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Clinical pathologic correlations of Lyme disease
1Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111.
Reviews of Infectious Diseases
|September 1, 1989
Summary
Lyme disease, caused by Borrelia burgdorferi, affects multiple body systems unpredictably across three stages. Chronic Lyme disease presents with diverse skin conditions and neurological issues, with spirochetes found in most affected tissues.
Area of Science:
- Infectious Diseases
- Neurology
- Dermatology
Background:
- Lyme disease, caused by Borrelia burgdorferi, exhibits complex multisystemic effects.
- The infection progresses through distinct stages, each with characteristic manifestations.
Purpose of the Study:
- To describe the varied multisystemic effects of Borrelia burgdorferi infection in Lyme disease.
- To detail the progression of Lyme disease through its stages and associated chronic manifestations.
Main Methods:
- Review of clinical presentations and pathological findings in Lyme disease patients.
- Identification of Borrelia burgdorferi spirochetes in affected tissues via silver staining and recovery.
Main Results:
- Stage I: acute, viral-like illness. Stage II: cardiovascular (myocarditis) and central nervous system (CNS) involvement (meningoencephalitis, polyradiculitis). Stage III: peripheral neuropathy, CNS disorders (dementia, myelitis), and large joint arthritis.
- Chronic Lyme disease is linked to diverse cutaneous manifestations including acrodermatitis chronica atrophicans and sclerodermoid-like reactions.
- Spirochetes were detected in most examined lesions, but not in autonomic ganglia or peripheral nerves.
Conclusions:
- Borrelia burgdorferi infection leads to a wide spectrum of multisystemic and cutaneous manifestations.
- The pathological findings underscore the diverse and unpredictable nature of Lyme disease progression.
- Further research may be needed to understand spirochetal presence in neurological tissues.