Lyme disease (Lyme borreliosis) is a tick-borne, zoonosis of adults and children caused by genospecies of the Borrelia burgdorferi sensu lato complex. The ailment, widespread throughout the Northern Hemisphere, continues to increase globally due to multiple environmental factors, coupled with increased incursion of humans into habitats that harbor the spirochete. B. burgdorferi sensu lato is transmitted by ticks from the Ixodes ricinus complex. In North America, B. burgdorferi causes nearly all infections; in Europe, B. afzelii and B. garinii are most associated with human disease. The spirochete's unusual fragmented genome encodes a plethora of differentially expressed outer surface lipoproteins that play a seminal role in the bacterium's ability to sustain itself within its enzootic cycle and cause disease when transmitted to its incidental human host. Tissue damage and symptomatology (i.e., clinical manifestations) result from the inflammatory response elicited by the bacterium and its constituents. The deposition of spirochetes into human dermal tissue generates a local inflammatory response that manifests as erythema migrans (EM), the hallmark skin lesion. If treated appropriately and early, the prognosis is excellent. However, in untreated patients, the disease may present with a wide range of clinical manifestations, most commonly involving the central nervous system, joints, or heart. A small percentage (~10%) of patients may go on to develop a poorly defined fibromyalgia-like illness, post-treatment Lyme disease (PTLD) unresponsive to prolonged antimicrobial therapy. Below we integrate current knowledge regarding the ecologic, epidemiologic, microbiologic, and immunologic facets of Lyme disease into a conceptual framework that sheds light on the disorder that healthcare providers encounter.

中文翻译：

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人类莱姆病。

莱姆病（莱姆疏螺旋体病）是一种由蜱传的成人和儿童人畜共患病，由伯氏疏螺旋体复合体基因种引起。由于多种环境因素以及人类对螺旋体栖息地的入侵增加，这种疾病在整个北半球广泛传播，并在全球范围内继续增加。伯氏疏螺旋体是通过蓖麻硬蜱传播的。在北美，伯氏疏螺旋体几乎引起所有感染；在欧洲，B. afzelii和B. garinii与人类疾病关系最为密切。螺旋体不寻常的片段化基因组编码大量差异表达的外表面脂蛋白，这些脂蛋白对于细菌在其地方性动物循环中维持自身并在传播到偶然的人类宿主时引起疾病的能力发挥着重要作用。组织损伤和症状（即临床表现）是由细菌及其成分引起的炎症反应引起的。螺旋体沉积到人体真皮组织中会产生局部炎症反应，表现为游走性红斑 (EM)，这是一种标志性皮肤病变。如果及早治疗，预后良好。然而，在未经治疗的患者中，该疾病可能会出现多种临床表现，最常见的是中枢神经系统、关节或心脏。一小部分（~10%）患者可能会继续发展为一种定义不清的纤维肌痛样疾病，即治疗后莱姆病（PTLD），对长期抗菌治疗无反应。下面我们将有关莱姆病的生态学、流行病学、微生物学和免疫学方面的最新知识整合到一个概念框架中，以阐明医疗保健提供者遇到的疾病。