Related Experiment Video
Updated: Jun 22, 2026
Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Lyme disease--current state of knowledge
Roland Nau1, Hans-Jürgen Christen, Helmut Eiffert
1Geriatrisches Zentrum, Evangelisches Krankenhaus Göttingen-Weende, Abteilung für Neurologie, Universitätsklinikum Göttingen, Göttingen, Germany. rnau@gwdg.de
Background:
Lyme disease is the most frequent tick-borne infectious disease in Europe. The discovery of the causative pathogen Borrelia burgdorferi in 1982 opened the way for the firm diagnosis of diseases in several clinical disciplines and for causal antibiotic therapy. At the same time, speculation regarding links between Borrelia infection and a variety of nonspecific symptoms and disorders resulted in overdiagnosis and overtreatment of suspected Lyme disease.
Method:
The authors conducted a selective review of the literature, including various national and international guidelines.
Results:
The spirochete Borrelia burgdorferi sensu lato is present in approximately 5% to 35% of sheep ticks (Ixodes ricinus) in Germany, depending on the region. In contrast to North America, different genospecies are found in Europe. The most frequent clinical manifestation of Borrelia infection is erythema migrans, followed by neuroborreliosis, arthritis, acrodermatitis chronica atrophicans, and lymphocytosis benigna cutis. Diagnosis is made on the basis of the clinical symptoms, and in stages II and III by detection of Borrelia-specific antibodies. In adults erythema migrans is treated with doxycycline, in children with amoxicillin. The standard treatment of neuroborreliosis is third-generation cephalosporins.
Conclusions:
After appropriate antibiotic therapy, the outcome is favorable. In approximately 95% of cases neuroborreliosis is cured without long-term sequelae. When chronic borreliosis is suspected, other potential causes of the clinical syndrome must be painstakingly excluded.
Insights
Lyme disease, caused by Borrelia burgdorferi, is common in Europe. Prompt diagnosis and antibiotic treatment lead to favorable outcomes, with most neuroborreliosis cases resolving without lasting effects.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Lyme disease is the most prevalent tick-borne illness in Europe, caused by Borrelia burgdorferi.
- Its discovery enabled diagnosis and antibiotic treatment but also led to overdiagnosis of non-specific symptoms.
- Understanding Borrelia burgdorferi prevalence and manifestations is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review the diagnosis and treatment of Lyme disease in Europe.
- To differentiate between confirmed Lyme disease and suspected non-specific symptoms.
- To provide an overview of current diagnostic and therapeutic guidelines.
Main Methods:
- A selective literature review was performed.
- National and international guidelines on Lyme disease were included.
- The review focused on epidemiology, clinical manifestations, diagnosis, and treatment.
Main Results:
- Borrelia burgdorferi sensu lato is found in 5-35% of Ixodes ricinus ticks in Germany, with regional variations in genospecies.
- Erythema migrans is the most common symptom, followed by neuroborreliosis, arthritis, and skin conditions.
- Diagnosis relies on clinical symptoms and antibody detection; treatment varies by manifestation and patient age, with doxycycline or amoxicillin for erythema migrans and cephalosporins for neuroborreliosis.
Conclusions:
- Appropriate antibiotic therapy ensures a favorable prognosis for Lyme disease.
- Approximately 95% of neuroborreliosis cases resolve without long-term sequelae.
- When chronic borreliosis is suspected, alternative diagnoses must be rigorously excluded.
Related Concept Videos
01:26Encephalitis ll: Pathophysiology
01:26Rocky Mountain Spotted Fever
01:19Encephalitis l: Introduction
01:30Bacterial Phylum Spirochaetes
01:28Infectious Diseases and Their Occurrence
01:28Toxoplasmosis