Lyme disease is a vector-borne infection, primarily transmitted by Ixodes ticks, and caused by Borrelia burgdorferi. It has a wide distribution in the northern hemisphere. In Korea, however, only one human case has been reported, although B. burgdorferi was isolated from the vector tick I. persulcatus in the region. A 60-year-old male and a 45-year-old female developed the clinical sign of erythema migrans. Each patients were bitten by a tick four weeks and five weeks, respectively, before entering the hospital. On serologic examination, significantly increased IgM and IgG antibody titers to B. burgdorferi were observed in consecutive tests performed at an interval of two weeks. They responded well to treatment with tetracycline.
Case Report ; Erythema Chronicum Migrans/pathology* ; Erythema Chronicum Migrans/immunology ; Erythema Chronicum Migrans/drug therapy ; Female ; Human ; Korea ; Lyme Disease/pathology* ; Lyme Disease/immunology ; Lyme Disease/drug therapy ; Male ; Middle Age

Lyme borreliosis is a multi-systemic tick-borne infectious disease caused by the spirochaete, Borrelia burgdorferi. It has many non-specific symptoms affecting the skin, eye, musculoskeletal system, cardiovascular system, and central and peripheral nervous system. Typical cutaneous manifestations of lyme borreliosis include erythema chronicum migrans, borrelia lymphocytoma appearing a few weeks after the tick bite, and acrodermatitis chronica atrophicans developing a few years after. The diagnosis is based on clinical findings with detection of specific Ig M and Ig G antibodies to Borrelia burgdorferi. A 50-year old woman presented with an erythematous to violaceous annular patch with central scaly hyperpigmented patch on the right arm and an erythematous indurated patch on the right thigh for a month. She did not recall a deer tick bite. She had severe arthralgia on the right shoulder and myalgia on the right thigh at the first visit. Three months later, she complained of chest pain, and mild dyspnea on exertions. Serologic examinations revealed increased levels of Ig M and Ig G antibodies to borrelial antigen via ELISA, and Western blot test for Borrelia burgdorferi was positive. Her general symptoms as well as skin lesions subsided with an antibiotics (Doxycycline) and steroid therapy over 4 weeks.
Acrodermatitis ; Anti-Bacterial Agents ; Antibodies ; Arm ; Arthralgia ; Bites and Stings ; Blotting, Western ; Borrelia ; Borrelia burgdorferi ; Cardiovascular System ; Chest Pain ; Communicable Diseases ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Erythema Chronicum Migrans ; Eye ; Female ; Humans ; Ixodes ; Lyme Disease ; Musculoskeletal System ; Peripheral Nervous System ; Pseudolymphoma ; Shoulder ; Skin ; Thigh ; Ticks