Lyme disease, or borreliosis, is a severe infectious disease caused a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. It is transmitted through the bites of ticks (and possibly other insects) and is prevalent across the United States and throughout the world. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms. Case reports in the medical literature document the protean manifestations of Lyme disease, and familiarity with its varied presentations is key to recognizing disseminated disease.
Ticks know no borders and respect no boundaries. A patient's county of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease for each individual.
The key symptom is a large target shaped rash centered at the site of the tick bite. However, fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete.
Although the disease is rarely fatal, if left untreated the neurological symptoms become progressively worse, can become irreversible, and can result in death. The disease is treatable if caught in it's early stages, but due to the potentially severe long term complications, prevention is essential. Those who walk or hike where ticks are common (forest, tall grass or weeds, etc.) should wear clothing that covers the entire body, particularly at the ankles where tick bites are the most common.