Summary

Lyme disease (LD), also known as Lyme borreliosis and carried by Ixodes ticks, is the most common zoonotic disease in the northern hemisphere. Although the prevalence of the disease in Turkey is not known exactly, seroepidemiologic studies show that the prevelance ranges between 2-44%. Case reports suggest that our country is endemic for Lyme. In addition, a recent study showed that Borrelia burgdorferi (B. burgdorferi) sensu stricto, Borrelia garinii, Borrelia afzelii, Borrelia lusitania and Borrelia valaisiana from B. burgdorferi sensu lato group of species were found in Ixodes ricinus in the Thrace region of Turkey. In untreated patients, the disease process can be seen in three phases. Erythema migrans (EM) and flu-like illness may be seen in the first phase. EM migrans lesions, joint, nervous system, eyes, and heart involvement may develop 3-10 weeks after receipt of the pathogen in the second phase. Last stage is after months or years. Joint and neurological involvements are prominent in the absence of EM lesions in almost 11% of patients. The duration and choice of antibiotic treatment may vary according to the severity of organ involvement and disease. Anti-inflammatory drug treatment is also as important as antibiotics. Different clinical courses in which EM are not found can cause diagnostic difficulties and untreated disease. Even in the absence of a history of tick bite, LD should be considered in the differential diagnosis. Early diagnosis and initiation of antibiotic treatment are of importance. Determining endemic regions and enhancing knowledge of the disease among physicians and society are needed for early diagnosis, treatment, and control of Lyme disease.