Lyme disease classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Lyme disease may be classified into three stages. The first stage is localized Lyme disease, the second is disseminated Lyme disease and the third is late disseminated Lyme disease. During stage 1, the patient can develop erythema migrans rash. Ten to twenty percent of the patients who have Lyme disease can develop post treatment Lyme disease syndrome.

Classification

Classification Based on Clinical Stage

• Stage 1 is called early localized Lyme disease. The infection is not yet widespread throughout the body.
• Stage 2 is called early disseminated Lyme disease. The bacteria have begun to spread throughout the body.
• Stage 3 is called late disseminated Lyme disease. The bacteria have spread throughout the body.

Classification Based on Causative Organism

• Lyme disease is usually caused by B. burgdorferi. However, B. mayonii has recently been discovered to be responsible for development of Lyme disease.
• The following table demonstrates key clinical and epidemiological features that distinguish B. burgdorferi from B. mayonii:

General information	B. burgdorferi	B. mayonii
Transmission	Tick bite	Tick bite
Distribution in the USA	Northeast, Mid-Atlantic, and Midwest regions	Midwest region
Bacteria Concentration in Blood (Spirochetemia)	Lower	Higher
Early Symptoms	Fever, headache, rash, neck pain
Late Symptoms and Complications	Joint pain and Arthritis
Nausea / Vomiting?	No	Yes
Rash Characteristics	Bull's-eye target lesion	Diffuse rash
Diagnosis	Serology or PCR	Serology or PCR
Treatment	Doxycycline	Doxycycline

^{Adapted from Pritt BS et al. Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infectious Diseases. DOI: http://dx.doi.org/10.1016/S1473-3099(15)00464-8 | Centers for Disease Control and Prevention (CDC). New Lyme-disease-causing bacteria species discovered. URL: http://www.cdc.gov/media/releases/2016/p0208-lyme-disease.html. Retrieved February 9th 2016.}

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