Tom G. Schwan, PhD; Warren J. Simpson, PhD
To the Editors: Borrelia burgdorferi is considered to be the causative agent in Lyme borreliosis, a tick-borne zoonosis that afflicts both humans and domestic mammals. In the last 10 years, however, the diversity of clinical manifestations assumed to be the result of infection with B. burgdorferi has continued to increase, and Lyme borreliosis is sometimes difficult to diagnose. Why do only 70% of patients develop erythema migrans, the characteristic annular red rash that develops around the infective site? Why does a "flu-like syndrome" characterized by fever, headaches, and cough develop in only a portion of infected patients? Why do some patients appear to have no acute or early disease, but later develop severe cardiac, arthritic, or neurologic manifestations? Why do some
Schwan TG, Simpson WJ. Diagnosing Lyme Disease. Ann Intern Med. ;115:577–578. doi: 10.7326/0003-4819-115-7-577_2
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Published: Ann Intern Med. 1991;115(7):577-578.
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