Borrelia burgdorferi (Lyme borreliosis)
Dr. med. Hartmut Campe, Dr. med. Hanns-Georg Klein
With up to 100.000 new infections per year Lyme borreliosis is the most prevalent infection transmitted by ticks in Germany. It is caused by an infection with different species of borrelia (B. burgdorferi sensu stricto, B. garinii und B. afzelii). In Central Europe, the pathogen is transmitted by the tick ixodes ricinus. The number of infections rises significantly in summer and autumn.
Early signs and symptoms in acute Lyme borreliosis include unspecific general symptoms (headache, arthralgia, myalgia, gastrointestinal problems, fever is not obligatory) as well as erythema migrans, which is usually located at the site of the bite and is characterized by centrifugal spread and might also manifest in a disseminated form. The pathogen can be detected in skin biopsies obtained from the area surrounding the site of the bite using PCR. Futhermore radicular pain and/or cranial nerve palsy may occur. Both symptoms are signs of an acute neuroborreliosis (Lymphocytic meningoradiculitis (Bannwarth's syndrome)).
After a latency period from a few to several weeks, hematogenous dissemination of the pathogen may occur. Since this stage is generally not accompanied by signs or symptoms, the right time to detect the pathogen in the blood cannot be determined. The dissemination stage may be followed by late manifestations of borreliosis (such as Lyme arthritis, acrodermatitis chronica atrophicans or rarely chronic neuroborreliosis). Depending on the course of the disease the pathogens can be detected in the liquor or joint effusion).