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Lyme disease, which is caused by the tick-borne spirochete Borrelia burgdorferi, usually begins with a characteristic skin lesion erythema chronicum migrans (ECM), that may be followed by neurological or cardiac abnormalities and is accompanied by malaise, fatigue, fever, myalgia, headache, lymphadenopathy and is often followed by arthritis. The
disease takes its name from
Lyme, Connecticut, where the full spectrum of illness was first described in 1975. It is known to be a multisystemic infectious
disease. Because culture and direct visualisation of spirochetes are often negative in
Lyme disease, serological testing has been the only practical laboratory aid in diagnosis and primarily clinical findings.