Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Borrelia burgdorferi sensu lato — Lyme disease

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 29 October 2026 · Methodology

Borreliaceae · Spirochaete

Zoonose vectorielle la plus fréquente d'Europe et d'Amérique du Nord (tique Ixodes ricinus). Trois stades : (1) primaire : érythème migrant (EM) centrifuge ≥5cm autour de la morsure — diagnostic clinique suffisant, pas de sérologie nécessaire ; (2) secondaire (semaines–mois) : atteinte neurologique (méningoradiculite de Bannwarth), cardiaque (BAV), articulaire ; (3) tertiaire (mois–années) : arthrite de Lyme, encéphalopathie chronique. Sérologie : ELISA puis Western blot (stratégie 2 temps). ATB (HAS 2025) : doxycycline en 1re intention de l'érythème migrant (duration not verified) et de la neuroborréliose (duration not verified) — see cited source ; amoxicilline en 2e intention de l'érythème migrant ; ceftriaxone IV en 2e intention de la neuroborréliose.

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Borrelia burgdorferi sensu lato are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Skin — Érythème migrant	High tropism	Evidence B	2	direct
Central nervous system	High tropism	Evidence B	2	hematogenous
Bones / Joints	High tropism	Evidence B	1	hematogenous
Heart / Endocardium — Bloc auriculo-ventriculaire	Moderate tropism	Evidence B	2	hematogenous
Eye — Manifestations ophtalmologiques de Lyme	Rare tropism	Evidence B	3	hematogenous

Described portals of entry

• Skin

Spread routes recorded: 5 of 5 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Sources

• HAS — Borréliose de Lyme et autres maladies vectorielles à tiques (MVT) (recommandation de bonne pratique, actualisation 2025) (2025) — https://www.has-sante.fr/jcms/c_2857558/fr/borreliose-de-lyme-et-autres-maladies-vectorielles-a-tiques
• Lantos PM et al. — IDSA/AAN/ACR Clinical Practice Guidelines for Lyme Disease (2020) — doi:10.1093/cid/ciaa1215
• Steere AC et al. — Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities (Arthritis Rheum) (1977) — doi:10.1002/art.1780200102
• Mikkilä HO et al. — The expanding clinical spectrum of ocular Lyme borreliosis (Ophthalmology) (2000) — doi:10.1016/s0161-6420(99)00128-1

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