INTRODUCTION
Lyme disease is the most common tick-borne disease in the United States, Canada, and Europe. It is a spirochetal infection caused by seven or more species in the spirochete family Borreliaceae. The taxonomy of these spirochetes is undergoing revision, and the genus name may be represented as either Borrelia or Borreliella. In either case, the abbreviation for the genus is "B" and stands for both terminologies in the discussion below.In North America, infection is caused primarily by B. burgdorferi sensu stricto (hereafter called B. burgdorferi) and, less commonly, in a region of the upper Midwest, by B. mayonii. In Europe and Asia, infection is caused primarily by either B. afzelii or B. garinii, less commonly by B. burgdorferi, and even less commonly by B. spielmanii, B. lusitaniae, B. valaisiana, or B. bavariensis.
Lyme disease primarily affects the skin, joints, nervous system, and heart. There is a broad spectrum of manifestations, and the severity of disease is due, in part, to differences in the infecting species.
This topic will review the treatment of Lyme disease in adults and children. The microbiology, epidemiology, clinical manifestations, and diagnosis of Lyme disease are discussed elsewhere:
●(See "Microbiology of Lyme disease".)