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Lyme disease — infection with the tickborne spirochete Borrelia burgdorferi — is becoming more common, and its geographic zone is enlarging. The infection has protean manifestations and has been blamed for chronic symptoms of arthritis and fatigue. The most common initial symptom is erythema migrans (EM), a target-like lesion. Some patients, despite appropriate antibiotic treatment, experience recurrent EM. Distinguishing reinfection from relapse in these individuals can be difficult, and the issue remains controversial.
To explore this matter, researchers compared B. burgdorferi isolates from the skin or blood of adults with recurrent EM (17 patients, 22 paired consecutive episodes). All patients were treated with standard courses of antibi…