Lyme Disease

Abstract

LYME disease was described as a separate entity in 1977 because of a geographic clustering of children in Lyme, Conn., who were thought to have juvenile rheumatoid arthritis.¹ The rural setting of the case clusters and the identification of erythema migrans (Fig. 1) as a feature of the illness suggested that the disorder was transmitted by an arthropod. It soon became apparent that Lyme disease was a multisystem illness that affected primarily the skin, nervous system, heart, and joints.² Epidemiologce studies of patients with erythema migrans implicated certain ixodes ticks as vectors of the disease.^{3 4 5} An important clue to the . . .