The purpose of the study the clinical picture of a «new» infection — ixodic Lyme borreliosis caused by B. miyamotoi. The work is based on the results of a prospective observation of 76 patients with disease caused by B. miyamotoi. Diagnosis is confirmed by PCR. The study shows that a syndrome of fever and a manifestation of intoxication — headache, fatigue, myalgia, vomiting and other substances are at the heart of a typical clinical picture. In some cases, for unclear reasons, the pathological process involves internal organs — lungs, liver, kidney, gastrointestinal tract, heart. This fact may be the cause of a diagnostic error.

Aim. The objective of this study was to confirm the role of B. miyamotoi in the etiology of ITBB-WOEM in Udmurtia and to investigate in detail the clinical presentation of this "new" disease.Materials and methods. 50 adult patients with ITBB-WOEM treated in Republic Hospital for Infectious Diseases, Udmurtia, in 2010-2011 had PCR-confirmed infection by B. miyamotoi. The laboratory evidence of co-infection by other pathogens, including tick-borne encephalitis virus, B. burgdorferi sensu lato, A. phagocytophilum, E. chaffeensis, and E. muris, were absent. Results. All patients had a tick bite from 10 to 18 days before the acute disease onset. The main clinical signs were high fever, fatigue, headache, chill, and sweat. Clinical, biochemical, and instrumental investigations also showed the signs of functional impairment of various organs: the liver (in about half of the patients), kidney (in 10 patients), heart (6 patients), etc. In contrast, acute ITBB with erythema migrans was usually a localized infection without a pronounced intoxication syndrome and impairments of the organs. Conclusion. ITBB-WOEM caused by B. miyamotoi is a systemic disease that is clinically closer to relapsing fevers transmitted by argasid ticks than to Lyme borreliosis. The number of B. miyamotoi infections in Russia may be comparable with that of Lyme disease cases, so the investigations of epidemiology, clinical presentation and therapy of this "new" disease are urgently requested.

Recently possibilities detection bacterial patogenesis to ixodes pincers have extended so in 1995 in Japan for the first time have found out in I. persulcatus kind B. miyamotoi. The role of this microorganism in a pathology of the person is widely discussed.The conducted research is devoted studying of features of defeat of lungs at the disease caused B. miyamotoi. The attention to possible defeat of lungs is paid at borreliosis miyamotoi. This weight and the form of this defeat can vary from nonspecific hypervolemia a small circle (8,8 %) and a bronchitis (17,6 %) to a pneumonia (8,8 %), arising in a debut of disease and complicating a clinical substantiation of the diagnosis.Possibility of a clinical course with a primary respiratory component is underlined, it is offered to allocate the catarrhal clinical form of disease (so-called ОRD without a pneumonia), a pneumonia to consider as complication borreliosis miyamotoi.