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The incidence of
Lyme disease is increasing, and the
disease is spreading geographically. Prompt diagnosis requires recognition of characteristic signs and symptoms of infection with the spirochete Borrelia burgdorferi. In more than half of cases, erythema migrans is the earliest sign of
Lyme disease. Although less frequently seen than erythema migrans, peripheral neuropathy of the seventh cranial nerve is another important sign. Tests for
Lyme disease await refinement, but laboratory evaluation can be helpful when
Lyme disease is suspected.