[Clinical manifestations of Lyme disease]

Lyme disease can be divided into three phases; (1) a primary phase where the inconstant erythema migrans predominates; (2) a secondary phase, sometimes revealing the disease, with isolated or associated cutaneous and cardiac signs and articular or neurological manifestations responding to antibiotics, and (3) a tertiary phase with cutaneous, articular and above all neurological signs which are chronic and sometimes severe. A better knowledge of this infection has enabled some rheumatological or neurological manifestations to be explained. Clinicians should be aware of this, since these disorders are amenable to antibiotic therapy. Conversely, multivisceral symptoms should not be ascribed to Lyme disease without strong positive arguments.