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Lyme disease is a tick-borne illness caused by the spirochetal bacterium Borrelia burgdorferi. Recognition of the clinical manifestations and geographic range of this illness has expanded rapidly in recent years. Although much remains to be explained about this infection, most patients can be treated effectively on the basis of the clinical experience gathered to date. Antibiotics are the mainstay of therapy for all stages of illness. Development of a vaccine and improvement in laboratory diagnostic techniques glimmer on the horizon but will not replace careful clinical observation and follow-up as the foundations of management.