LYME BORRELIOSIS - HOW DOES IT MANIFEST IN SPAIN

BACKGROUND: Lyme borreliosis is not usually diagnosed in Spanish patie nts since before 1987. The aim of this study was to know the clinical spectrum of infection by Borrelia burgdorferi in Spain by a prospectiv e epidemiologic study. METHODS: The period of collection of cases was from 1987 to 1989 and the follow-up period was of 2 years following di agnosis. Detection of serum antibodies was performed by indirect immun ofluorescence and ELISA to patients with clinical suspicion of Lyme bo rreliosis established in 17 Spanish hospitals. The clinical and serolo gic data and the possibility of other disease which could justify the symptoms were evaluated with the doctor responsible for the patient. R ESULTS: Fifty-four patients with clinical manifestations and serologic data indicative of the disease and in whom other diagnosis were exclu ded were detected. Other diseases which could be the cause of the symp tomatology were diagnosed in 26 patients with positive serology. Sixty -three percent of the patients had neurologic symptoms, 46 % articular symptoms, 44 % cutaneous symptoms and 9 % cardiac symptoms. CONCLUSIO NS: Lyme borreliosis is not excepcional in Spain. Its clinical spectru m may be situated half way between American and European epidemiologic descriptions. Serology must be interpreted by the clinical manifestat ions.