Background: Lyme borreliosis is a tick-borne zoonotic disease caused by Borrelia
burgdorferi spirochetes transmitted by Ixodes ticks. It is prevalent worldwide
and spreads within one to two weeks, potentially causing erythema migrans and
other symptoms. Diagnosing and treating Lyme borreliosis is challenging due to
varied clinical presentations and diagnostic test limitations. Diagnosis: Diagnosis
involves clinical symptoms and serological tests. Erythema migrans alone is
diagnostic without further tests. The standard two-tiered testing approach,
involving an initial ELISA followed by a confirmatory Western Blot, is commonly
used but has low sensitivity in early-stage disease. Modified two-tiered testing
aims to improve diagnostic accuracy but requires two stages for sufficient
sensitivity and specificity. New diagnostic methods include lateral flow
immunoassays, EliSpot techniques, biomarker-based approaches, pathogen
culture, and PCR with modifications like immune-PCR. The methods mentioned
each have their limitations. The lack of a gold standard method makes exploring
a valid diagnostic algorithm necessary. Treatment: Treatment primarily involves
antibiotics such as doxycycline, usually for no more than 28 days. Long-term
antibiotic therapy is not supported by evidence and is not recommended for nonspecific
post-Lyme syndrome symptoms. Conclusions: In conclusion,
advancements in Lyme borreliosis diagnostics continue, but challenges remain in
developing a simple, cost-effective, and highly accurate diagnostic test. Improved
diagnostics are crucial for timely treatment, preventing complications, and
minimizing unnecessary antibiotic use.
Keywords: Lyme disease; Borrelia burgdorferi; tick-borne; diagnostic algorithm;
antibiotic treatment