ABSTRACT
Lyme borreliosis is the most common vectorborne disease in the United States; other parts of the world in which this infection occurs include Europe, Russia, Japan, and China [1]. The causal agent of infection is a spirochete, Borrelia burgdorferi, which is transmitted by Ixodes ticks. Clinical manifestations ascribed to this multisystem disease include erythema migrans, borrelial lymphocytoma, acrodermatitis chronica atrophicans, carditis, arthritis, and neurologic conditions such as seventh nerve palsy [2]. Lyme disease was first reported in the United States in 1977 [3,4]. Today, almost 25 years later, Lyme disease remains a significant cause of morbidity with an increasing incidence in some established endemic regions along with geographic spread to new areas [5]. In the United States alone, approximately 10,000 cases of Lyme disease are reported annually [6].
