Lyme borreliosis (LB)

Extract

• Lyme borreliosis, is a bacterial disease occurring worldwide, spread by ticks and manifesting in various organs.
• The primary manifestation of Lyme disease is a characteristic skin rash known as erythema migrans (EM). Recognizing EM and starting antimicrobial medication without delay in primary health care form the basis of treatment for preventing later symptoms. No laboratory tests are needed at this stage.
• If there is an area of erythema more than 5 cm in diameter at the site of a tick bite and more than one week has elapsed since the bite, it should be regarded as EM. A typical rash of more than 5 cm in diameter should be treated immediately.
• About half of patients with untreated EM will have later manifestations of the disease.
• At later stages, diagnosis must always be based on three factors: the possibility of having been bitten by a tick carrying Borrelia bacteria, clinical findings and laboratory tests.
• The clinical picture shows varying progression. Various symptoms may occur simultaneously. The main skin, nervous system and musculoskeletal symptoms caused by borreliosis should be kept in mind.
• There is a separate guideline for antimicrobial treatment of later stages of the disease.
• Persistent or chronic Borrelia infection is extremely rare in patients who have received appropriate treatment. If diagnosis and treatment are significantly delayed, symptoms associated with the convalescence or with permanent tissue damage may occur even after the infection has been cured. In such cases repeated antimicrobial treatments are not indicated.

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