All Posts Tagged With: "Lyme borreliosis"

Full article: http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=20461540&retmode=ref&cmd=prlinks

Excerpt:

OBJECTIVE: By using the published incidence of Lyme borreliosis
in endemic regions of the World, and the sensitivity and
specificity data of the best Lyme serological tests, we computed
the positive predictive value of Borrelia burgdorferi antibody
testing. METHODS: The calculation of predictive value was based
on Bayes’ theorem. We also analyzed the frequency distribution of
the specific and non-specific symptoms and complaints of 27,194
patients sent to the Centre for Tick-borne Diseases in Budapest
from 1986 to 2008. RESULTS: This evaluation demonstrated that
practitioners often use Lyme serology in a “trial and error” way,
without any reasonable ground. According to our calculation the
positive predictive value of the best Lyme antibody tests if
applied in this way is <9.1%. CONCLUSION: Our study suggests that
the present practice of applying Lyme serological tests may
result in more harm than benefit.
 

Excerpt:

This case serves to underscore several clinical points. Firstly, Lyme borreliosis may present by mimicking a malignancy. Secondly, a previous episode of borrelial infection may not confer immunity. Reinfection is uncommon, but is more likely to occur in patients whose previous episode was promptly treated rather than in those with longstanding infection, who have a well‐developed antibody response before treatment.5 Thirdly, patients may not specifically recall a tick bite. Thus, it is important that a history of tick exposure risk, which may be residential, occupational or recreational, is sought from patients. Finally, Beevor’s sign has a useful localisation value

Full article: http://aac.asm.org/cgi/content/full/49/4/1294

Excerpt:

Clinical treatment failures have been reported to occur in early Lyme borreliosis (LB) for many suitable antimicrobial agents. Investigations of possible resistance mechanisms of the Borrelia burgdorferi complex must analyze clinical isolates obtained from LB patients, despite their receiving antibiotic treatment. Here, borrelial isolates obtained from five patients with erythema migrans (EM) before the start of antibiotic therapy and again after the conclusion of treatment were investigated. The 10 isolates were characterized by restriction fragment length polymorphism analysis and plasmid profile analysis and subjected to susceptibility testing against a variety of antimicrobial agents including those used for initial chemotherapy. Four out of five patients were infected by the same genospecies (Borrelia afzelii, n = 3; Borrelia garinii, n = 1) at the site of the EM lesion before and after antimicrobial therapy. In one patient the genospecies of the initial isolate (B. afzelii) differed from that of the follow-up isolate (B. garinii). No significant changes in the in vitro susceptibilities became obvious for corresponding clinical isolates before the start and after the conclusion of antimicrobial therapy. This holds true for the antimicrobial agents used for specific chemotherapy of the patients, as well as for any of the additional agents tested in vitro.

Excerpt:

Lyme borreliosis differs in dogs and humans in terms of clinical
outcome following infection, diagnostic approaches, prevention
strategies and treatment recommendations. Nonetheless, serologic
evidence of exposure of dogs to B. burgdorferi agrees with the
geographical distribution of autochthonous transmission of the
agent of Lyme borreliosis, and continued monitoring of exposure
rates in dogs might allow early recognition of geographic
expansion of endemic areas as well as identify hyperendemic areas
where both humans and dogs are at increased risk of infection.
Copyright (c) 2010. Published by Elsevier Ltd. Continued

Full article: http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=000209229

Excerpt:

Lyme serology was positive for both IgG and IgM (ELISA, Enzygnost
Borreliosis , Siemens, Dade Behring, Germany, and blot,
Euroline WB , Euroimmun, Germany). A punch biopsy of a papule showed a dermal perifollicular ( fig. 2 ) – and occasionnally perineural – infiltrate of lymphocytes and plasma cells, consistent with a borrelial infection. Borrelia burgdorferi DNA was amplified from fresh tissue obtained from a skin biopsy performed on a peripilar papule, using a specific real-time PCR according to Mäkinen et al. [1] (culture not performed). The erythema resolved after a 3-week doxycycline treatment whereas arthralgia and dysesthesia persisted.

Excerpt:

Borrelia burgdorferi sensu lato is the causative agent
of Lyme borreliosis in humans. This inflammatory disease can
affect the skin, the peripheral and central nervous system, the
musculoskeletal and cardiovascular system and rarely the eyes.
Early stages are directly associated with viable bacteria at the
site of inflammation. The pathogen-host interaction is complex
and has been elucidated only in part. B. burgdorferi is highly
susceptible to antibiotic treatment and the majority of patients
profit from this treatment

 The Lyme borreliosis agent Borrelia burgdorferi and the relapsing fever group
species Borrelia miyamotoi co-occur in the United States. We used
species-specific, quantitative polymerase chain reaction to study both species
in the blood and skin of Peromyscus leucopus mice and host-seeking Ixodes
scapularis nymphs at a Connecticut site. Bacteremias with B. burgdorferi or B.
miyamotoi were most prevalent during periods of greatest activity for nymphs or
larvae, respectively. Continued

Among the various species of hard ticks, Ixodes ricinus is the most frequently found tick throughout Europe. As with other ixodid ticks, the developmental cycle runs through three stages. In each stage a blood meal is required in order to develop to the next stage. Ixodes ricinus has been found to feed on more than 300 different vertebrate species. Usually, larval ticks feed on small mammals such as mice and become infected with various microorganisms and viruses, of which some are substantial pathogens to humans. The pathogens remain in the tick during molting and are thus transstadially transmitted to the next developmental stage. Pathogens transmitted to humans are the agents of Lyme borreliosis, the tick-borne encephalitis virus, Rickettsia species, Anaplasma phagocytophilum, occasionally Francisella tularensis, and protozoal Babesia species. Within the scope of an EU project Ixodes ricinus ticks from all federal states of Austria were searched by means of PCR methods for bacterial pathogens such as Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Coxiella burnetii, Ehrlichia spp., Francisella tularensis, Rickettsia spp., and protozoal Babesia. Additionally, the prevalence of Bartonella spp. in this tick species was also determined. Besides the singular detection of Coxiella burnetii and Francisella tularensis in one tick collection site the overall prevalence of Anaplasma phagocytophilum, borreliae, rickettsae and babesiae in Ixodes ricinus amounted to 15%, 14%, 6% and surprising 36% and 51%, respectively. Bartonellae were detected in about 7%. Continued

Background.Standard 2‐tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second‐tier IgG blot that performs well throughout the infection. Continued

BACKGROUND: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome.

METHODS: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years.

RESULTS: Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies. Continued