Infection with Borrelia burgdorferi sensu lato causes Lyme disease, a multisystem inflammatory disease transmitted by infected Ixodes ticks.[1][2] The disease is endemic in North America, Europe, and Asia, with incidence influenced by tick distribution.[1][2] The risk of transmission increases with the length of time the tick is attached, for example reaching 70% after 36 hours.[1][5] The best-known symptom of the early localized form is erythema migrans (EM), which appears 3–30 days after attachment at the bite site.[1][2][3] EM often has central fading, distinct peripheral margins without elevation.[1][2][4] It is estimated that 70–95% of infections are asymptomatic and 50% of untreated patients progress to a disseminated form.[2][3][4] The disease occurs in three stages.[3][4]