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  lüll Lyme disease--current state of knowledge Nau R; Christen HJ; Eiffert HDtsch Arztebl Int  2009[Jan]; 106 (5): 72-81; quiz 82, IBACKGROUND: Lyme disease is the most frequent tick-borne infectious disease in  Europe. The discovery of the causative pathogen Borrelia burgdorferi in 1982  opened the way for the firm diagnosis of diseases in several clinical disciplines  and for causal antibiotic therapy. At the same time, speculation regarding links  between Borrelia infection and a variety of nonspecific symptoms and disorders  resulted in overdiagnosis and overtreatment of suspected Lyme disease. METHOD:  The authors conducted a selective review of the literature, including various  national and international guidelines. RESULTS: The spirochete Borrelia  burgdorferi sensu lato is present in approximately 5% to 35% of sheep ticks  (Ixodes ricinus) in Germany, depending on the region. In contrast to North  America, different genospecies are found in Europe. The most frequent clinical  manifestation of Borrelia infection is erythema migrans, followed by  neuroborreliosis, arthritis, acrodermatitis chronica atrophicans, and  lymphocytosis benigna cutis. Diagnosis is made on the basis of the clinical  symptoms, and in stages II and III by detection of Borrelia-specific antibodies.  In adults erythema migrans is treated with doxycycline, in children with  amoxicillin. The standard treatment of neuroborreliosis is third-generation  cephalosporins. CONCLUSIONS: After appropriate antibiotic therapy, the outcome is  favorable. In approximately 95% of cases neuroborreliosis is cured without  long-term sequelae. When chronic borreliosis is suspected, other potential causes  of the clinical syndrome must be painstakingly excluded.|*Health Knowledge, Attitudes, Practice[MESH]|Clinical Trials as Topic/*trends[MESH]|Evidence-Based Medicine/*trends[MESH]|Humans[MESH]|Lyme Disease/*diagnosis/*therapy[MESH] |