453-61.
Lyme disease was recognized as a separate entity because of close geographic clustering of affected children in Lyme, Connecticut, with what was thought to be juvenile rheumatoid arthritis. It then became apparent that Lyme disease is a complex, multisystem disorder. The illness usually begins in summer with erythema chronicum migrans and associated symptoms (stage 1). Weeks to months later, some patients develop neurologic or cardiac abnormalities (stage 2), and weeks to years later, many patients develop intermittent attacks of arthritis (stage 3), which may become chronic, with erosion of cartilage and bone. Patients with severe and prolonged illness have an increased frequency of the B-cell alloantigen, DR2. For patients with early Lyme disease, tetracycline appears to be the most effective drug, then penicillin, and finally erythromycin. High-dose intravenous penicillin is effective for the later stages of the disease.
莱姆病最初被视为一种独立的疾病实体，因为在康涅狄格州莱姆镇，受影响的儿童在地理上高度聚集，当时被认为患有幼年类风湿性关节炎。后来人们逐渐认识到莱姆病是一种复杂的多系统疾病。该病通常始于夏季，出现慢性游走性红斑及相关症状（1期）。数周或数月后，部分患者会出现神经或心脏异常（2期），数周或数年后，许多患者会出现间歇性关节炎发作（3期），这种关节炎可能会发展为慢性，导致软骨和骨侵蚀。病情严重且病程较长的患者，B细胞同种异体抗原DR2的出现频率增加。对于早期莱姆病患者，四环素似乎是最有效的药物，其次是青霉素，最后是红霉素。大剂量静脉注射青霉素对该病的后期阶段有效。
