Clinical Manifestations and Diagnosis of Lyme Disease - Borreliosis

Erythema migrans

 - 3-32 days (median: 7-10 days)

 - Expanding red or bluish-red patch, often with central clearing, advancing edge typically distinct, often intensely coloured

 - No specific laboratory findings, Lyme serology negative

Acrodermatitis chronica atrophicans

 - 6 months to years

 - Long-standing red or bluish-red lesions, initially doughy swelling, eventually becominq atrophic

 - High specific IgG antibody titers

Early neuroborreliosis

 - weeks to months

 - Meningitis, painful meningo-radiculoneuritis, with or without facial palsy or other cranial neuritis

 - Lymphocytic pleocytosis in cerebrospinal fluid, Intrathecal specific antibody production may be missing in early disease

Late neuroborreliosis

 - months to years (mostly 2-3 years)

 - Encephalitis, encephalomyelitis, meningoencephalitis, radiculomyelitis

 - Intrathecally produced specific antibodies, Specific serum IgG antibodies

Lyme arthritis

 - 2 weeks to 2 years (median: 4-6 months)

 - Recurrent brief attacks of objective joint swelling in one or a few large joints, occasionally progressing to chronic arthritis

 - Significant increase of specific IgG antibodies (early arthritis), High specific IgG titers (late arthritis)

Lyme carditis

 - 4 days to 7 months (median: 21 days)

 - Acute onset of atrio-ventricular conduction disturbances, rarely myocarditis or pancarditis

 - Significant increase of specific IgG antibodies



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