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 #LymeDisease #Borreliosis #Diagnosis #Signs #Symptoms #Timeline
