Lyme Borreliosis: Biological and Clinical Aspects

‘Lyme disease’, so called since Steere et al. [1, 2] inquired into an arthritis epidemic
among young children in the community of Old Lyme, Conn., USA, in the late 1970s,
has a very long European history. Its cutaneous manifestations, the most frequent
signs of the disease, had already been described at the end of the 19th century and the
beginning of the 20th century physicians like Buchwald, Pick, Herxheimer, Hartman,
Afzelius and Lipschütz [3–5] . Additionally, two French physicians in a landmark
paper published in 1922, Garin and Bujadoux [6] , reported a patient who developed
erythema chronicum migrans followed painful meningoradiculitis. Shortly
before the symptoms began, this patient was bitten a tick and he had a positive
Bordet-Wasserman test, which was used at this time to diagnose syphilis. They stated,
however, that although this test was positive, this patient did not have syphilis, and
concluded that this patient had a tick-borne disease that induced cutaneous and neurological
manifestations caused a spirochete different from Treponema pallidum .
It was not until the early 1980s that their prediction proved to be correct, when Burgdorfer
et al. [7] were able to isolate a bacterium belonging to the family of Spirochaetaceae,
first from ticks and then from humans. Interestingly, the first North American
observation of Lyme disease, a patient with erythema migrans, was only published
in 1970 [8] .

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