Lyme disease

The study of Lyme disease challenges traditional concepts of the separation of disciplines in clinical medicine and the biomedical sciences. The manifestations of this illness span the areas of dermatology, rheumatology, neurology, cardiology, and infectious disease. Study of the epidemiology of Lyme disease is inseparable from an examination of the molecular biology of B. burgdorferi and the ecology of the tick vectors of this protean disease. The answers to the remaining questions concerning the pathogenesis of infection, mechanism(s) of disease persistence, and variability of clinical expression in Lyme disease are almost certainly to be found in a better understanding of the molecular biology of B. burgdorferi. This is of obvious interest to rheumatologists who routinely treat patients suffering from illnesses notorious for their variability in clinical expression. Because the causative organism has been isolated and can be studied, Lyme disease can function as a model for other chronic rheumatic and neurologic diseases with similarities in clinical expression but with no known relationship to an infectious organism.