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Analyzing the clinical observations of 1343 patients, made in the Kama river region in 1991 to 2002, could establish a number of characteristic syndromes of the acute period of Ixodes tick-borne borreliotosis (ITBB). The early period of the diseases manifested itself as two forms: erythematous in 1041 (77.5%) patients and erythema-free in 302 (22.5%). The erythematous form was characterized by the occurrence of the major clinical marker–erythema migrans at the site of tick suction. In Russia, the clinical features of the acute phase of borreliotosis were marked by the early (at weeks 2-3 of the
disease) affliction of different organs (the liver) and systems (the nervous, cardiovascular, and locomotor ones). The leading clinical types of the erythema-free ITBB were neurological, arthromyalgic, influenza-like, cardiovascular, hepatitis, regional lymphadenitis, and mixed. The diagnosis of ITBB is established on the basis of a characteristic epidemiological history, clinical manifestations by taking into account the most common types of its early period and the data of a serological survey by the proposed algorithm.