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Borrelia Burgdoferi is the predominant cause in the U.S., whereas Borrelia garinii and Borrelia afzelli are implicated in most European cases. This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection.
The disease presentation varies widely typically beginning with flu-like symptoms and a characteristic bullseye rash which is known to occur in less than 25% of cases. This is why Lyme disease is commonly misdiagnosed or goes unnoticed. In the second stage, musculoskeletal and neurological symptoms may begin to occur along with cardiac manifestations. Other common symptoms may include lack of energy, poor focus and concentration known as brain fog, poor quality of sleep, poor memory, anxiety, or depression to name a few.
Co-infections such as Bartonella or Babesia are usually seen with Lyme patients causing the symptoms to vary from person to person. Lyme disease especially in its chronic stage is commonly misdiagnosed as fibromyalgia, multiple sclerosis, bipolar, depression, anxiety, chronic fatigue syndrome, ALS, IBS, Crohn’s disease, RA, and/or thyroid disease. Late or inadequate treatment can lead to late stage chronic Lyme disease that can be disabling and very difficult to treat.