Lyme borreliosis: a European perspective on diagnosis and clinical management.

PURPOSE OF REVIEW: Lyme borreliosis has been widely recognized in Europe, but diagnostic and therapy concepts are still a matter for discussion. False-positive microbiologic results can lead to unnecessary antibiotic treatment, which even in genuine cases is sometimes unnecessarily prolonged. This review addresses new research on diagnosis, treatment, and eco-epidemiology. RECENT
FINDINGS: Recent research work in Europe since the last annual review has mostly dealt with diagnostic concepts. Improvement of serology has been achieved by use of multiple recombinant or peptide antigens, or of just the most frequently targeted antigen for detection of specific immunoglobulin G or immunoglobulin M antibodies to Borrelia burgdorferi sensu lato, the causative agent of Lyme borreliosis. Concerning management of the disease, early work on the efficacy of oral treatment of Lyme neuroborreliosis has been confirmed. Studies on the ecology of the vectors and pathogens have elucidated aspects of epidemiology.
SUMMARY: Widespread awareness of Lyme borreliosis in Europe continues to grow due to increasing numbers of medical publications, information on the Internet, and from the media and patient support groups. The emphasis in scientific and medical publications has been on improvements in laboratory diagnostics, confirmation of therapeutic protocols, and the ecology of the vectors and pathogens.