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A correction has been published: N Engl J Med 2008;358(10):1084.

Review Article
Current Concepts
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Volume 357:1422-1430 October 4, 2007 Number 14
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A Critical Appraisal of "Chronic Lyme Disease"
Henry M. Feder, Jr., M.D., Barbara J.B. Johnson, Ph.D., Susan O'Connell, M.D., Eugene D. Shapiro, M.D., Allen C. Steere, M.D., Gary P. Wormser, M.D., and the Ad Hoc International Lyme Disease Group

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Lyme disease, the most common tick-borne infection in the northern hemisphere, is a serious public health problem. In North America, it is caused exclusively by Borrelia burgdorferi sensu stricto (hereafter referred to as B. burgdorferi), whereas in Europe it is caused by B. afzelii, B. garinii, B. burgdorferi, and occasionally by other species of borrelia.1

This complex infection has a number of objective manifestations, including a characteristic skin lesion called erythema migrans (the most common presentation of early Lyme disease), certain neurologic and cardiac manifestations, and pauciarticular arthritis (the most common presentation of late Lyme disease), all of which . . . [Full Text of this Article]

Chronic Lyme Disease

Categories of Chronic Lyme Disease

Treatment of Post–Lyme Disease Symptoms

Persistent B. burgdorferi Infection and Post–Lyme Disease Symptoms

Advice to Clinicians

Chronic Lyme Disease in the Public Domain

Conclusions


Source Information

From the Departments of Family Medicine and Pediatrics, Connecticut Children's Medical Center, Hartford, and University of Connecticut Health Center, Farmington (H.M.F.); Microbiology Laboratory, Division of Vector-Borne Infectious Diseases, Centers for Diseases Control and Prevention, Fort Collins, CO (B.J.B.J.); Lyme Borreliosis Unit, Health Protection Agency Microbiology Laboratory, Southampton General Hospital, Southampton, United Kingdom (S.O.); Departments of Pediatrics and Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT (E.D.S.); Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston (A.C.S.); and the Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla (G.P.W.)

Address reprint requests to Dr. Feder at the Departments of Family Medicine and Pediatrics, University of Connecticut Health Center, Farmington, CT 06030, or at hfeder@nso2.uchc.edu.


Related Letters:

An Appraisal of "Chronic Lyme Disease"
Mayer L., Merz S., Maloney E. L., Holmes K. D., Volkman D. J., Cameron D. J., Drapkin M. S., Feder H. M. Jr., the Ad Hoc International Lyme Disease Group
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N Engl J Med 2008; 358:428-431, Jan 24, 2008. Correspondence

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