Enfermedad de LymeLyme disease

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Resumen

La enfermedad de Lyme (EL) es un proceso multisistémico, de distribución universal, provocado por Borrelia burgdorferi sensu lato (s.l.) y transmitido por garrapatas duras. De hecho, es la enfermedad transmitida por garrapatas más frecuente del hemisferio norte. En España la transmite la garrapata Ixodes ricinus y la genoespecie de B. burgdorferi s.l. mayormente implicada es Borrelia garinii. A la EL se la conoce como “el último gran imitador”, por el amplio espectro clínico que puede provocar. Salvo en el caso de eritema migratorio (patognomónico de la enfermedad), el resto de manifestaciones clínicas deben confirmarse mediante pruebas microbiológicas.

Esta revisión pretende proporcionar a los lectores una visión actual sobre la etiología, epidemiología, manifestaciones clínicas, diagnóstico de laboratorio y tratamiento de la enfermedad en nuestro medio. Se resaltan aspectos polémicos originados por la utilización de pruebas microbiológicas no validadas que están siendo utilizadas sin rigor científico.

Abstract

Lyme disease (LD) is a worldwide-distributed multisystemic process caused by Borrelia burgdorferi sensu lato (s.l.) and transmitted by hard ticks. In fact, it is the most common tick-borne infectious disease in the northern hemisphere. In Spain it is transmitted by Ixodes ricinus ticks and Borrelia garinii is the genoespecies of B. burgdorferi s.l. mostly involved in our area. LD is known as “the last great imitator” due to the broad clinical spectrum that may cause. Except in the case of erythema migrans (pathognomonic feature of the disease), the remaining clinical manifestations should be confirmed using microbiological tests.

This review is intended to provide readers a current vision of the etiology, epidemiology, clinical manifestations, laboratory diagnosis and treatment of Lyme disease in our environment. Controversial aspects arising from the use of non-validated microbiological tests that are being used without scientific rigor are highlighted.

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