CLINICAL SIGNS AND TREATMENT
The clinical syndrome of Lyme disease is best described in humans(26,49). Clinically silent infections are common, mild manifestations are the general rule and severe disease is comparatively rare.
The frequency of individual manifestations varies depending on the age and physiological status of the patient and the infecting genospecies.The disease is traditionally staged in three stages, but a complete presentation of the disease is unusual.
Early, localized disease is characterized by the spreading of a painless, but sometimes itching erythema (EM) around the feeding site in a ring-like pattern. EM may be accompanied by malaise, fever, musculoskeletal pain, headache and fatigue and is most often caused by B. afzelii (70—90%), less frequently by B. garinii (10—20%), rarely by B. burgdorferi s.s. and only exceptionally by other species. Only a minor proportion (humans is doxycycline. Antibiotic therapy has no impact on post-Lyme syndrome. Some evidence suggests that B. burgdorferi may persist in some dogs following antibiotic treatment. Some researchers argue that this is a consequence of medication-induced formation of resistant cysts that have the potential to revert to produce viable spiro- chaetes when favourable conditions return(53).