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Sample records for acute lyme neuroborreliosis

  1. Lyme neuroborreliosis

    Correll, Mette Hedegaard; Datta, N; Arvidsson, Henrik Sven Strandbygaard;

    2015-01-01

    BACKGROUND: Lyme neuroborreliosis (LNB) designates central nervous system involvement caused by the tick-borne spirochaete Borrelia burgdorferi (Bb). The present study describes a spectrum of acquired ocular motor disorders in children with LNB. METHODS: Six paediatric patients (age 3-15 years...... partial sixth nerve palsy, one with ptosis and one with Adie's pupil. Five of the patients presented with severe fatigue, malaise, nausea, headache and fever. Four had recognised a tick bite recently, and two developed erythema migrans. Intrathecal synthesis of IgM and/or IgG antibodies specific for Bb...

  2. Lyme neuroborreliosis

    Hansen, Klaus; Crone, Clarissa; Kristoferitsch, Wolfgang

    2013-01-01

    Lyme neuroborreliosis (LNB) designates the nervous system disorders caused by the tick-borne spirochete Borrelia burgdorferi (Bb). The clinical syndromes are usually distinct and are classified as early and the rare late or chronic LNB. Early LNB occurs 3-6 weeks after infection most frequently as...... and meningovascular CNS involvement, whereas the peripheral nervous system is not primarily affected. In early and late LNB the diagnosis is based on a characteristic clinical appearance and CSF inflammation with Bb-specific intrathecal antibody production. Both conditions, but not the ACA...... biopsies, autopsies, animal models, and nerve conduction studies showed that the pathology is a lymphocytic perineuritis leading to multisegmental axonal injury of nerve roots, spinal ganglia, and distal nerve segments. Due to meningeal and root inflammation cerebrospinal fluid (CSF) shows lymphocytic...

  3. Unilateral phrenic nerve lesion in Lyme neuroborreliosis

    Djukic Marija; Larsen Jörg; Lingor Paul; Nau Roland

    2013-01-01

    Abstract Background Among a variety of more common differential diagnoses, the aetiology of acute respiratory failure includes Lyme neuroborreliosis. Case presentation We report an 87-years old huntsman with unilateral phrenic nerve palsy as a consequence of Lyme neuroborreliosis. Conclusion Although Lyme neuroborreliosis is a rare cause of diaphragmatic weakness, it should be considered in the differential workup because of its potentially treatable nature.

  4. Lyme neuroborreliosis

    Milovanović Aleksandar

    2011-01-01

    Full Text Available Lyme borreliosis (LB is a multisystemic zoonotic disease which in humans can involve the skin, joints, heart and/or nervous system. In this study a total of 11 patients with clinical manifestations have been assessed at the Institute for Occupational Health. Evaluation of the patients was done in order to determine their working capability and further professional orientation. Patients were of different gender, age, education and profession. They fulfilled at least two of the three criteria: tick infestation data (epidemiological criteria, central and/or peripheral neurological symptoms (clinical criteria and a positive serological finding. Diagnosis was done upon classical clinical criteria: electromyeloneurography (EMNG analysis, neurological impairments, electroencephalography (EEG, computer tomography (CT and/or magnetic resonance imaging (MRI. IgM and IgG antibodies against B. burgdorferi were determined by commercial ELISA kits. IgM antibodies were recorded in the serum of 4 (44.4% and IgG in 6 (66.7% patients. Electro-myeloneurography findings of the upper and lower limbs were positive in 5 (83.3%, electroencephalography in 4 (66.6% of the 6 observed patients and CT was positive in 4 (36.4% of the 5 observed patients. The study has established that in patients with neuroborreliosis (NB the capability to carry out intellectual tasks, as well as responsible duties is impaired due to poor memory. Patients suffering from peripheral neuropathies are not fit to withstand longterm walks, weight lifting and carrying or any other form of physical stress.

  5. Lyme neuroborreliosis

    Milovanović Aleksandar; Milovanović J.; Obrenović Sonja; Milovanović Anđela; Simonović P.; Čemerikić D.; Tačević Z.; Petronić Ivana; Grajić M.; Kekuš Divna; Popević M.

    2011-01-01

    Lyme borreliosis (LB) is a multisystemic zoonotic disease which in humans can involve the skin, joints, heart and/or nervous system. In this study a total of 11 patients with clinical manifestations have been assessed at the Institute for Occupational Health. Evaluation of the patients was done in order to determine their working capability and further professional orientation. Patients were of different gender, age, education and profession. They fulfilled...

  6. The clinical spectrum of Lyme neuroborreliosis.

    Elamin, M

    2010-02-01

    Lyme disease is a multisystem infectious disease, endemic in parts of Europe, including the West of Ireland. Neurological manifestions (neuroborreliosis) are variable. Presenting neurological syndromes include meningitis, cranial neuropathies, myeloradiculitis and mononeuritis multiplex. A lack of specificity in serological diagnosis may add to diagnostic confusion. We reviewed thirty cases of acute Lyme disease in the West of Ireland and found neurological syndromes in 15 (50%), with painful radiculopathy (12 patients; 80%) and cranial neuropathy (7 patients; 46%) occurring frequently. Neuroborreliosis needs to be considered in the differential diagnosis of these neurological syndromes in the appropriate clinical context.

  7. Gender Differences in Childhood Lyme Neuroborreliosis

    Dag Tveitnes; Knut Øymar

    2015-01-01

    Background. Many neurological diseases show differences between genders. We studied gender differences in childhood Lyme neuroborreliosis (LNB) in an endemic area of Lyme borreliosis in Norway. Methods. In a population based study, all children (

  8. Inflammation in the Pathogenesis of Lyme Neuroborreliosis

    Ramesh, Geeta; Didier, Peter J.; England, John D.; Santana-Gould, Lenay; Doyle-Meyers, Lara A.; Martin, Dale S.; Jacobs, Mary B.; Philipp, Mario T.

    2016-01-01

    Lyme neuroborreliosis, caused by the spirochete Borrelia burgdorferi, affects both peripheral and central nervous systems. We assessed a causal role for inflammation in Lyme neuroborreliosis pathogenesis by evaluating the induced inflammatory changes in the central nervous system, spinal nerves, and dorsal root ganglia (DRG) of rhesus macaques that were inoculated intrathecally with live B. burgdorferi and either treated with dexamethasone or meloxicam (anti-inflammatory drugs) or left untreated. ELISA of cerebrospinal fluid showed significantly elevated levels of IL-6, IL-8, chemokine ligand 2, and CXCL13 and pleocytosis in all infected animals, except dexamethasone-treated animals. Cerebrospinal fluid and central nervous system tissues of infected animals were culture positive for B. burgdorferi regardless of treatment. B. burgdorferi antigen was detected in the DRG and dorsal roots by immunofluorescence staining and confocal microscopy. Histopathology revealed leptomeningitis, vasculitis, and focal inflammation in the central nervous system; necrotizing focal myelitis in the cervical spinal cord; radiculitis; neuritis and demyelination in the spinal roots; and inflammation with neurodegeneration in the DRG that was concomitant with significant neuronal and satellite glial cell apoptosis. These changes were absent in the dexamethasone-treated animals. Electromyography revealed persistent abnormalities in F-wave chronodispersion in nerve roots of a few infected animals; which were absent in dexamethasone-treated animals. These results suggest that inflammation has a causal role in the pathogenesis of acute Lyme neuroborreliosis. PMID:25892509

  9. Gender Differences in Childhood Lyme Neuroborreliosis

    Dag Tveitnes

    2015-01-01

    Full Text Available Background. Many neurological diseases show differences between genders. We studied gender differences in childhood Lyme neuroborreliosis (LNB in an endemic area of Lyme borreliosis in Norway. Methods. In a population based study, all children (<14 years of age with symptoms suspicious of LNB, including all children with acute facial nerve palsy, were evaluated for LNB by medical history, clinical examination, blood tests, and lumbar puncture. LNB was diagnosed according to international criteria. Results. 142 children were diagnosed with LNB during 2001–2009. Facial nerve palsy was more common in girls (86% than in boys (62% p<0.001, but headache and/or neck stiffness as the only symptom was more common in boys (30% than in girls (10% p=0.003. The girls were younger than boys and had a shorter duration of symptoms, but boys had a higher level of pleocytosis than girls. In a multivariate analysis, both gender and having headache and neck stiffness were associated with a higher level of pleocytosis. Conclusion. Girls and boys have different clinical presentations of LNB, and boys have a higher level of inflammation than girls independent of the clinical presentation.

  10. Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism

    Anckarsäter Henrik

    2010-06-01

    Full Text Available Abstract Background The metabolism of amyloid precursor protein (APP and β-amyloid (Aβ is widely studied in Alzheimer's disease, where Aβ deposition and plaque development are essential components of the pathogenesis. However, the physiological role of amyloid in the adult nervous system remains largely unknown. We have previously found altered cerebral amyloid metabolism in other neuroinflammatory conditions. To further elucidate this, we investigated amyloid metabolism in patients with Lyme neuroborreliosis (LNB. Methods The first part of the study was a cross-sectional cohort study in 61 patients with acute facial palsy (19 with LNB and 42 with idiopathic facial paresis, Bell's palsy and 22 healthy controls. CSF was analysed for the β-amyloid peptides Aβ38, Aβ40 and Aβ42, and the amyloid precursor protein (APP isoforms α-sAPP and β-sAPP. CSF total-tau (T-tau, phosphorylated tau (P-tau and neurofilament protein (NFL were measured to monitor neural cell damage. The second part of the study was a prospective cohort-study in 26 LNB patients undergoing consecutive lumbar punctures before and after antibiotic treatment to study time-dependent dynamics of the biomarkers. Results In the cross-sectional study, LNB patients had lower levels of CSF α-sAPP, β-sAPP and P-tau, and higher levels of CSF NFL than healthy controls and patients with Bell's palsy. In the prospective study, LNB patients had low levels of CSF α-sAPP, β-sAPP and P-tau at baseline, which all increased towards normal at follow-up. Conclusions Amyloid metabolism is altered in LNB. CSF levels of α-sAPP, β-sAPP and P-tau are decreased in acute infection and increase after treatment. In combination with earlier findings in multiple sclerosis, cerebral SLE and HIV with cerebral engagement, this points to an influence of neuroinflammation on amyloid metabolism.

  11. Clinical characteristics and cerebrospinal fluid parameters in patients with peripheral facial palsy caused by Lyme neuroborreliosis compared with facial palsy of unknown origin (Bell's palsy

    Hagberg Lars

    2011-08-01

    Full Text Available Abstract Background Bell's palsy and Lyme neuroborreliosis are the two most common diagnoses in patients with peripheral facial palsy in areas endemic for Borrelia burgdorferi. Bell's palsy is treated with corticosteroids, while Lyme neuroborreliosis is treated with antibiotics. The diagnosis of Lyme neuroborreliosis relies on the detection of Borrelia antibodies in blood and/or cerebrospinal fluid, which is time consuming. In this study, we retrospectively analysed clinical and cerebrospinal fluid parameters in well-characterised patient material with peripheral facial palsy caused by Lyme neuroborreliosis or Bell's palsy, in order to obtain a working diagnosis and basis for treatment decisions in the acute stage. Methods Hospital records from the Department of Infectious Diseases, Sahlgrenska University Hospital, for patients with peripheral facial palsy that had undergone lumbar puncture, were reviewed. Patients were classified as Bell's palsy, definite Lyme neuroborreliosis, or possible Lyme neuroborreliosis, on the basis of the presence of Borrelia antibodies in serum and cerebrospinal fluid and preceding erythema migrans. Results One hundred and two patients were analysed; 51 were classified as Bell's palsy, 34 as definite Lyme neuroborreliosis and 17 as possible Lyme neuroborreliosis. Patients with definite Lyme neuroborreliosis fell ill during the second half of the year, with a peak in August, whereas patients with Bell's palsy fell ill in a more evenly distributed manner over the year. Patients with definite Lyme neuroborreliosis had significantly more neurological symptoms outside the paretic area of the face and significantly higher levels of mononuclear cells and albumin in their cerebrospinal fluid. A reported history of tick bite was uncommon in both groups. Conclusions We found that the time of the year, associated neurological symptoms and mononuclear pleocytosis were strong predictive factors for Lyme neuroborreliosis as a

  12. Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

    Stuart Orsher; Younger, David S.

    2010-01-01

    Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serolo...

  13. Residual orofacial complaints following Lyme neuroborreliosis: an unusual case of TMD

    E. te Veldhuis; F. Lobbezoo; A. te Veldhuis; C. Visscher; M. Naeije; M. van Selms

    2011-01-01

    Patients with tick-borne Lyme neuroborreliosis (LNB) can present with a variety of symptoms, and frequently the oral and maxillofacial areas are affected. Even though treatment with antibiotics generally results in a remission of symptoms, patients with permanent nerve damage may show residual sympt

  14. A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

    Vivek Verma

    2014-12-01

    Full Text Available A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.

  15. Possible role of glial cells in the onset and progression of Lyme neuroborreliosis

    Jacobs Mary B

    2009-08-01

    Full Text Available Abstract Background Lyme neuroborreliosis (LNB may present as meningitis, cranial neuropathy, acute radiculoneuropathy or, rarely, as encephalomyelitis. We hypothesized that glia, upon exposure to Borrelia burgdorferi, the Lyme disease agent, produce inflammatory mediators that promote the acute cellular infiltration of early LNB. This inflammatory context could potentiate glial and neuronal apoptosis. Methods We inoculated live B. burgdorferi into the cisterna magna of rhesus macaques and examined the inflammatory changes induced in the central nervous system (CNS, and dorsal root nerves and ganglia (DRG. Results ELISA of the cerebrospinal fluid (CSF showed elevated IL-6, IL-8, CCL2, and CXCL13 as early as one week post-inoculation, accompanied by primarily lymphocytic and monocytic pleocytosis. In contrast, onset of the acquired immune response, evidenced by anti-B. burgdorferi C6 serum antibodies, was first detectable after 3 weeks post-inoculation. CSF cell pellets and CNS tissues were culture-positive for B. burgdorferi. Histopathology revealed signs of acute LNB: severe multifocal leptomeningitis, radiculitis, and DRG inflammatory lesions. Immunofluorescence staining and confocal microscopy detected B. burgdorferi antigen in the CNS and DRG. IL-6 was observed in astrocytes and neurons in the spinal cord, and in neurons in the DRG of infected animals. CCL2 and CXCL13 were found in microglia as well as in endothelial cells, macrophages and T cells. Importantly, the DRG of infected animals showed significant satellite cell and neuronal apoptosis. Conclusion Our results support the notion that innate responses of glia to B. burgdorferi initiate/mediate the inflammation seen in acute LNB, and show that neuronal apoptosis occurs in this context.

  16. Childhood neuroborreliosis: clinicoradiological correlation

    We report the cranial CT and MRI findings in three children with Lyme disease (neuroborreliosis). The neuroimaging findings in children have been rarely reported. We found cranial MRI far superior to cranial CT. Ring-enhancing lesions have been described in acute disseminating encephalomyelitis and multiple sclerosis but not in neuroborreliosis. Although other infectious and inflammatory diseases cannot be excluded, Lyme disease should be included in the differential diagnosis and put forward as being the most likely diagnosis in the appropriate clinical setting. Gadopentetate dimeglumine is helpful in assessing the response to antibiotic treatment. (orig.)

  17. Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

    David S. Younger

    2010-01-01

    Full Text Available Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serological evidence of late infection. In the remaining patients symptoms initially ascribed to Lyme disease were probably unrelated to B. burgdorferi infection. Our findings suggest early susceptibility and protracted involvement of the nervous system most likely due to the immunological effects of B. burgdorferi infection, although the exact mechanisms remain uncertain.

  18. A case of hemifacial paresis in a patient with Lyme neuroborreliosis treated with antibiotics in whom Borrelia meningitis developed.

    Shimizu, Hisao; Haratani, Koji; Miyazaki, Masayuki; Kakehi, Yoshiaki; Nagami, Shuhei; Katanami, Yuichi; Kawabata, Hiroki; Takahashi, Nobuyuki

    2016-07-28

    A 38-year-old man visited our hospital because of hemifacial paresis that developed 2 months after being bit by a tick. We diagnosed idiopathic peripheral facial palsy and gave the patient oral prednisolone and valacyclovir. Although the symptoms completely resolved in about 2 weeks, there was a risk of Lyme neuroborreliosis. The patient therefore received doxycycline (100 mg twice daily) and amoxicillin (1,000 mg 3 times daily) for 14 days. Two months later, he had symptoms of meningitis such as headache and fever accompanied by lymphocytic cerebrospinal fluid pleocytosis. Viral meningitis was diagnosed and treated with parenteral acyclovir. The symptoms of meningitis improved. Tests for serum IgG antibodies against borrelia were positive. We gave the patient a diagnosis of Lyme neuroborreliosis. The patient received intravenous ceftriaxone and had no relapse. It is a rare for meningitis to develop in a patient with cranial neuropathy who received doxycycline. Lyme neuroborreliosis is a rare disease in Japan. Care should therefore be exercised in the diagnosis of Lyme neuroborreliosis and evaluation of the response to treatment. PMID:27356734

  19. Improving national surveillance of Lyme neuroborreliosis in Denmark through electronic reporting of specific antibody index testing from 2010 to 2012

    Dessau, Ram Benny; Espenhain, L; Mølbak, K;

    2015-01-01

    Our aim was to evaluate the results of automated surveillance of Lyme neuroborreliosis (LNB) in Denmark using the national microbiology database (MiBa), and to describe the epidemiology of laboratory-confirmed LNB at a national level. MiBa-based surveillance includes electronic transfer of...

  20. Lyme neuroborreliosis

    Eyselbergs, M; Tillemans, B; Pals, P.; Vuyst, D De; Vanhoenacker, FM

    2013-01-01

    Background: A 24-year-old woman presented to the emergency department with headache, apathy, aphasia and mild paresis of the right leg. Routine laboratory results revealed slightly raised infectious parameters.

  1. Acetate supplementation reduces microglia activation and brain interleukin-1β levels in a rat model of Lyme neuroborreliosis

    Brissette Catherine A

    2012-11-01

    Full Text Available Abstract Background We have found that acetate supplementation significantly reduces neuroglia activation and pro-inflammatory cytokine release in a rat model of neuroinflammation induced with lipopolysaccharide. To test if the anti-inflammatory effect of acetate supplementation is specific to a TLR4-mediated injury, we measured markers of neuroglia activation in rats subjected to B. burgdorferi-induced neuroborreliosis that is mediated in large part by a TLR2-type mechanism. Methods In this study, rats were subjected to Lyme neuroborreliosis following an intravenous infusion of B. burgdorferi (B31-MI-16. Acetate supplementation was induced using glyceryl triacetate (6g/kg by oral gavage. Immunohistochemistry, qPCR, and western blot analyses were used to measure bacterial invasion into the brain, neuroglial activation, and brain and circulating levels of interleukin 1β. Statistical analysis was performed using one-way analysis of variance (ANOVA followed by a Tukey’s post hoc tests or using a Student’s t test assuming unequal variances when appropriate. Results We found that acetate supplementation significantly reduced microglia activation by 2-fold as determined by immunohistochemical and western blot analysis. Further, acetate supplementation also reduced the expression of the pro-inflammatory cytokine IL-1β by 2-fold as compared to controls. On the other hand, the inoculation of rats with B. burgdorferi had no effect on astroglial activation as determined by immunocytochemistry and western blot analysis despite significant increases in circulation levels of antigen toward B. burgdorferi and presence of the bacteria in the central nervous system. Conclusions These results suggest that microglial activation is an essential component to neuroborreliosis and that acetate supplementation may be an effective treatment to reduce injury phenotype and possibly injury progression in Lyme neuroborreliosis.

  2. Advances in the study of Lyme neuroborreliosis%神经莱姆病的研究进展

    李静; 宝福凯; 柳爱华

    2013-01-01

    莱姆病是20世纪70年代发现的以硬蜱作为传播媒介,由伯氏疏螺旋体感染所致的人兽共患传染病.国内于1986年在黑龙江省首次报道.其临床分为多个阶段,可造成多个器官损害,其中神经系统的损害是莱姆病的主要表现之一,临床表现多样无特异性,已引起医学界的高度重视.本文对近年神经莱姆病的研究进展作一综述.%Lyme disease is a zoonotic, vector-borne infection that first appeared in the 1970s. The disease is transmitted by the tick-borne spirochete Borrelia burgdorferi. In China, Lyme disease was reported for the first time in Hei-longjiang Province in 1986. Clinically, it can be divided into multiple stages and causes multi-system damage. Damage to the nervous system is one of the major manifestations of Lyme disease. Its clinical manifestations are varied and nonspecific, so it has garnered the attention of the medical field. This paper mainly reviews recent advances in the study of Lyme neuroborreliosis.

  3. Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection

    Bremell Daniel

    2013-01-01

    Full Text Available Abstract Background It has been suggested that cerebrospinal fluid (CSF CXCL13 is a diagnostic marker of Lyme neuroborreliosis (LNB, as its levels have been shown to be significantly higher in LNB than in several other CNS infections. Levels have also been shown to decline after treatment with intravenous ceftriaxone, but levels after treatment with oral doxycycline have previously not been studied. Like Borrelia burgdorferi, HIV also has neurotropic properties. Elevated serum CXCL13 concentrations have been reported in HIV patients, but data on CSF levels are limited. Methods We longitudinally analysed CSF CXCL13 concentrations in 25 LNB patients before and after oral doxycycline treatment. Furthermore, we analysed CSF CXCL13 concentrations in 16 untreated LNB patients, 27 asymptomatic untreated HIV-1 infected patients and 39 controls with no signs of infectious or inflammatory disease. Results In the longitudinal LNB study, initially high CSF CXCL13 levels declined significantly after doxycycline treatment, which correlated to a decreased CSF mononuclear cell count. In the cross-sectional study, all the LNB patients had CSF CXCL13 levels elevated above the lowest standard point of the assay (7.8 pg/mL, with a median concentration of 500 pg/mL (range 34–11,678. Of the HIV patients, 52% had elevated CSF CXCL13 levels (median 10 pg/mL, range 0–498. There was a clear overlap in CSF CXCL13 concentrations between LNB patients and asymptomatic HIV patients. All but one of the 39 controls had CSF CXCL13 levels below 7.8 pg/mL. Conclusions We confirm previous reports of highly elevated CSF CXCL13 levels in LNB patients and that these levels decline after oral doxycycline treatment. The same pattern is seen for CSF mononuclear cells. CSF CXCL13 levels are elevated in neurologically asymptomatic HIV patients and the levels overlap those of LNB patients. The diagnostic value of CSF CXCL13 in LNB remains to be established.

  4. Brainstem abnormalities and vestibular nerve enhancement in acute Neuroborreliosis

    Farshad-Amacker, Nadja A.; Scheffel, Hans; Frauenfelder, Thomas; Alkadhi, Hatem

    2013-01-01

    BACKGROUND: Borreliosis is a widely distributed disease. Neuroborreliosis may present with unspecific symptoms and signs and often remains difficult to diagnose in patients with central nervous system symptoms, particularly if the pathognomonic erythema chronica migrans does not develop or is missed. Thus, vigilance is mandatory in cases with atypical presentation of the disease and with potentially severe consequences if not recognized early. We present a patient with neuroborreliosis demons...

  5. Indications of Th1 and Th17 responses in cerebrospinal fluid from patients with Lyme neuroborreliosis: a large retrospective study

    Malmvall Bo-Eric

    2011-04-01

    Full Text Available Abstract Background Previous studies indicate that successful resolution of Lyme neuroborreliosis (NB is associated with a strong T helper (Th 1-type cytokine response in the cerebrospinal fluid (CSF followed by a down-regulating Th2 response, whereas the role of the recently discovered Th17 cytokine response is unknown. Methods To investigate the relative contribution of different Th associated cytokine/chemokine responses, we used a multiple bead array to measure the levels of CXCL10 (Th1 marker, CCL22 (Th2 marker, IL-17 (Th17 marker and CXCL8 (general inflammation marker, in serum and in CSF from untreated patients with confirmed NB (n = 133, and non-NB patients (n = 96, and related the findings to clinical data. Samples from patients with possible early NB (n = 15 and possible late NB (n = 19 were also analysed, as well as samples from an additional control group with orthopaedic patients (n = 17, where CSF was obtained at spinal anaesthesia. Results The most prominent differences across groups were found in the CSF. IL-17 was elevated in CSF in 49% of the patients with confirmed NB, but was not detectable in the other groups. Patients with confirmed NB and possible early NB had significantly higher CSF levels of CXCL10, CCL22 and CXCL8 compared to both the non-NB group and the control group (p Borrelia-antibodies. Conclusion Our results support the notion that early NB is dominated by a Th1-type response, eventually accompanied by a Th2 response. Interestingly, IL-17 was increased exclusively in CSF from patients with confirmed NB, suggesting a hitherto unknown role for Th17 in NB. However, for conclusive evidence, future prospective studies are needed.

  6. Magnetic resonance in neuroborreliosis

    Magnetic resonance (MR) is commonly used in diagnosing infections of the central nervous system. The aim of the study is to evaluate central nervous system changes in neuroborreliosis patients. MR examinations were performed in 44 patients with clinical symptoms, epidemiology and laboratory tests results of neuroborreliosis. Abnormalities were detected in 22 patients. Most of them presented cortico-subcortical atrophy (86%). In 9 cases foci of increased signal in T2-weighted and FLAIR images were observed in white matter. They were single or multiple, located subcorticaly and paraventriculary. In 2 subjects areas of increased signal were found in the brain stem. Central nervous system abnormalities detected with MR are not specific for Lyme disease. They can suggest demyelinating lesions and/or gliosis observed in many nervous system disorders (SM, ADEM, lacunar infarcts). (author)

  7. Cerebrospinal Fluid Proteome of Patients with Acute Lyme Disease

    Angel, Thomas E.; Jacobs, Jon M.; Smith, Robert P.; Pasternack, Mark S.; Elias, Susan; Gritsenko, Marina A.; Shukla, Anil K.; Gilmore, Edward C.; McCarthy, Carol; Camp, David G.; Smith, Richard D.

    2012-10-05

    Acute Lyme disease results from transmission of and infection by the bacterium Borrelia burgdorferi following a tick bite. During acute infection, bacteria can disseminate to the central nervous system (CNS) leading to the development of Lyme meningitis. Here we have analyzed pooled cerebrospinal fluid (CSF) allowing for a deep view into the proteome for a cohort of patients with early-disseminated Lyme disease and CSF inflammation leading to the identification of proteins that reflect host responses, which are distinct for subjects with acute Lyme disease. Additionally, we analyzed individual patient samples and quantified changes in protein abundance employing label-free quantitative mass spectrometry based methods. The measured changes in protein abundances reflect the impact of acute Lyme disease on the CNS as presented in CSF. We have identified 89 proteins that differ significantly in abundance in patients with acute Lyme disease. A number of the differentially abundant proteins have been found to be localized to brain synapse and thus constitute important leads for better understanding of the neurological consequence of disseminated Lyme disease.

  8. Post-infectious glomerulonephritis presenting as acute renal failure in a patient with Lyme disease

    Rolla, Davide; Conti, Novella; Ansaldo, Francesca; Panaro, Laura; Lusenti, Tiziano

    2013-01-01

    Introduction: We report a case of a patient with acute renal failure in Lyme disease-associated focal proliferative mesangial nephropathy. Lyme disease is a vector-borne disease caused by Borrelia burgdorferi, transmitted by the bite of an infected ixodes tick. Post-infectious glomerulonephritis (GN)secondary to Borrelia burgdorferi infection in man could be fatal, as it is in canine Lyme borreliosis. Case: A 61-year old man with chronic ethanolic hepatitis was admitted to a provincial hospit...

  9. Borrelia miyamotoi-Associated Neuroborreliosis in Immunocompromised Person.

    Boden, Katharina; Lobenstein, Sabine; Hermann, Beate; Margos, Gabriele; Fingerle, Volker

    2016-09-01

    Borrelia miyamotoi is a newly recognized human pathogen in the relapsing fever group of spirochetes. We investigated a case of B. miyamotoi infection of the central nervous system resembling B. burgdorferi-induced Lyme neuroborreliosis and determined that this emergent agent of central nervous system infection can be diagnosed with existing methods. PMID:27533748

  10. [Lyme disease--clinical manifestations and treatment].

    Stock, Ingo

    2016-05-01

    Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings. PMID:27348896

  11. Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

    Nguyen Hanh

    2010-06-01

    Full Text Available Abstract Introduction Dermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later. Case presentation We present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease. Conclusions This case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung disease of a common disease (lyme infection is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.

  12. 神经莱姆病1例报告与分析%Lyme neuroborreliosis : report and analysis of a case

    潘小玲; 王刚; 刘建荣

    2009-01-01

    病例:女,73岁。4个月前因"虫咬后出现四肢乏力1年余,加重4个月"入院。患者20个月前于美国居住期间,在自家后院搬运旧木料时被不明虫子咬伤右季肋部,1周后被咬处出现鸡蛋大小深紫色包块,并于半个月余后出现左侧口眼歪斜,就诊于当地医院,查血抗伯氏疏螺旋体(Borrelia burgdorferi.Bb)抗体IgM 4.66U/mL(参考范围〈0.9U/mL),诊断为莱姆病(Lyme disease,LD).

  13. Lyme disease (image)

    Lyme disease is an acute inflammatory disease characterized by skin changes, joint inflammation and symptoms similar to the ... that is caused by the bacterium Borrelia burgdorferi . Lyme disease is transmitted by the bite of a deer ...

  14. Lyme disease (image)

    Lyme disease is an acute inflammatory disease characterized by skin changes, joint inflammation and symptoms similar to ... that is caused by the bacterium Borrelia burgdorferi . Lyme disease is transmitted by the bite of a ...

  15. MR imaging in neuroborreliosis of the cervical spinal cord

    The central nervous system is involved in 10-20% of cases in Lyme disease. The neurological symptoms, time course of the disease and imaging findings are multifaceted. We report two patients with cervical radiculitis. Magnetic resonance imaging revealed strong enhancement of the cervical nerve roots on contrast-enhanced T1-weighted images. These imaging patterns of borrelia-associated radiculitis have not been reported before. Knowledge of these imaging features may help to diagnose neuroborreliosis, which presents with non-specific symptoms. (orig.)

  16. MR imaging in neuroborreliosis of the cervical spinal cord

    Hattingen, Elke; Weidauer, Stefan; Zanella, Friedhelm E. [University of Frankfurt, Institute of Neuroradiology, Frankfurt (Germany); Kieslich, Matthias; Boda, Volker [University of Frankfurt, Department of Pediatric Neurology, Frankfurt (Germany)

    2004-11-01

    The central nervous system is involved in 10-20% of cases in Lyme disease. The neurological symptoms, time course of the disease and imaging findings are multifaceted. We report two patients with cervical radiculitis. Magnetic resonance imaging revealed strong enhancement of the cervical nerve roots on contrast-enhanced T1-weighted images. These imaging patterns of borrelia-associated radiculitis have not been reported before. Knowledge of these imaging features may help to diagnose neuroborreliosis, which presents with non-specific symptoms. (orig.)

  17. Acute exudative polymorphous vitelliform maculopathy in a patient with Lyme disease.

    Singh, Ravi S J; Tran, Lac H; Kim, Judy E

    2013-01-01

    Acute exudative polymorphous vitelli-form maculopathy (AEPVM) is a rare condition of unclear etiology that has been seen in association with respiratory and viral infections. It has also been reported as a paraneoplastic phenomenon in older individuals. The authors report the first case of AEPVM associated with Lyme disease with over 3.5 years of follow-up. Multimodality serial imaging suggested the lesions began as multiple serous detachments followed by accumulation of photoreceptor outer segments in the subretinal space that gradually resolved over time and gave rise to the characteristic fundus findings at various stages. PMID:24044715

  18. Stroke as an Unusual First Presentation of Lyme Disease

    Mohamad Almoussa

    2015-01-01

    Full Text Available Introduction. Lyme neuroborreliosis is a nervous system infection caused by spirochete Borrelia burgdorferi with diverse neurological complications. Stroke due to cerebral vasculitis is a rare consequence of neuroborreliosis and has been described in just a few case reports. Case Presentation. Here, we report the case of a 43-year-old patient who presented with discrete left-sided hemiparesis and amnestic cognitive impairment. Brain magnetic resonance imaging showed a thalamic infarct, and serological and cerebrospinal fluid (CSF tests confirmed the diagnosis of active neuroborreliosis. The antibiotic treatment with intravenous ceftriaxone for three weeks led to an improvement of the symptoms and remarkable regression of radiological findings, but not to full recovery of the amnestic cognitive disorder. Conclusion. Lyme neuroborreliosis should be suspected in patients with cerebrovascular events without obvious risk factors, especially those living in endemic areas such as northern Europe or those who have been exposed to ticks and those with clinical or radiological findings suggesting Lyme neuroborreliosis, in order to establish the diagnosis and start a proper antibiotic therapy.

  19. Rapid Typing of Borrelia burgdorferi Sensu Lato Species in Specimens from Patients with Different Manifestations of Lyme Borreliosis

    Lünemann, Jan D.; Zarmas, Silvia; Priem, Susanne; Franz, Juliane; Zschenderlein, Rolf; Aberer, Elisabeth; Klein, Rolf; Schouls, Leon; Burmester, Gerd R.; Krause, Andreas

    2001-01-01

    To further investigate the pathogenic potential of different Borrelia burgdorferi genospecies, specimens from 27 patients with different manifestations of Lyme borreliosis were analyzed by PCR and reverse line blotting (RLB). In samples from Lyme arthritis patients, B. burgdorferi sensu stricto was predominantly identified, while in patients with neuroborreliosis or acrodermatitis, Borrelia garinii and Borrelia afzelii, respectively, were exclusively detected. The results demonstrate that PCR...

  20. Lyme disease

    ... Causes Lyme disease is caused by bacteria called Borrelia burgdorferi ( B burgdorferi ). Blacklegged ticks and other species of ... Names Borreliosis; Bannwarth syndrome Images Lyme disease organism, Borrelia burgdorferi Tick, deer engorged on the skin Lyme disease - ...

  1. [Why can it be difficult for clinicians to diagnose acute lyme disease? From physiopathology to diagnosis, via abductive reasoning and Bayes theorem].

    Godefroid, C; Buttafuoco, F; Richard, T; Goubella, A; Vanhaeverbeek, M

    2014-01-01

    The diagnosis of acute neuroborreliosis may be difficult if it's regarded as a "classical" infectious disease. Through a clinical case, we illustrate the difficulties met and we suggest two ways of reflexion to assist in the diagnosis:--firstly, we explain how the comprehension of the behavior of the pathogen agent, which is similar to a parasitic behavior, can help to choose and interpret the results of additional tests;--secondly, we develop practically the clinical form of Bayes's theorem to demonstrate the interest of a rational Bayesian and abductive approach which should be preferred to the classical hypothetical and deductive reasoning. PMID:25672014

  2. The association of thrombocytopaenia and Lyme disease.

    Ballard, H. S.; Bottino, G.; Bottino, J.

    1994-01-01

    The association of asymptomatic thrombocytopaenia in six patients with acute Lyme disease is described. Recovery from thrombocytopaenia occurred shortly following antibiotic therapy. Patients residing in endemic areas for Lyme disease who present with flu-like symptoms and laboratory findings of thrombocytopaenia should prompt suspicion of acute Lyme disease. Appropriate clinical studies should be undertaken to confirm the diagnosis.

  3. MR findings in acute Lyme disease affecting the knee. A case report

    In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

  4. MR findings in acute Lyme disease affecting the knee. A case report

    Cavallaro, A.; Harrer, T.; Richter, H.; Bautz, W.; Fellner, F.A. [Friedrich-Alexander-Univ., Erlangen-Nuernberg (Germany)

    2002-07-01

    In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

  5. Multiplex assay (Mikrogen recomBead) for detection of serum IgG and IgM antibodies to 13 recombinant antigens of Borrelia burgdorferi sensu lato in patients with neuroborreliosis

    Dessau, Ram Benny; Møller, Jens K.; Kolmos, Birte;

    2015-01-01

    with Lyme neuroborreliosis (LNB), 218 Danish blood donor controls, a set of 61 Swedish patients with LNB and 139 Swedish non-LNB patients investigated for suspected LNB were used. There are four parts developed in this study: a characterization of the sero-epidemiological antibody-response pattern, the...

  6. Lyme Disease and the Orthopaedic Implications of Lyme Arthritis

    Smith, Brian G; Cruz, Aristides I.; Milewski, Matthew D.; Shapiro, Eugene D.

    2011-01-01

    Lyme disease is the most common tick-borne disease in the United States and Europe. Increased awareness of the clinical manifestations of the disease is needed to improve detection and treatment. In the acute and late stages, Lyme disease may be difficult to distinguish from other disease processes. The epidemiology and pathophysiology of Lyme disease are directly related to the Borrelia burgdorferi spirochete and its effects on the integumentary, neurologic, cardiac, and musculoskeletal syst...

  7. Season is an unreliable predictor of Lyme neuroborreliosis

    Petersen, Bo Bødker; Møller, Jens Kjølseth; Vilholm, Ole Jakob

    2015-01-01

    on the seasonal variation, anamnesis, symptoms, laboratory data and course of the disease in adults (≥ 16 years). METHODS: The medical records of 69 patients with confirmed LNB who attended the Department of Neurology, Lillebaelt Hospital, Vejle, Denmark, were analysed. The diagnosis was confirmed by the presence...

  8. Lyme Disease

    ... enabling JavaScript. Top Banner Content Area Skip Content Marketing Share this: Main Content Area Lyme Disease Lyme ... research with the major goals of developing better means of diagnosing, treating, and preventing the disease. To accomplish ...

  9. [Bilateral peripheral facial paralysis secondary to Lyme disease].

    Zapater Latorre, E; Castillo Ruiz, A; Alba García, J R; Armengot Carceller, M; Sancho Rieger, J; Basterra Alegría, J

    2004-01-01

    Simultaneous bilateral facial paralisis (SBFP) occurs in 0.3-2% of all facial paralisis. We report a case of SBFP in association with Lyme disease. A review of literature about SBFP is made, studing specially the one caused by Borrelia burgdorferi. We present a diagnostic guideline of SBFP. Suspect diagnosis of Lyme disease is based on clinical and epidemiological criteria. Culture isolation of this bacteria is difficult, therefore serologic testing is required. Neuroborreliosis treatment is intravenous Ceftriaxone or Cefotaxime. Oral Doxycycline is useful in the treatment of neuritis without central nervous system involvement. PMID:15566265

  10. Local Production of Interferon Gamma by Invariant Natural Killer T cells Modulates Acute Lyme Carditis

    Olson, Chris M.; Bates, Tonya C.; Izadi, Hooman; Radolf, Justin D.; Huber, Sally A.; Boyson, Jonathan E.; Anguita, Juan

    2009-01-01

    The Lyme disease spirochete, Borrelia burgdorferi, is the only known human pathogen that directly activates invariant natural killer T (iNKT) cells. The number and activation kinetics of iNKT cells vary greatly among different strains of mice. We now report the role of the iNKT cell response in the pathogenesis of Lyme disease using C57Bl/6 mice, a strain with optimal iNKT cell activation that is resistant to the development of spirochetal-induced inflammation. During experimental infection of B6 mice with B. burgdorferi, iNKT cells localize to the inflamed heart where they are activated by CD1d-expressing macrophages. Activation of iNKT cells in vivo results in the production of IFNγ, which we demonstrate ameliorates the severity of murine Lyme carditis by at least two mechanisms. First, IFNγ enhances the recognition of B. burgdorferi by macrophages, leading to increased phagocytosis of the spirochete. Secondly, IFNγ activation of macrophages increases the surface expression of CD1d, thereby facilitating further iNKT activation. Collectively, our data demonstrate that in the resistant background, B6, iNKT cells modulate the severity of murine Lyme carditis through the action of IFNγ, which appears to self-renew through a positive feedback loop during infection. PMID:19265151

  11. "Chronic Lyme Disease"

    ... Content Marketing Share this: Main Content Area "Chronic Lyme Disease" What is "chronic Lyme disease?" Lyme disease is an infection caused by ... J Med 357:1422-30, 2008). How is Lyme disease treated? For early Lyme disease, a short ...

  12. Enfermedad de Lyme aguda en Costa Rica: Descripción del primer caso autóctono Acute Lyme Disease in Costa Rica: Description of the First Autochthonous Case

    Manuel-Antonio Villalobos-Zúñiga

    2012-03-01

    Full Text Available Paciente masculino de 44 años de edad, vecino de Santa Teresa de Puntarenas con un cuadro agudo de fiebre, escalosfríos, artralgias intensas y malestar general; 15 días después de una picadura de garrapata. Se realizó inmunofluorescencia indirecta para Borrelia burgdorferi, cual fue positiva y el paciente mejoró con 14 días de tratamiento con doxiciclina. Se descartaron otras patologías infecciosas y no infecciosas, por lo que consideramos el caso como el primer caso autóctono de enfermedad de Lyme (EL en Costa Rica.This is the case of a 44-year-old patient, who lives in Santa Teresa, Puntarenas; with acute onset of fever, chills, severe arthralgias and malaise, 15 days after a tick bite. The indirect fluorescent antibody test for Lyme was positive and the patient improved with doxycicline for 14 days.Other infectious and noninfectious diseases were ruled out; we consider this case as the first autochtonous case of Lyme disease in Costa Rica.

  13. Lyme Disease (For Parents)

    ... Story" 5 Things to Know About Zika & Pregnancy Lyme Disease KidsHealth > For Parents > Lyme Disease Print A ... Pacific Northwest, and the northern Midwest states. About Lyme Disease Lyme disease is caused by the bacterium ...

  14. [Neuroborreliosis--a disease with many faces].

    Czell, D; Rodic, B; Imoberdorf, R

    2011-05-11

    Borreliosis has been widely recognized in Switzerland and is often used in unclear cases with non-specific symptoms. Two illustrative cases should emphasize the current options for diagnosis and therapy of neuroborreliosis. The keystones of the diagnostic instruments are a history with typical symptoms and analysis of the cerebrospinal fluid with determination of appropriate antibodies. Therapy deals with ceftriaxon with intravenous and doxycyclin with oral application making ambulatory treatment possible. PMID:21563099

  15. The diagnostic accuracy of serological tests for Lyme borreliosis in Europe

    Leeflang, M M G; Ang, C W; Berkhout, J;

    2016-01-01

    BACKGROUND: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe....... METHODS: We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist...... % CI 40 % to 61 %); neuroborreliosis 77 % (95 % CI 67 % to 85 %); acrodermatitis chronica atrophicans 97 % (95 % CI 94 % to 99 %); unspecified Lyme borreliosis 73 % (95 % CI 53 % to 87 %). Specificity was around 95 % in studies with healthy controls, but around 80 % in cross-sectional studies. Two...

  16. Multiple sclerosis and positive lyme serology

    Marco Aurélio Lana-Peixoto

    1994-12-01

    Full Text Available As Lyme neuroborreliosis (LNB may clinically mimick multiple sclerosis (MS the presence of antibodies to Borrelia burgdorferi in serum of patients with a MS-like disease in non-edemic areas for Lyme disease may be troublesome. We report the case of a 45-year-old white female with the diagnosis of relapsing/ remitting form of MS due to a 15-year history of optic neuritis and recurrent episodes of motor and sensation disturbance in the upper right limb and in both lower extremites associated with bladder dysfunction. A magnetic resonance imaging of the brain revealed multiple high intensity periventricular white matter lesions. The patient had been exposed to ticks but did not recall the presence of erythema migrans. ELISA for Lyme disease was positive in two different laboratories and the positive serology was confirmed by Western blotting. No convincing reponse followed treatment with ceftriaxone. Although it is clear that the patient had been infect by Borrelia burgdorferi the relationship of this spirochetal infection with the neurological disease could not be ascertained.

  17. Lyme Disease

    Ozdemir, Davut; İnce, Nevin

    2014-01-01

    Lyme disease (LD) is caused by the spirochete, Borrelia burgdorferi sensu lato complex. Humans are infected by a tick bite to the skin. This disease is a non-contagious infectious disease. It has been known since the 19th century. LD has a worldwide distribution. It is endemic in Europe, North and South America. There are case reports since 1990 in Turkey. The clinical presentation varies depending on the stage of the disease. Lyme disease is classified into three stages: early localized dise...

  18. Borreliose de Lyme Lyme borreliosis

    Mônica Santos; Vidal Haddad Júnior; Rodrigo Ribeiro-Rodrigues; Sinésio Talhari

    2010-01-01

    As borrelioses constituem um grupo de doenças infecciosas causadas por espiroquetas do gênero Borrelia. A borreliose de Lyme, também denominada doença de Lyme, é uma doença infecciosa, não contagiosa, causada por espiroquetas pertencentes ao complexo Borrelia burgdorferi Sensu Lato e transmitida, mais frequentemente, por picada de carrapatos do gênero Ixodes. A doença apresenta quadro clínico variado, podendo desencadear manifestações cutâneas, articulares, neurológicas e cardíacas.Borreliosi...

  19. Lyme Disease

    ... simply be displayed as a subtle area of pink or red skin rather than the classic bull's-eye rash. Overview Lyme disease is the result of infection with the bacteria Borrelia burgdorferi. The disease is transmitted by infected ticks that also feed on mice and deer. The tick can be found attached ...

  20. Lyme Disease

    Weil, M L

    1989-01-01

    Lyme disease, caused by spirochete Borrelia burgdorferi, is the most common vector-borne disease in the United States. The clinical presentation varies depending on the stage of the illness: early disease includes erthyma migrans, early disseminated disease includes multiple erythema migrans, meningitis, cranial nerve palsies and carditis; late disease is primarily arthritis. The symptoms and signs of infection resolve in the vast majority of patients after appropriate treatment with antimicr...

  1. A CASE OF LYME DISEASE (LYME BORRELIOSIS

    P. Tabatabaie A. Siadati

    2006-07-01

    Full Text Available While an important infectious disease in the United States and Eurasia, Lyme disease is rare in Iran. We present a 9-year old boy admitted in Children’s Medical Center in December 2001 with final diagnosis of Lyme disease. On admission he showed arthritis and a history of previous skin lesions. Serologic examination including enzyme–linked immunosorbent assay and Western blot was positive for Lyme borreliosis. Patient was treated with doxycycline for four weeks, with good results. Although it is difficult to confirm diagnosis of Lyme disease in our patients, we should be aware that Lyme borreliosis is also found in Iran.

  2. Lyme Disease: Fact or Fiction?

    ... message, please visit this page: About CDC.gov . Lyme Disease Lyme Disease Preventing tick bites On people On pets ... and symptoms What you need to know about Lyme carditis Lyme Disease Rashes and Look-alikes Diagnosis ...

  3. Chronic Lyme disease: misconceptions and challenges for patient management

    Halperin JJ

    2015-05-01

    Full Text Available John J HalperinDepartment of Neurosciences, Overlook Medical Center, Summit, NJ, USAAbstract: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%–15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease. Keywords: Lyme disease, Borrelia burgdorferi, chronic, diagnosis, treatment, chronic

  4. Prospective study on the chemokine CXCL13 in neuroborreliosis and other aseptic neuroinfections.

    Pícha, D; Moravcová, L; Smíšková, D

    2016-09-15

    The study evaluates the clinical significance of CXCL13 (leukocyte chemoattractant synthesized in CSF ) in Lyme neuroborreliosis (LNB) and other aseptic CNS infections. 244 patients with symptoms of neuroinfection and/or LNB were divided into groups: A - patients with LNB-positive antibodies in serum and CSF (96) or CSF only (14); B - patients with aseptic non-borrelial neuroinfections (82); C - negative controls (52). Group A was divided into A1-A4 according to pleocytosis in CSF and AIIgG positivity. The highest CSF CXCL13 concentrations (max. 81,287.60pg/ml; median 1766.90pg/ml) were in A1 (positive AI, pleocytosis) and A3 (negative AIIgG, pleocytosis; max. 7201,60pg/ml, median 56.22pg/ml). A2 (positive AI without pleocytosis) and A4 (negative AI without pleocytosis) had low CXCL13 levels - A2 max. 650.50pg/ml (medianAI positivity. PMID:27538636

  5. Gender disparity between cutaneous and non-cutaneous manifestations of Lyme borreliosis.

    Franc Strle

    Full Text Available Cutaneous manifestations of Lyme borreliosis in Europe include erythema migrans (EM and acrodermatitis chronica atrophicans (ACA; the most common non-cutaneous manifestations are Lyme neuroborreliosis (LNB and Lyme arthritis. The purpose of this study was to evaluate the gender distribution of patients with these clinical manifestations of Lyme borreliosis. Data on gender were obtained from the clinical records of patients with Lyme borreliosis aged ≥15 years who had been evaluated at the University Medical Center Ljubljana, Ljubljana, Slovenia. Among 10,539 patients diagnosed with EM, 6,245 (59.3% were female and among 506 ACA patients 347 (68.6% were female. In contrast, among the 60 patients with Lyme arthritis only 15 (25% were female (p<0.0001 for the comparison of gender with EM or ACA and among the 130 patients with LNB only 51 (39.2% were females (p<0.0001for the comparison of gender with EM or ACA. Although the proportion that was female in the LNB group was greater than that of patients with Lyme arthritis, this difference did not reach statistical significance (p = 0.10. Although older individuals are more likely to be female in the general Slovenian population, the age of patients with cutaneous versus non-cutaneous manifestations was not the explanation for the observed differences in gender. In conclusion, patients with cutaneous manifestations of Lyme borreliosis were predominantly female, whereas those with non-cutaneous manifestations were predominantly male. This provocative finding is unexplained but may have direct relevance to the pathogenesis of Lyme borreliosis.

  6. A CASE OF LYME DISEASE (LYME BORRELIOSIS)

    P. Tabatabaie A. Siadati

    2006-01-01

    While an important infectious disease in the United States and Eurasia, Lyme disease is rare in Iran. We present a 9-year old boy admitted in Children’s Medical Center in December 2001 with final diagnosis of Lyme disease. On admission he showed arthritis and a history of previous skin lesions. Serologic examination including enzyme–linked immunosorbent assay and Western blot was positive for Lyme borreliosis. Patient was treated with doxycycline for four weeks, with good results. Although it...

  7. Lyme Disease Tests

    ... be limited. Home Visit Global Sites Search Help? Lyme Disease Tests Share this page: Was this page helpful? ... else I should know? How is it used? Lyme disease tests are used to determine if a person ...

  8. Lyme Disease Data

    ... Lyme disease FAQ Health care providers Educational materials Data and Statistics Recommend on Facebook Tweet Share Compartir ... in the northeast and upper Midwest. Lyme Disease Data File To facilitate the public health and research ...

  9. Serodiagnosis in Early Lyme Disease

    1994-01-01

    Using a commercially available enzyme-linked immunosorbent assay (ELISA) and an immunoblot assay (IB), we tested sera from 100 patients with erythema migrans (EM) seen in 1991 a the Westchester County Medical Center Lyme Disease Diagnostic Center. Convalescent-phase sera were available from 59 patients. Fifty-five patients had EM of 14 days' duration. During the acute phase of infection, 35 patients had a positive ELI...

  10. Lyme Disease (For Kids)

    ... Got Homework? Here's Help White House Lunch Recipes Lyme Disease KidsHealth > For Kids > Lyme Disease Print A A A Text Size What's ... Fight the Bite en español La enfermedad de Lyme In the spring and summer, you might hear ...

  11. Hyperosmia in Lyme disease

    Basant K. Puri

    2014-08-01

    Full Text Available Neurological involvement in Lyme disease has been reported to include meningitis, cranial neuropathy and radiculoneuritis. While it is known that in some cases of asceptic meningitis patients may develop hyperosmia, the association between hyperosmia and Lyme disease has not previously been studied. Objective To carry out the first systematic study to ascertain whether hyperosmia is also a feature of Lyme disease. Method A questionnaire regarding abnormal sensory sensitivity in respect of the sense of smell was administered to 16 serologically positive Lyme disease patients and to 18 control subjects. Results The two groups were matched in respect of age, sex and body mass. None of the 34 subjects was suffering from migraine. Eight (50% of the Lyme patients and none (0% of the controls suffered from hyperosmia (p=0.0007. Conclusion This first systematic controlled study showed that Lyme disease is associated with hyperosmia.

  12. Hyperosmia in Lyme disease

    2014-01-01

    Neurological involvement in Lyme disease has been reported to include meningitis, cranial neuropathy and radiculoneuritis. While it is known that in some cases of asceptic meningitis patients may develop hyperosmia, the association between hyperosmia and Lyme disease has not previously been studied. Objective To carry out the first systematic study to ascertain whether hyperosmia is also a feature of Lyme disease. Method A questionnaire regarding abnormal sensory sensitivity in respect of ...

  13. Lyme Disease and Pregnancy

    Alexander, James M.; Cox, Susan M.

    1995-01-01

    Lyme disease is the most commonly transmitted vector-borne disease in the United States, with many regions of the country at risk. Like other spirochete-borne infections, Lyme disease progresses in stages, making diagnosis in the early stages of the illness and prompt treatment important for cure. An early diagnosis is made difficult by the less-than-ideal serologic tests and the varied clinical presentations of the disease. Although Lyme disease has been reported in pregnancy, the transmissi...

  14. Gallium-positive Lyme disease myocarditis

    Alpert, L.I.; Welch, P.; Fisher, N.

    1985-09-01

    In the course of a work-up for fever of unknown origin associated with intermittent arrhythmias, a gallium scan was performed which revealed diffuse myocardial uptake. The diagnosis of Lyme disease myocarditis subsequently was confirmed by serologic titers. One month following recovery from the acute illness, the abnormal myocardial uptake completely resolved.

  15. Gallium-positive Lyme disease myocarditis

    In the course of a work-up for fever of unknown origin associated with intermittent arrhythmias, a gallium scan was performed which revealed diffuse myocardial uptake. The diagnosis of Lyme disease myocarditis subsequently was confirmed by serologic titers. One month following recovery from the acute illness, the abnormal myocardial uptake completely resolved

  16. What's My Lyme Disease Risk?

    ... I Help a Friend Who Cuts? What's My Lyme Disease Risk? KidsHealth > For Teens > What's My Lyme Disease Risk? Print A A A Text Size What's ... la enfermedad de Lyme? Is the thought of Lyme disease making you feel you'd be safer in ...

  17. Neurogenic Bladder in Lyme Disease

    Kim, Mi-Hwa; Kim, Won Chan; Park, Dong-Su

    2012-01-01

    Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 3...

  18. Lyme myocarditis diagnosed by indium-111-antimyosin antibody scintigraphy

    Casans, I.; Villar, A.; Almenar, V.; Blanes, A.

    1989-06-01

    We report a new case of Lyme disease with cardiac manifestations, which has been possible to follow during the long period of 12 years. We have detected the usual ECG abnormalities, and concentric hypertrophic myocardiopathy, by echocardiography. The acute myocarditis was demonstrated by /sup 111/In-antimyosin scintigraphy, which showed global myocardial uptake of the tracer, constituting the first report, to our knowledge, of Lyme myocarditis diagnosed by this method.

  19. Lyme myocarditis diagnosed by indium-111-antimyosin antibody scintigraphy

    We report a new case of Lyme disease with cardiac manifestations, which has been possible to follow during the long period of 12 years. We have detected the usual ECG abnormalities, and concentric hypertrophic myocardiopathy, by echocardiography. The acute myocarditis was demonstrated by 111In-antimyosin scintigraphy, which showed global myocardial uptake of the tracer, constituting the first report, to our knowledge, of Lyme myocarditis diagnosed by this method. (orig.)

  20. Lyme arthritis in Southern Norway - an endemic area for Lyme Borreliosis

    Haugeberg, Glenn; Hansen, Inger Johanne W.; Skarpaas, Tone; Noraas, Sølvi; Kjelland, Vivian

    2014-01-01

    Background: Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA). In the literature controversies exist if acute LA can develop into chronic arthritis. Our objective was to identify and characterize patients with LA in Southern Norway and explore disease course after antibiotic treatment.Methods: Patients aged 20 years or older with arthritis and a positive serology for Borrelia burgdorferi infection (IgG and/or IgM) suspected of havin...

  1. Zandhagedissen kunnen Lyme verwijderen

    Spitzen-van der Sluijs, A.

    2010-01-01

    Onlangs hebben het RIVM en RAVON onderzoek gedaan naar zandhagedissen en teken. Teken kunnen diverse ziektes overbrengen op hun gastheer, zoals de ziekte van Lyme. Sommige gastheren zijn echter incompetent, ze raken niet besmet met de bacterie of kunnen deze zelfs verwijderen uit het bloed. Op deze manier dragen ze niet bij aan het verspreiden van, in dit geval, de ziekte van Lyme. De zandhagedis is een dergelijke incompetente gastheer.

  2. Epidemiology of Lyme Disease

    White, Dennis J

    1991-01-01

    Investigation of the epidemiology of Lyme disease depends upon information generated from several sources. Human disease surveillance can be conducted by both passive and active means involving physicians, public health agencies and laboratories. Passive and active tick surveillance programs can document the extent of tick-borne activity, identify the geographic range of potential vector species, and determine the relative risk of exposure to Lyme disease in specific areas. Standardized labor...

  3. A possible role for inflammation in mediating apoptosis of oligodendrocytes as induced by the Lyme disease spirochete Borrelia burgdorferi

    Ramesh Geeta

    2012-04-01

    Full Text Available Abstract Background Inflammation caused by the Lyme disease spirochete B. burgdorferi is an important factor in the pathogenesis of Lyme neuroborreliosis. Our central hypothesis is that B. burgdorferi can cause disease via the induction of inflammatory mediators such as cytokines and chemokines in glial and neuronal cells. Earlier we demonstrated that interaction of B. burgdorferi with brain parenchyma induces inflammatory mediators in glial cells as well as glial (oligodendrocyte and neuronal apoptosis using ex vivo and in vivo models of experimentation. Methods In this study we evaluated the ability of live B. burgdorferi to elicit inflammation in vitro in differentiated human MO3.13 oligodendrocytes and in differentiated primary human oligodendrocytes, by measuring the concentration of immune mediators in culture supernatants using Multiplex ELISA assays. Concomitant apoptosis was quantified in these cultures by the in situ terminal deoxynucleotidyl transferase mediated UTP nick end labeling (TUNEL assay and by quantifying active caspase-3 by flow cytometry. The above phenomena were also evaluated after 48 h of stimulation with B. burgdorferi in the presence and absence of various concentrations of the anti-inflammatory drug dexamethasone. Results B. burgdorferi induced enhanced levels of the cytokine IL-6 and the chemokines IL-8 and CCL2 in MO3.13 cells as compared to basal levels, and IL-8 and CCL2 in primary human oligodendrocytes, in a dose-dependent manner. These cultures also showed significantly elevated levels of apoptosis when compared with medium controls. Dexamethasone reduced both the levels of immune mediators and apoptosis, also in a manner that was dose dependent. Conclusions This finding supports our hypothesis that the inflammatory response elicited by the Lyme disease spirochete in glial cells contributes to neural cell damage. As oligodendrocytes are vital for the functioning and survival of neurons, the inflammation and

  4. Lyme disease and conservation

    Ginsberg, H.

    1994-01-01

    Lyme disease is a tick-borne illness that is wide-spread in North America, especially in the northeastern and northcentral United States. This disease could negatively influence efforts to conserve natural populations in two ways: (1) the disease could directly affect wild animal health; and (2) tick control efforts could adversely affect natural populations and communities. Lyme disease affects several domestic animals, but symptoms have been reported in only a few wild species. Direct effects of Lyme disease on wild animal populations have not been reported, but the disease should be considered as a possible cause in cases of unexplained population declines in endemic areas. Methods available to manage ticks and Lyme disease include human self-protection techniques, manipulation of habitats and hosts species populations, biological control, and pesticide applications. The diversity of available techniques allows selection of approaches to minimize environmental effects by (1) emphasizing personal protection techniques, (2) carefully targeting management efforts to maximize efficiency, and (3) integrating environmentally benign techniques to improve management while avoiding broad-scale environmentally destructive approaches. The environmental effects of Lyme disease depend, to a large extent, on the methods chosen to minimize human exposure to infected ticks. Conservation biologists can help design tick management programs that effectively lower the incidence of human Lyme disease while simultaneously minimizing negative effects on natural populations.

  5. Lyme Disease and the Heart

    ... of the American Heart Association Cardiology Patient Page Lyme Disease and the Heart Peter J. Krause and Linda ... in a few cases. Diagnosis and Treatment of Lyme Disease The Centers for Disease Control and Prevention has ...

  6. Treatment Complications of Lyme Meningitis

    J Gordon Millichap

    2012-01-01

    Researchers at Alfred I duPont Hospital for Children, Wilmington, DE, and other Centers in Lyme endemic areas determined the frequency and type of all treatment complications at return visits within 30 days of an initial Lyme meningitis diagnosis.

  7. PERIPHERAL FACIAL PALSY IN CHILDHOOD - LYME BORRELIOSIS TO BE SUSPECTED UNLESS PROVEN OTHERWISE

    CHRISTEN, HJ; BARTLAU, N; HANEFELD, F; EIFFERT, H; THOMSSEN, R

    1990-01-01

    27 consecutive cases with acute peripheral facial palsy were studied for Lyme borreliosis. In 16 out of 27 children Lyme borreliosis could be diagnosed by detection of specific IgM antibodies in CSF. CSF findings allow a clear distinction according to etiology. All children with facial palsy due to

  8. Lyme disease: The great imitator

    Savić-Jevđenić S.; Grgić Ž.; Vidić B.; Petrović A.

    2007-01-01

    Lyme disease, or Lyme borreliosis can occur in domestic animals and in people, with no characteristic symptoms. That is why Lyme disease is often diagnosed and treated as some other disease. Clinical symptoms of this disease are not specific and they can look like a number of different diseases, which is why the disease is called - the great imitator. The reservoirs of the disease are ticks Ixodes ricinus. During the research from 2005 to 2007 it was established that the prevalence with Lyme ...

  9. Lyme disease: the next decade

    Stricker, Raphael B.; Lorraine Johnson

    2011-01-01

    Raphael B Stricker, Lorraine JohnsonInternational Lyme and Associated Diseases Society, Bethesda, MD, USAAbstract: Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme sp...

  10. Lyme Disease in Northern California

    Campagna, Joan; Lavoie, Paul E.; Birnbaum, Neal S.; Furman, Deane P.

    1983-01-01

    Lyme disease is a recently described clinical entity with cutaneous, neurologic, articular and cardiac manifestations. Since the original description of the disease in 1977, more than 500 cases have been reported. Although the vast majority of patients have been from the area near Lyme, Connecticut, we have seen four patients from northern California with various aspects of Lyme disease.

  11. Lyme Disease in Oregon ▿

    Doggett, J. Stone; Kohlhepp, Sue; Gresbrink, Robert; Metz, Paul; Gleaves, Curt; Gilbert, David

    2008-01-01

    The incidence of Lyme disease in Oregon is calculated from cases reported to the Oregon State Health Division. We reviewed the exposure history of reported cases of Lyme disease and performed field surveys for infected Ixodes pacificus ticks. The incidence of Lyme disease correlated with the distribution of infected I. pacificus ticks.

  12. Lyme disease: review

    Biesiada, Grażyna; Czepiel, Jacek; Leśniak, Maciej R.; Garlicki, Aleksander; Mach, Tomasz

    2012-01-01

    Lyme disease is a multi-organ animal-borne disease, caused by spirochetes of Borrelia burgdorferi (Bb), which typically affect the skin, nervous system, musculoskeletal system and heart. A history of confirmed exposure to tick bites, typical signs and symptoms of Lyme borreliosis and positive tests for anti-Bb antibodies, are the basis of a diagnosis. A two-step diagnosis is necessary: the first step is based on a high sensitivity ELISA test with positive results confirmed by a more specific ...

  13. Induction of lyme arthritis in LSH hamsters

    Schmitz, J.L.; Schell, R.F.; Hejka, A.; England, D.M.; Konick, L.

    1988-09-01

    In studies of experimental Lyme disease, a major obstacle has been the unavailability of a suitable animal model. We found that irradiated LSH/Ss Lak hamsters developed arthritis after injection of Borrelia burgdorferi in the hind paws. When nonirradiated hamsters were injected in the hind paws with B. burgdorferi, acute transient synovitis was present. A diffuse neutrophilic infiltrate involved the synovia and periarticular structures. The inflammation was associated with edema, hyperemia, and granulation tissue. Numerous spirochetes were seen in the synovial and subsynovial tissues. The histopathologic changes were enhanced in irradiated hamsters. The onset and duration of the induced swelling were dependent on the dose of radiation and the inoculum of spirochetes. Inoculation of irradiated hamsters with Formalin-killed spirochetes or medium in which B. burgdorferi had grown for 7 days failed to induce swelling. This animal model should prove useful for studies of the immune response to B. burgdorferi and the pathogenesis of Lyme arthritis.

  14. Induction of lyme arthritis in LSH hamsters

    In studies of experimental Lyme disease, a major obstacle has been the unavailability of a suitable animal model. We found that irradiated LSH/Ss Lak hamsters developed arthritis after injection of Borrelia burgdorferi in the hind paws. When nonirradiated hamsters were injected in the hind paws with B. burgdorferi, acute transient synovitis was present. A diffuse neutrophilic infiltrate involved the synovia and periarticular structures. The inflammation was associated with edema, hyperemia, and granulation tissue. Numerous spirochetes were seen in the synovial and subsynovial tissues. The histopathologic changes were enhanced in irradiated hamsters. The onset and duration of the induced swelling were dependent on the dose of radiation and the inoculum of spirochetes. Inoculation of irradiated hamsters with Formalin-killed spirochetes or medium in which B. burgdorferi had grown for 7 days failed to induce swelling. This animal model should prove useful for studies of the immune response to B. burgdorferi and the pathogenesis of Lyme arthritis

  15. Lyme Disease Frequently Asked Questions (FAQ)

    ... Lyme disease FAQ Health care providers Educational materials Lyme Disease Frequently Asked Questions (FAQ) Language: English Español ( ... been bitten by a tick. Do I have Lyme disease? If you have not done so already, ...

  16. Beware of Ticks … & Lyme Disease

    ... ten by them. &LymeDisease This is important because Lyme disease, an infection caused by the bacterium Borrelia ... is transmitted via the bite of infected ticks. Lyme disease is named after a town in Connecticut ...

  17. Lyme Disease Transmission

    ... through the use of tick control products for animals. You will not get Lyme disease from eating venison or squirrel meat, but in keeping with general food safety principles, always cook meat thoroughly. Note that hunting and dressing deer or squirrels may bring you ...

  18. Zandhagedissen kunnen Lyme verwijderen

    Spitzen-van der Sluijs, A.

    2010-01-01

    Onlangs hebben het RIVM en RAVON onderzoek gedaan naar zandhagedissen en teken. Teken kunnen diverse ziektes overbrengen op hun gastheer, zoals de ziekte van Lyme. Sommige gastheren zijn echter incompetent, ze raken niet besmet met de bacterie of kunnen deze zelfs verwijderen uit het bloed. Op deze

  19. Chronic Lyme Disease: An appraisal

    Marques, Adriana

    2008-01-01

    “Chronic Lyme disease” is a confusing term that has been used to describe very different patient populations. Studies have shown that most patients diagnosed with “chronic Lyme disease” either have no objective evidence of previous or current infection with B. burgdorferi or are patients that should be classified as having post-Lyme disease syndrome, which is defined as continuing or relapsing non-specific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in a patient...

  20. Laboratory aspects of Lyme borreliosis.

    Barbour, A G

    1988-01-01

    Lyme borreliosis (Lyme disease), a common tick-borne disorder of people and domestic animals in North America and Europe, is caused by the spirochete Borrelia burgdorferi. Following the discovery and initial propagation of this agent in 1981 came revelations that other tick-associated infectious disorders are but different forms of Lyme borreliosis. A challenge for the clinician and microbiology laboratory is confirmation that a skin rash, a chronic meningitis, an episode of myocarditis, or a...

  1. Lyme disease: the next decade

    Raphael B Stricker

    2011-01-01

    Full Text Available Raphael B Stricker, Lorraine JohnsonInternational Lyme and Associated Diseases Society, Bethesda, MD, USAAbstract: Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade.Keywords: Lyme disease, Borrelia burgdorferi, L-forms, cysts, biofilms, proteomics

  2. Diastolic Heart Murmur, Nocturnal Back Pain, and Lumbar Rigidity in a 7-Year Girl: An Unusual Manifestation of Lyme Disease in Childhood

    Genn Kameda

    2012-01-01

    Full Text Available A 7-year-old girl presented with nocturnal pain in her back and legs. The physical examination revealed a loud opening sound of the mitral valve and lumbar rigidity. With the exception of significantly increased anti-nuclear antibody (ANA levels, the immunological findings did not show any other abnormal parameters, also spinal magnetic resonance imaging (MRI and ultrasound examination of the abdomen and pelvis yield no pathological findings. The lumbar puncture showed a lymphocytic pleocytosis as well as an intrathecal synthesis of Borrelia-specific antibodies. Echocardiography showed a thickened mitral valve with mild regurgitation. No other signs of florid endocarditis or myocarditis could be detected. Due to these findings, the diagnosis Lyme neuroborreliosis was made and an intravenous antibiotic therapy was given. The clinical symptoms subsided. Six months later, she had an almost normal mitral valve with only trivial mitral insufficiency. The association between the lumbar rigidity and the thickened mitral valve remains unclear. The case of our patient with nocturnal back and leg pain may be considered a rare case of Lyme neuroborreliosis with meningoradiculitis in children, and to our knowledge these symptoms together with cardiac involvement, such as a significantly thickened mitral valve, have not yet been described in the literature.

  3. Tired of Lyme borreliosis: Lyme borreliosis in the Netherlands

    J. Coumou; T. van der Poll; P. Speelman; J.W.R. Hovius

    2011-01-01

    Lyme borreliosis has become the most common vector-borne illness in North Eastern USA and Europe. It is a zoonotic disease, with well-defined symptoms, caused by B. burgdorferi sensu lato, and transmitted by ticks. Lyme borreliosis is endemic in the Netherlands with a yearly incidence of approximate

  4. Lyme Disease and Oncothermia

    2013-01-01

    Lyme disease is a tick-borne disease with multiple organ failures, and systemic disorders. Dramatic change becomes apparent in the chronic phase of the disease. Chronic fatigue syndrome, lapse of concentration, depression, joint pain, and muscle pain are a few, but major clinical symptoms characterizing the disease. The human immune system is defenseless. Borrelia uses various mechanisms to escape from immunoattacks or antibiotic therapies. This “stealth phenomenon” needs new therapeutic prin...

  5. Lyme disease: a review.

    Nathwani, D.; Hamlet, N.; Walker, E.

    1990-01-01

    In the last decade, Lyme borreliosis has emerged as a complex new infection whose distribution is worldwide. The multisystem disorder, which primarily affects the skin, joints, heart and nervous system at different stages, is caused by the tick-borne spirochaete Borrelia burgdorferi. After the first weeks of infection almost all patients have a positive antibody response to the spirochaete and serological determinations are currently the most practical laboratory aid in diagnosis. Treatment w...

  6. Diagnosis of Lyme Borreliosis

    Aguero-Rosenfeld, Maria E.; Wang, Guiqing; Schwartz, Ira; Wormser, Gary P.

    2005-01-01

    A large amount of knowledge has been acquired since the original descriptions of Lyme borreliosis (LB) and of its causative agent, Borrelia burgdorferi sensu stricto. The complexity of the organism and the variations in the clinical manifestations of LB caused by the different B. burgdorferi sensu lato species were not then anticipated. Considerable improvement has been achieved in detection of B. burgdorferi sensu lato by culture, particularly of blood specimens during early stages of diseas...

  7. Treatment of Lyme borreliosis

    Girschick, Hermann J.; Morbach, Henner; Tappe, Dennis

    2009-01-01

    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 patient...

  8. Pancytopenia in Lyme disease

    Mehrzad, Raman; Bravoco, Joseph

    2014-01-01

    We present a 49-year-old man with subacute onset of fever, weakness, shortness of breath, unilateral lower extremity oedema and pancytopenia who was found to have positive serology for Lyme disease. The patient presented with an intravascular haemolytic pattern on laboratory findings where an extensive infectious disease and haematological workup ruled out ehrlichiosis, anaplasmosis, babesiosis, Rocky Mountain spotted fever, HIV, hepatitis B and other parasitic infections. This left a very at...

  9. Uveitis and Lyme borreliosis.

    Breeveld, J; Kuiper, H; Spanjaard, L.; Luyendijk, L; Rothova, A.

    1993-01-01

    In a retrospective study 56 consecutive patients with uveitis of unknown origin and 56 consecutive patients suffering from uveitis of established aetiology were investigated. The purpose of this study was to determine the frequency of positive serological tests for Lyme borreliosis among patients with uveitis and to relate laboratory data to clinical findings. The antibody titre for Borrelia burgdorferi was determined by two assays: the indirect immunofluorescence assay and the enzyme linked ...

  10. Lyme Borreliosis and Skin

    Biju Vasudevan; Manas Chatterjee

    2013-01-01

    Lyme disease is a multisystem illness which is caused by the strains of spirochete Borrelia burgdorferi sensu lato and transmitted by the tick, Ixodes. Though very commonly reported from the temperate regions of the world, the incidence has increased worldwide due to increasing travel and changing habitats of the vector. Few cases have been reported from the Indian subcontinent too. Skin manifestations are the earliest to occur, and diagnosing these lesions followed by appropriate treatment, ...

  11. Histopathology of Lyme arthritis in LSH hamsters

    Hejka, A.; Schmitz, J.L.; England, D.M.; Callister, S.M.; Schell, R.F.

    1989-05-01

    The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis.

  12. Histopathology of Lyme arthritis in LSH hamsters

    The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis

  13. Altered mental status, an unusual manifestation of early disseminated Lyme disease: A case report

    Chabria Shiven B

    2007-08-01

    Full Text Available Abstract Early disseminated Lyme disease can have a myriad of central nervous system manifestations. These run the gamut from meningitis to radiculopathy and cranial neuropathy. Here we present a case that manifested with only acute mental status change in the setting of central nervous system involvement with Lyme disease. A paucity of other central nervous system manifestations is rare, especially with positive serum and cerebrospinal fluid markers. This article underscores the importance of a high index of clinical suspicion in detection of Lyme disease related manifestations in endemic areas.

  14. Altered mental status, an unusual manifestation of early disseminated Lyme disease: A case report

    Chabria Shiven B; Lawrason Jock

    2007-01-01

    Abstract Early disseminated Lyme disease can have a myriad of central nervous system manifestations. These run the gamut from meningitis to radiculopathy and cranial neuropathy. Here we present a case that manifested with only acute mental status change in the setting of central nervous system involvement with Lyme disease. A paucity of other central nervous system manifestations is rare, especially with positive serum and cerebrospinal fluid markers. This article underscores the importance o...

  15. New insights into Lyme disease

    Brandon N. Peacock

    2015-08-01

    Full Text Available Lyme borreliosis is transmitted through the bite of a tick that is infected by the bacterial spirochete Borrelia burgdorferi. Clinical manifestation of the disease can lead to heart conditions, neurological disorders, and inflammatory disorders. Oxidative stress has been implicated in the pathogenesis of many human diseases. The aim of this study was to investigate the mechanisms of oxidative stress and intracellular communication in Lyme borreliosis patients. Mitochondrial superoxide and cytosolic ionized calcium was measured in peripheral blood mononuclear cells (PBMCs of Lyme borreliosis patients and healthy controls. Mitochondrial superoxide levels were significantly higher (p<0.0001 in Lyme borreliosis patients (n=32 as compared to healthy controls (n=30. Significantly low (p<0.0001 levels of cytosolic ionized calcium were also observed in Lyme borreliosis patients (n=11 when compared to healthy controls (n=11. These results indicate that there is an imbalance of reactive oxygen species and cytosolic calcium in Lyme borreliosis patients. The results further suggest that oxidative stress and interrupted intracellular communication may ultimately contribute to a condition of mitochondrial dysfunction in the immune cells of Lyme borreliosis patients.

  16. Clocking the Lyme Spirochete

    Stephen E Malawista; de Boisfleury Chevance, Anne

    2008-01-01

    In order to clear the body of infecting spirochetes, phagocytic cells must be able to get hold of them. In real-time phase-contrast videomicroscopy we were able to measure the speed of Borrelia burgdorferi (Bb), the Lyme spirochete, moving back and forth across a platelet to which it was tethered. Its mean crossing speed was 1,636 µm/min (N = 28), maximum, 2800 µm/min (N = 3). This is the fastest speed recorded for a spirochete, and upward of two orders of magnitude above the speed of a human...

  17. Improved serodiagnosis of Lyme disease

    Davidson, M.M.; Chisholm, S M; Wiseman, A D; Joss, A W L; Ho-Yen, D O

    1996-01-01

    Aims—To determine whether enzyme linked immunosorbent assay (ELISA) results for Borrelia burgdorferi require confirmation by immunoblotting and how immunoblotting may best be used in the diagnosis of Lyme disease.

  18. LymeDisease_9211_county

    U.S. Department of Health & Human Services — To facilitate the public health and research community's access to NNDSS data on Lyme disease, CDC has developed a public use dataset. Based on reports submitted to...

  19. Serum inflammatory mediators as markers of human Lyme disease activity.

    Mark J Soloski

    Full Text Available Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low of acute Lyme patients with distinct cytokine signatures that also differed significantly (p<0.0005 in symptom presentation. In particular, the T cell chemokines CXCL9 (MIG, CXCL10 (IP-10 and CCL19 (MIP3B were coordinately increased in the mediator-high group and levels of these chemokines could be associated with seroconversion status and elevated liver function tests (p = 0.027 and p = 0.021 respectively. There was also upregulation of acute phase proteins including CRP and serum amyloid A. Consistent with the role of CXCL9/CXCL10 in attracting immune cells to the site of infection, CXCR3+ CD4 T cells are reduced in the blood of early acute Lyme disease (p = 0.01 and the decrease correlates with chemokine levels (p = 0.0375. The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations.

  20. Lyme Disease: diagnosis and treatment

    Ivan Maluf Junior; Mariana Ribas Zahdi; Aguinaldo Bonalumi Filho; Cristina Rodrigues Cruz

    2010-01-01

    Lyme disease is a multisystem bacterial infection caused by the spirochete Borrelia burgdorferi. It is transmitted by the bite of infected ticks of the genus Ixodes and Amblyomma. The disease is endemic in wooded, brushy areas, which are habitats for wild animals and ticks. It is the disease most commonly transmitted by ticks, but rarely reported in Brazil. Early local Lyme Disease often starts with erythema migrans at the site of the tick bite, followed by flu-like symptoms. In advanced stag...

  1. Immunodiagnostic tests for Lyme disease.

    Wilkinson, H W

    1984-01-01

    Standardized serologic tests for Lyme disease are needed, as isolation or in situ demonstration of the spirochete has proved difficult. At the Centers for Disease Control (CDC), an indirect immunofluorescence assay (IFA) was modified from a previously described IFA, and an enzyme-linked immunosorbent assay (ELISA) was developed with soluble spirochetal antigens. Both tests were evaluated with sera from Lyme disease patients, normal controls, and patients with other diseases. They were highly ...

  2. Neurological findings of Lyme disease.

    Pachner, A. R.; Steere, A. C.

    1984-01-01

    Neurologic involvement of Lyme disease typically consists of meningitis, cranial neuropathy, and radiculoneuritis, alone or in combination, lasting for months. From 1976 to 1983, we studied 38 patients with Lyme meningitis. Headache and mild neck stiffness, which fluctuated in intensity, and lymphocytic pleocytosis were the common findings. Half of the patients also had facial palsies, which were unilateral in 12 and bilateral in seven. In addition, 12 patients had motor and/or sensory radicu...

  3. Lyme disease. A Canadian perspective.

    Green, L.; Costero, A.

    1993-01-01

    Lyme disease is an expanding community health issue in the United States. This has led to greater public awareness in Canada, although the disease remains rare here. We review the biology of ticks and show how feeding patterns are relevant to disease transmission. Diagnosing Lyme disease is sometimes problematic, but treatment can be effective, particularly in the early stages. Preventive measures are aimed at avoiding tick contact and early tick removal.

  4. Intermediate uveitis and Lyme borreliosis.

    Breeveld, J; Rothova, A.; Kuiper, H

    1992-01-01

    A case of chronic intermediate uveitis and associated classic snowbanking (pars planitis) with severe cystoid macular oedema probably due to Lyme borreliosis is reported. Despite a disease duration of 10 years the patient's ocular symptoms and visual acuity responded promptly to intravenous ceftriaxone treatment. This case demonstrates that periodic reevaluation of patients with intermediate uveitis is necessary to obtain a specific diagnosis which may include Lyme borreliosis.

  5. The emergence of Lyme disease

    Steere, Allen C.; Coburn, Jenifer; Glickstein, Lisa

    2004-01-01

    Since its identification nearly 30 years ago, Lyme disease has continued to spread, and there have been increasing numbers of cases in the northeastern and north central US. The Lyme disease agent, Borrelia burgdorferi, causes infection by migration through tissues, adhesion to host cells, and evasion of immune clearance. Both innate and adaptive immune responses, especially macrophage- and antibody-mediated killing, are required for optimal control of the infection and spirochetal eradicatio...

  6. New insights into Lyme disease

    Peacock, Brandon N.; Gherezghiher, Teshome B.; Hilario, Jennifer D.; Kellermann, Gottfried H.

    2015-01-01

    Lyme borreliosis is transmitted through the bite of a tick that is infected by the bacterial spirochete Borrelia burgdorferi. Clinical manifestation of the disease can lead to heart conditions, neurological disorders, and inflammatory disorders. Oxidative stress has been implicated in the pathogenesis of many human diseases. The aim of this study was to investigate the mechanisms of oxidative stress and intracellular communication in Lyme borreliosis patients. Mitochondrial superoxide and cyt...

  7. Subacute transverse myelitis with Lyme profile dissociation

    Ajjan, Mohammed

    2008-06-01

    Full Text Available Introduction: Transverse myelitis is a very rare neurologic syndrome with an incidence per year of 1-5 per million population. We are presenting an interesting case of subacute transverse myelitis with its MRI (magnetic resonance imaging and CSF (cerebrospinal fluid findings. Case: A 46-year-old African-American woman presented with decreased sensation in the lower extremities which started three weeks ago when she had a 36-hour episode of sore throat. She reported numbness up to the level just below the breasts. Lyme disease antibodies total IgG (immunoglobulin G and IgM (immunoglobulin M in the blood was positive. Antinuclear antibody profile was within normal limits. MRI of the cervical spine showed swelling in the lower cervical cord with contrast enhancement. Cerebrospinal fluid was clear with negative Borrelia Burgdorferi IgG and IgM. Herpes simplex, mycoplasma, coxiella, anaplasma, cryptococcus and hepatitis B were all negative. No oligoclonal bands were detected. Quick improvement ensued after she was given IV Ceftriaxone for 7 days. The patient was discharged on the 8th day in stable condition. She continued on doxycycline for 21 days. Conclusions: Transverse myelitis should be included in the differential diagnosis of any patient presenting with acute or subacute myelopathy in association with localized contrast enhancement in the spinal cord especially if flu-like prodromal symptoms were reported. Lyme disease serology is indicated in patients with neurological symptoms keeping in mind that dissociation in Lyme antibody titers between the blood and the CSF is possible.

  8. Utilization of serology for the diagnosis of suspected Lyme borreliosis in Denmark: Survey of patients seen in general practice

    Skarphedinsson Sigurdur

    2010-11-01

    Full Text Available Abstract Background Serological testing for Lyme borreliosis (LB is frequently requested by general practitioners for patients with a wide variety of symptoms. Methods A survey was performed in order to characterize test utilization and clinical features of patients investigated for serum antibodies to Borrelia burgdorferi sensu lato. During one calendar year a questionnaire was sent to the general practitioners who had ordered LB serology from patients in three Danish counties (population 1.5 million inhabitants. Testing was done with a commercial ELISA assay with purified flagella antigen from a Danish strain of B. afzelii. Results A total of 4,664 patients were tested. The IgM and IgG seropositivity rates were 9.2% and 3.3%, respectively. Questionnaires from 2,643 (57% patients were available for analysis. Erythema migrans (EM was suspected in 38% of patients, Lyme arthritis/disseminated disease in 23% and early neuroborreliosis in 13%. Age 0-15 years and suspected EM were significant predictors of IgM seropositivity, whereas suspected acrodermatitis was a predictor of IgG seropositivity. LB was suspected in 646 patients with arthritis, but only 2.3% were IgG seropositive. This is comparable to the level of seropositivity in the background population indicating that Lyme arthritis is a rare entity in Denmark, and the low pretest probability should alert general practitioners to the possibility of false positive LB serology. Significant predictors for treating the patient were a reported tick bite and suspected EM. Conclusions A detailed description of the utilization of serology for Lyme borreliosis with rates of seropositivity according to clinical symptoms is presented. Low rates of seropositivity in certain patient groups indicate a low pretest probability and there is a notable risk of false positive results. 38% of all patients tested were suspected of EM, although this is not a recommended indication due to a low sensitivity of

  9. Appropriateness of Lyme Disease Serologic Testing

    Ramsey, Alan H.; Belongia, Edward A.; Chyou, Po-Huang; Davis, Jeffrey P.

    2004-01-01

    BACKGROUND Although rapid diagnosis of Lyme disease is essential for effective treatment, there is concern about inappropriate testing. We conducted a prospective, cross-sectional survey of clinicians to assess the use and appropriateness of Lyme disease serologic tests (LDSTs).

  10. Lyme disease - what to ask your doctor

    ... this page: //medlineplus.gov/ency/patientinstructions/000252.htm Lyme disease - what to ask your doctor To use ... this page, please enable JavaScript. You may get Lyme disease when you are bitten by a tick ...

  11. Lyme Disease Treatment (Beyond the Basics)

    ... Terms of Use ©2016 UpToDate, Inc. Patient information: Lyme disease treatment (Beyond the Basics) Author Linden Hu, ... Steere, MD Grant/Research/Clinical Trial Support: Immunetics [Lyme disease (Diagnostic test, not available commercially)]. Jennifer Mitty, ...

  12. Post-Treatment Lyme Disease Syndrome

    ... FAQ Health care providers Educational materials Post-Treatment Lyme Disease Syndrome Recommend on Facebook Tweet Share Compartir ... ONE 7(1): e29914. HHS Special Webinar on Lyme Disease Persistence frame support disabled and/or not ...

  13. Diagnostic challenges of early Lyme disease: Lessons from a community case series

    Schwarzwalder Alison

    2009-06-01

    Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

  14. Hypersensitivity to Ticks and Lyme Disease Risk

    Burke, Georgine; Wikel, Stephen K; Spielman, Andrew; Telford, Sam R.; McKay, Kathleen; Krause, Peter J.; ,

    2005-01-01

    Although residents of Lyme disease–endemic regions describe frequent exposure to ticks, Lyme disease develops in relatively few. To determine whether people who experience cutaneous hypersensitivity against tick bite have fewer episodes of Lyme disease than those who do not, we examined several factors that might restrict the incidence of Lyme disease among residents of Block Island, Rhode Island. Of 1,498 study participants, 27% (95% confidence interval [CI] 23%–31%) reported >1 tick bites, ...

  15. Lyme disease and current aspects of immunization

    Kamradt, Thomas

    2001-01-01

    Lyme disease is a tick-borne multisystem disease that affects primarily the skin, nervous system, heart and joints. At least three species of Borrelia burgdorferi sensu lato, namely Borrelia burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii, can cause the disease. This review will focus mainly on the pathophysiology of Lyme arthritis, the long-term outcome of Lyme disease, and the recently licensed vaccine against Lyme disease.

  16. Sinus Pause in Association with Lyme Carditis

    Oktay, A. Afsin; Dibs, Samer R.; Friedman, Harvey

    2015-01-01

    Lyme disease is the most prevalent tick-borne disease in the United States. It is caused by the spirochete Borrelia burgdorferi. Cardiac involvement is seen in 4% to 10% of patients with Lyme disease. The principal manifestation of Lyme carditis is self-limited conduction system disease, with predominant involvement of the atrioventricular node. On rare occasions, Lyme carditis patients present with other conduction system disorders such as bundle branch block, intraventricular conduction del...

  17. Serum carnitine concentration is decreased in patients with Lyme borreliosis

    Alina Kępka

    2016-03-01

    Full Text Available Background: Lyme borreliosis (LB is a serious infectious disease. Carnitine plays a crucial role in metabolism and inflammatory responses. Carnitine may be important in improving neuronal dysfunction and loss of neurons. Aim: To evaluate serum carnitine concentration in adult patients with various clinical types of LB. Material/Methods: Groups: 1 patients with erythema migrans (EM, n=16, 2 neuroborreliosis (NB, n=10, 3 post-Lyme disease (PLD, n=22 and healthy controls (HC, n=32. Total (TC and free (FC carnitine were determined with the spectrophotometric method. Results: TC levels (44.9±10.4, 28.0±8.4, 35.9±15.6 μmol/L in the EM, NB and PLD patients were lower than in HC (54.0±11.4 μmol/L, p < 0.001. FC levels (32.7±7.7, 23.6±6.8, 26.3±11.2 μmol/L in the EM, NB and PLD patients were lower than in HC (40.5±7.6 μmol/L, p < 0.001. AC levels (12.2±5.2, 4.4±2.6, 9.6±7.4 μmol/L in the EM, NB and PLD patients were lower in the NB and PLD patients than in HC (13.5±8.40 μmol/L, p <0.001. AC/FC ratio was 0.31±0.14, 0.18±0.09, 0.39±0.33 in the EM, NB and PLD patients. Conclusions: LB patients exhibit a significant decrease of their serum carnitine concentrations. The largest changes were in the NB and PLD patients. To prevent late complications of the disease a possibility of early supplementation with carnitine should be considered. Further studies are required to explain the pathophysiological significance of our findings.

  18. Isolation and cultivation of Lyme disease spirochetes.

    Barbour, A G

    1984-01-01

    The successful isolation and cultivation of Lyme disease spirochetes traces its lineage to early attempts at cultivating relapsing fever borreliae. Observations on the growth of Lyme disease spirochetes under different in vitro conditions may yield important clues to both the metabolic characteristics of these newly discovered organisms and the pathogenesis of Lyme disease. Images FIG. 1

  19. Rational diagnostic strategies for Lyme borreliosis in children and adolescents: recommendations by the Committee for Infectious Diseases and Vaccinations of the German Academy for Pediatrics and Adolescent Health.

    Huppertz, H I; Bartmann, P; Heininger, U; Fingerle, V; Kinet, M; Klein, R; Korenke, G C; Nentwich, H J

    2012-11-01

    The varying clinical manifestations of Lyme borreliosis, transmitted by Ixodes ricinus and caused by Borrelia burgdorferi, frequently pose diagnostic problems. Diagnostic strategies vary between early and late disease manifestations and usually include serological methods. Erythema migrans is pathognomonic and does not require any further laboratory investigations. In contrast, the diagnosis of neuroborreliosis requires the assessment of serum and cerebrospinal fluid. Lyme arthritis is diagnosed in the presence of newly recognized arthritis and high-titer serum IgG antibodies against B. burgdorferi. The committee concludes the following recommendations: Borrelial serology should only be ordered in case of well-founded clinical suspicion for Lyme borreliosis, i.e., manifestations compatible with the diagnosis. Tests for borrelial genomic sequences in ticks or lymphocyte proliferation assays should not be ordered. When results of such tests or of serological investigations that were not indicated are available, they should not influence therapeutic decisions. Laboratories should be cautious when interpreting results of serological tests and abstain from giving therapeutic recommendations and from proposing retesting after some time without intimate knowledge of patient's history and disease manifestations. PMID:22782450

  20. Enfermedad de Lyme (Borreliosis de Lyme) en Costa Rica

    Ricardo Boza-Cordero

    2011-01-01

    La enfermedad de Lyme o borreliosis de Lyme es una zoonosis transmitida por garrapatas del género Ixodes y producida por la espiroqueta Borrelia burgdorferi. Ha sido descrita principalmente en Norteamérica, Europa y Asia, y se caracteriza clínicamente por una presentación en tres etapas: inicial con eritema migrans que comienza alrededor de la picadura de la garrapata; infección diseminada con fiebre, ataque al estado general, artritis migratoria, linfadenopatías, alteraciones neurológicas y ...

  1. Lyme disease of the brainstem

    Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. Magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of Lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe Lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand. (orig.)

  2. Lyme disease of the brainstem

    Kalina, Peter [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Decker, Andrew [Northern Westchester Hospital Center, Department of Neurology, Mt. Kisco, NY (United States); Kornel, Ezriel [Northern Westchester Hospital Center, Division of Neurosurgery, Mt. Kisco, NY (United States); Halperin, John J. [North Shore University Hospital, Department of Neurology, Manhasset, NY (United States)

    2005-12-01

    Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. Magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of Lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe Lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand. (orig.)

  3. Lyme Disease: diagnosis and treatment

    Ivan Maluf Junior

    2010-11-01

    Full Text Available Lyme disease is a multisystem bacterial infection caused by the spirochete Borrelia burgdorferi. It is transmitted by the bite of infected ticks of the genus Ixodes and Amblyomma. The disease is endemic in wooded, brushy areas, which are habitats for wild animals and ticks. It is the disease most commonly transmitted by ticks, but rarely reported in Brazil. Early local Lyme Disease often starts with erythema migrans at the site of the tick bite, followed by flu-like symptoms. In advanced stage the disease may cause symptoms in the joints, eyes, heart and nervous system. Diagnosis is based on clinical symptoms, epidemiology and laboratory tests. Lyme disease is treated with antibiotics according to the stage of the disease.

  4. CSF-PCR in Diagnosis of Lyme Meningitis

    J Gordon Millichap

    2005-01-01

    The sensitivity, specificity and predictive value of a Lyme CSF-PCR assay were evaluated in children from a Lyme-endemic region admitted to the Alfred I duPont Hospital for Children, Wilmington, DE, for suspected Lyme meningitis.

  5. [Winged scapula in lyme borreliosis].

    Rausch, V; Königshausen, M; Gessmann, J; Schildhauer, T A; Seybold, D

    2016-06-01

    Here we present the case of a young patient with one-sided winged scapula and lyme borreliosis. This disease can be very delimitating in daily life. If non-operative treatment fails, dynamic or static stabilization of the scapula can be a therapeutic option. PMID:26849378

  6. Lyme Disease Comes to Camp.

    Peterson, Michael

    1989-01-01

    Describes one summer camp's plan for dealing with Lyme disease. Describes the disease and the deer tick. Recommends avoiding tick exposure through clothing, frequent examination, showers, and avoiding high grass and brushy areas, and using chemical insect repellents and chemicals to kill ticks in deer mouse nests. (DHP)

  7. [Post-Lyme disease syndrome].

    Błaut-Jurkowska, Justyna; Jurkowski, Marcin

    2016-02-01

    Lyme disease is a chronic infectious disease caused by the bacteria, spirochete of the Borrelia type. Skin, nervous system, musculoskeletal system and heart may be involved in the course of the disease. The prognosis for properly treated Lyme disease is usually good. However, in about 5% of patients so called Post-Lyme disease syndrome (PLSD) develops. It is defined as a syndrome of subjective symptoms persisting despite proper treatment of Borrelia burgdorferi infection. The most common symptoms include: fatigue, muscle and joint pain, and problems with memory and concentration. Pathogenesis of PLDS remains unknown. The differential diagnosis should include neurological, rheumatic and mental diseases. Till now there is no causative treatment of PLDS. In relieving symptom rehabilitation, painkillers, anti-inflammatory and antidepressants medicines are recommended. Emotional and psychological supports are also necessary. Non-specific symptoms reported by patients with post- Lyme disease syndrome raise the suspicion of other pathologies. This can lead to misdiagnosis and implementation of unnecessary, potentially harmful to the patient's therapy. An increase in tick-borne diseases needs to increase physicians awareness of these issues. PMID:27000820

  8. Hispathologic aspects of Lyme Borreliosis.

    Koning, Johannes de

    1994-01-01

    As a result of the recent interest in Lyme disease a large number of papers has been published on its different aspects. The purpose of this thesis is to present a comprehensive study of the most important histopathological manifestations based on the experience obtained during the last 11 years. In

  9. Forest fragmentation and Lyme disease

    Lyme disease is the most commonly reported vectorborne disease in the United States. It is associated with human exposure to infected Ixodes ticks which exist even in degraded forest and herbaceous habitat. We provide an overview of the epidemiology, ecology and landscape charact...

  10. Concentrations of doxycycline and penicillin G in sera and cerebrospinal fluid of patients treated for neuroborreliosis.

    Karlsson, M.; Hammers, S; Nilsson-Ehle, I; Malmborg, A S; Wretlind, B

    1996-01-01

    Concentrations of doxycycline and penicillin G in serum and cerebrospinal fluid (CSF) were analyzed in 46 patients during treatment for neuroborreliosis. Twenty patients were treated intravenously with penicillin G at 3 g every 6 h (q6h), and 26 patients were treated orally with doxycycline at 200 mg q24h. All samples were collected on day 13 of treatment. The median concentrations of penicillin G in serum were 0.5, 37, and 5.6 micrograms/ml before and 1 and 3 h after drug administration, and...

  11. Nervous system Lyme disease, chronic Lyme disease, and none of the above.

    Halperin, John J

    2016-03-01

    Lyme borreliosis, infection with the tick-borne spirochete Borrelia burgdorferi sensu lato, causes nervous system involvement in 10-15 % of identified infected individuals. Not unlike the other well-known spirochetosis, syphilis, infection can be protracted, but is microbiologically curable in virtually all patients, regardless of disease duration. Diagnosis relies on 2-tier serologic testing, which after the first 4-6 weeks of infection is both highly sensitive and specific. After this early, acute phase, serologic testing should rely only on IgG reactivity. Nervous system involvement most commonly presents with meningitis, cranial neuritis and radiculoneuritis, but can also present with a broader array of peripheral nervous system manifestations. Central nervous system infection typically elicits a cerebrospinal fluid pleocytosis and, often, intrathecal production of specific antibody, findings that should not be expected in disease not affecting the CNS. Treatment with recommended courses of oral or, when necessary, parenteral antibiotics is highly effective. The attribution of chronic, non-specific symptoms to "chronic Lyme disease", in the absence of specific evidence of ongoing B. burgdorferi infection, is inappropriate and unfortunate, leading not only to unneeded treatment and its associated complications, but also to missed opportunities for more appropriate management of patients' often disabling symptoms. PMID:26377699

  12. Scintigraphic evaluation of Lyme disease: Gallium-67 imaging of Lyme myositis

    Kengen, R.A.; v.d. Linde, M.; Sprenger, H.G.; Piers, D.A. (Univ. Hospital, Groningen (Netherlands))

    1989-10-01

    A patient suffering from Lyme disease had cardiac conduction abnormalities, symptoms of arthritis, and myalgia. A Ga-67 image showed evidence of endomyocarditis, but intense skeletal muscle uptake pointed to Lyme myositis. Reference is made to two other case reports of Lyme myositis.

  13. Scintigraphic evaluation of Lyme disease: Gallium-67 imaging of Lyme myositis

    A patient suffering from Lyme disease had cardiac conduction abnormalities, symptoms of arthritis, and myalgia. A Ga-67 image showed evidence of endomyocarditis, but intense skeletal muscle uptake pointed to Lyme myositis. Reference is made to two other case reports of Lyme myositis

  14. Contrasting emergence of Lyme disease across ecosystems.

    Mysterud, Atle; Easterday, William Ryan; Stigum, Vetle Malmer; Aas, Anders Bjørnsgaard; Meisingset, Erling L; Viljugrein, Hildegunn

    2016-01-01

    Global environmental changes are causing Lyme disease to emerge in Europe. The life cycle of Ixodes ricinus, the tick vector of Lyme disease, involves an ontogenetic niche shift, from the larval and nymphal stages utilizing a wide range of hosts, picking up the pathogens causing Lyme disease from small vertebrates, to the adult stage depending on larger (non-transmission) hosts, typically deer. Because of this complexity the role of different host species for emergence of Lyme disease remains controversial. Here, by analysing long-term data on incidence in humans over a broad geographical scale in Norway, we show that both high spatial and temporal deer population density increase Lyme disease incidence. However, the trajectories of deer population sizes play an overall limited role for the recent emergence of the disease. Our study suggests that managing deer populations will have some effect on disease incidence, but that Lyme disease may nevertheless increase as multiple drivers are involved. PMID:27306947

  15. Lyme disease and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS: an overview

    Rhee H

    2012-02-01

    Full Text Available Hanna Rhee1, Daniel J Cameron21Medicine, San Diego, CA, 2Northern Westchester Hospital, Mount Kisco, NY, USAAbstract: Lyme disease (LD is a complex, multisystemic illness. As the most common vector-borne disease in the United States, LD is caused by bacterial spirochete Borrelia burgdorferi sensu stricto, with potential coinfections from agents of anaplasmosis, babesiosis, and ehrlichiosis. Persistent symptoms and clinical signs reflect multiorgan involvement with episodes of active disease and periods of remission, not sparing the coveted central nervous system. The capability of microorganisms to cause and exacerbate various neuropsychiatric pathology is also seen in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS, a recently described disorder attributed to bacterium Streptococcus pyogenes of group A beta-hemolytic streptococcus in which neurologic tics and obsessive-compulsive disorders are sequelae of the infection. In the current overview, LD and PANDAS are juxtaposed through a review of their respective infectious etiologies, clinical presentations, mechanisms of disease development, courses of illness, and treatment options. Future directions related to immunoneuropsychiatry are also discussed.Keywords: neuroborreliosis, infection, obsessive-compulsive disorder, tic disorder, Borrelia burgdorferi, strep throat

  16. Cellular immune findings in Lyme disease.

    Sigal, L. H.; Moffat, C. M.; Steere, A. C.; Dwyer, J. M.

    1984-01-01

    From 1981 through 1983, we did the first testing of cellular immunity in Lyme disease. Active established Lyme disease was often associated with lymphopenia, less spontaneous suppressor cell activity than normal, and a heightened response of lymphocytes to phytohemagglutinin and Lyme spirochetal antigens. Thus, a major feature of the immune response during active disease seems to be a lessening of suppression, but it is not yet known whether this response plays a role in the pathophysiology o...

  17. Enfermedad de Lyme (Borreliosis de Lyme en Costa Rica

    Ricardo Boza-Cordero

    2011-01-01

    Full Text Available La enfermedad de Lyme o borreliosis de Lyme es una zoonosis transmitida por garrapatas del género Ixodes y producida por la espiroqueta Borrelia burgdorferi. Ha sido descrita principalmente en Norteamérica, Europa y Asia, y se caracteriza clínicamente por una presentación en tres etapas: inicial con eritema migrans que comienza alrededor de la picadura de la garrapata; infección diseminada con fiebre, ataque al estado general, artritis migratoria, linfadenopatías, alteraciones neurológicas y hepatitis; y la forma crónica, caracterizada por artritis, periostitis, encefalomielitis crónica y polirradiculopatía, entre otras manifestaciones. En Costa Rica se desconocen notificaciones de pacientes con esta patología, por lo que se presenta el caso de una mujer adulta que tras un viaje al Estado de La Florida en los Estados Unidos, presentó cuadro clínico y serológico compatible con la forma leve de la enfermedad de Lyme. Se discuten los hallazgos y se alerta sobre la posibilidad de diagnosticar esta zoonosis, dado el auge del turismo ecológico en estos días.

  18. Lyme Disease—Current State of Knowledge

    Nau, Roland; Christen, Hans-Jürgen; Eiffert, Helmut

    2009-01-01

    The spirochete Borrelia burgdorferi sensu lato is present in approximately 5% to 35% of sheep ticks (Ixodes ricinus) in Germany, depending on the region. In contrast to North America, different genospecies are found in Europe. The most frequent clinical manifestation of Borrelia infection is erythema migrans, followed by neuroborreliosis, arthritis, acrodermatitis chronica atrophicans, and lymphocytosis benigna cutis. Diagnosis is made on the basis of the clinical symptoms, and in stages II a...

  19. Laboratory Confirmation of Lyme Disease

    Schwan, Tom G.; Simpson, Warren J; Rosa, Patricia A.

    1991-01-01

    Lyme disease can be confirmed in the laboratory by isolation or detection of its causative agent, a tick-borne spirochete Borrelia burgdorferi, or by a diagnostic change in the titre of antibodies specific to the agent. B burgdorferi can be isolated and cultivated in Barbour-Stoenner-Kelly II medium. It can be detected by light microscopy in tissue sections or, rarely, in blood smears using various staining methods. There is interest in the development of alternative detection methods, includ...

  20. The Treatment of Lyme disease

    Bakken, Marianne Sibel Tuncel

    2014-01-01

    This review discusses the therapeutic interventions of the different stages of Lyme disease, including effectiveness and prognostics (where possible) and illustrates the various guidelines from Norway, Sweden, European Federation of Neurologic Societies (EFNS) and the Infectious Diseases Society of America (IDSA) and the recommendations from Uptodate, using the latest available research (2000-), guideline references and Uptodate recommendations which is the ultimate gold-standard for this res...

  1. Hispathologic aspects of Lyme Borreliosis.

    Koning, Johannes de

    1994-01-01

    As a result of the recent interest in Lyme disease a large number of papers has been published on its different aspects. The purpose of this thesis is to present a comprehensive study of the most important histopathological manifestations based on the experience obtained during the last 11 years. In the first years, serology was not yet available in our laboratory, the histopathology and demonstration of spirochaetes in tissue were a part of the cliagnostic tools; till to day the recognition ...

  2. Peripheral neuropathy in Lyme borreliosis

    Kindstrand, Eva

    1999-01-01

    Tick-transmitted Lyme borreliosis (LB) is frequently associated with manifestations from the peripheral nervous system. One aim of the thesis was to describe the relationship between peripheral neuropathy and LB by prospective studies of a) LB in some defined neurological conditions with peripheral nerve engagement and b) peripheral neuropathy in the late dermatological LB manifestation acrodermatitis chronica atrophicans (ACA). A second aim was to evaluate the effect of ant...

  3. Complement fixation test for the diagnosis of Lyme disease.

    Artsob, H; Huibner, S

    1990-01-01

    Sera from 43 patients were tested for complement-fixing antibodies to Borrelia burgdorferi; these patients included 8 with confirmed Lyme disease, 21 who were serologically positive but not likely to have Lyme disease, and 14 who were serologically negative. Seven individuals, all confirmed Lyme disease patients, had complement-fixing antibodies. Complement fixation may be a useful confirmatory test for Lyme disease.

  4. Acute Cerebellar Ataxia and Lyme Disease

    J Gordon Millichap

    2013-06-01

    Full Text Available Child neurologists at Baskent University Faculty of Medicine, Turkey, report the case of a 5-year-old girl from the Mediterranean region of Anatolia with a 4-day history of progressive ataxia.

  5. Sunburn and Lyme Disease: Two Preventable Injuries.

    Pavlicin, Karen M.

    1995-01-01

    Stresses the importance of educating campers and staff about the dangers of overexposure to the sun and the transmission of Lyme disease. Discusses the importance of using an appropriate sunscreen and avoiding outdoor activities during peak hours of sunlight. Discusses how Lyme disease is transmitted, the life cycle of a tick, and how to remove…

  6. LYME CARDITIS - CLINICAL CHARACTERISTICS OF 105 CASES

    VANDERLINDE, MR

    1991-01-01

    105 North American and European cases of Lyme carditis, being documented and in part published in the period 1977-1990, are reviewed and compared. The male: female ratio was 3:1, as well in Europe as in the USA. Transient atrioventricular block is the most frequent manifestation of Lyme carditis, wi

  7. Nieuw onderzoek naar de ziekte van Lyme

    Vliet, van A.J.H.; Wijngaard, van den K.; Bron, W.A.

    2015-01-01

    Jaarlijks krijgen ongeveer 25.000 mensen de ziekte van Lyme. Dat blijkt uit nieuwe onderzoeksgegevens van het RIVM. Hoewel het aantal mensen bij wie jaarlijks de ziekte van Lyme wordt vastgesteld lijkt te stabiliseren, blijft het aantal nieuwe patiënten groot. De meeste mensen genezen na een antibio

  8. Lyme disease in Haryana, India

    Vijayeeta Jairath; Manu Sehrawat; Nidhi Jindal; Jain, V. K.; Parul Aggarwal

    2014-01-01

    Lyme disease is a multiorgan animal-borne disease caused by the spirochete Borrelia burgdorferi. This case series highlights its presence in Haryana, a nonendemic zone. The first case was a 27-year-old housewife who presented with an annular erythematous patch with a central papule following an insect bite on the left upper arm. The second case was a 32-year-old farmer who gave a history of insect bite on the right arm followed by the development of an erythematous patch with a central bliste...

  9. Economic Impact of Lyme Disease

    Zhang, Xinzhi; Martin I Meltzer; Peña, César A.; Hopkins, Annette B.; Wroth, Lane; Fix, Alan D.

    2006-01-01

    To assess the economic impact of Lyme disease (LD), the most common vectorborne inflammatory disease in the United States, cost data were collected in 5 counties of the Maryland Eastern Shore from 1997 to 2000. Patients were divided into 5 diagnosis groups, clinically defined early-stage LD, clinically defined late-stage LD, suspected LD, tick bite, and other related complaints. From 1997 to 2000, the mean per patient direct medical cost of early-stage LD decreased from $1,609 to $464 (p

  10. Lyme disease in Haryana, India

    Vijayeeta Jairath

    2014-01-01

    Full Text Available Lyme disease is a multiorgan animal-borne disease caused by the spirochete Borrelia burgdorferi. This case series highlights its presence in Haryana, a nonendemic zone. The first case was a 27-year-old housewife who presented with an annular erythematous patch with a central papule following an insect bite on the left upper arm. The second case was a 32-year-old farmer who gave a history of insect bite on the right arm followed by the development of an erythematous patch with a central blister. The third case, a 17-year-old boy presented with a history of tick bite over right thigh and a typical bull′s eye lesion with central ulceration. These cases were managed with oral doxycycline 100 mg twice daily for 14 days. The fourth case was a 7-year-old boy with typical erythema migrans on the right check and neck while the fifth case, a 30-year-old housewife, presented with an erythematous patch with a central papule on the right buttock. These patients were treated with oral amoxycillin 25 mg/kg, thrice daily for 14 days. All patients showed IgM antibodies to B. burgdorferi. Treatment led to clearance of lesions in all the patients. Lyme borreliosis was diagnosed in these patients based on the history of established exposure to tick bites, presence of classic signs and symptoms, serology and the response to treatment.

  11. NNDSS - Table II. Lyme disease to Meningococcal

    U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2014In this Table, all conditions with a 5-year average annual national total of more than or equals 1,000 cases...

  12. NNDSS - Table II. Lyme disease to Meningococcal

    U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2016. In this Table, provisional* cases of selected†notifiable diseases (≥1,000 cases reported during the...

  13. NNDSS - Table II. Lyme disease to Meningococcal

    U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  14. Ziekte van Lyme : nasleep van een tekenbeet

    Broek, P.; Takken, W.

    2012-01-01

    Dit themanummer beschrijft de Ziekte van Lyme en geeft een overzicht over de stand van kennis over deze complexe ziekte in Nederland. De lymeziekte is uniek omdat zij veroorzaakt wordt door een bacterie die een teek als tussengastheer (vector) gebruikt.

  15. Cotton wool spots as possible indicators of retinal vascular pathology in ocular lyme borreliosis.

    Klaeger, Andres J; Herbort, Carl P

    2010-10-01

    Lyme borreliosis is an underdiagnosed infectious disease caused by a spirochete and transmitted by certain Ixodes ticks. In Lyme disease diagnostic problems are still discussed extensively as the laboratory workup is not standardized and a positive antibody result is not proof of active infection. It is therefore important to appreciate all clinical signs that can prompt us to the diagnostic investigation of Lyme borreliosis. We present a case of a woman with Lyme borreliosis and recurrent unilateral anterior uveitis in her right eye for 2 years, who developed cotton wool spots (CWS) in her left eye, followed by acute and recurrent anterior uveitis in this second eye. An extensive general examination, including blood coagulopathies and ultrasound of the carotid arteries, did not reveal any pathology. The CWS resolved within a few months. The recurrent anterior uveitis could be controlled by topical steroids. After treatment with 2 g of i.v. ceftriaxone for 3 weeks, she remained free of recurrences for 1 year of observation time. CWS can be the first clinical sign of ocular vascular pathology and/or uveitis. Further investigation will be necessary to confirm the relationship between CWS and ocular borreliosis. In patients with otherwise unexplained CWS, the possibility of an infection with borreliosis should be ruled out carefully. PMID:18854948

  16. Geographic Distribution and Expansion of Human Lyme Disease, United States

    2015-01-01

    Lyme disease occurs in specific geographic regions of the United States. We present a method for defining high-risk counties based on observed versus expected number of reported human Lyme disease cases. Applying this method to successive periods shows substantial geographic expansion of counties at high risk for Lyme disease.

  17. What Teachers Need to Know about Lyme Disease

    Cook, Lysandra

    2009-01-01

    Although widely misunderstood, Lyme disease is the most prevalent vector borne disease in the United States. Children are the most at-risk group for Lyme disease, which can impact every system in the body. It can produce the musculo-skeletal, neurologic, psychiatric, opthalmologic, and cardiac symptoms. The symptoms of Lyme disease can have a…

  18. Lyme borreliosis vaccination: the facts, the challenge and the future

    T.J. Schuijt; J.W. Hovius; T. van der Poll; A.P. van Dam; E. Fikrig

    2011-01-01

    Lyme disease, or Lyme borreliosis, the most prevalent arthropod-borne disease in the Western world, is caused by spirochetes belonging to the Borrelia burgdorferi sensu lato group and is predominantly transmitted through Ixodes ticks. There is currently no vaccine available to prevent Lyme borrelios

  19. An Unrecognized Rash Progressing to Lyme Carditis: Important Features and Recommendations Regarding Lyme Disease.

    Lee, Shawn; Singla, Montish

    2016-01-01

    We present a case report of 46-year-old man with no medical history, who complained of extreme fatigue, near-syncope, and palpitations. He initially presented in complete heart block. A transvenous pacemaker was placed in the emergency department, and he was started empirically on Ceftriaxone for Lyme disease. He was admitted and over the course of the next few days, his rhythm regressed to Mobitz type I first-degree atrioventricular block and then to normal sinus rhythm. This case report highlights some important features regarding Lyme carditis, a rare presentation of early disseminated Lyme disease (seen in a few weeks to months after the initial tick bite). In 25%-30% of patients, the characteristic targetoid rash may not be seen, a likely culprit of the disease not being detected early and progressing to disseminated disease. The most common cardiac complaint of Lyme disease is palpitations, occurring in 6.6% of patients, which may not accurately reflect progression into disseminated Lyme disease because it is a nonspecific finding. Conduction abnormality, occurring in 1.8% of patients, is a more specific finding of Borrelia invading cardiac tissue. Finally, this case report highlights a recommendation that patients with confirmed Lyme disease or those presenting with cardiac abnormalities or symptoms who have an atypical profile for a cardiac event should be screened with a 12-lead electrocardiogram, Lyme serology, and be considered for antibiotic therapy with the possibility of temporary pacing. PMID:25730155

  20. Enfermedad de Lyme (Borreliosis de Lyme) en Costa Rica Lyme disease in Costa Rica, a case report

    Ricardo Boza-Cordero

    2011-01-01

    La enfermedad de Lyme o borreliosis de Lyme es una zoonosis transmitida por garrapatas del género Ixodes y producida por la espiroqueta Borrelia burgdorferi. Ha sido descrita principalmente en Norteamérica, Europa y Asia, y se caracteriza clínicamente por una presentación en tres etapas: inicial con eritema migrans que comienza alrededor de la picadura de la garrapata; infección diseminada con fiebre, ataque al estado general, artritis migratoria, linfadenopatías, alteraciones neurológicas y ...

  1. Texas Occurrence of Lyme Disease and Its Neurological Manifestations

    Dandashi, Jad A; Nizamutdinov, Damir; Dayawansa, Samantha; Fonkem, Ekokobe; Huang, Jason H

    2016-01-01

    Today, Lyme disease is the most commonly reported tick-borne disease in the United States and Europe. The culprits behind Lyme disease are the Borrelia species of bacteria. In the USA, Borrelia burgdorferi causes the majority of cases, while in Europe and Asia Borrelia afzelii and Borrelia garinii carry the greatest burden of disease. The clinical manifestations of Lyme disease have been identified as early localized, early disseminated, and late chronic. The neurological effects of Lyme disease include both peripheral and central nervous systems involvement, including focal nerve abnormalities, cranial neuropathies, painful radiculoneuritis, meningitis, and/or toxic metabolic encephalopathy, known as Lyme encephalopathy. Given the geographic predominance of Lyme disease in the Northeast and Midwest of the USA, no major studies have been conducted regarding Southern states. Between 2005 and 2014, the Center for Disease Control has reported 582 confirmed cases of Lyme disease in Texas. Because of the potential for increased incidence and prevalence in Texas, it has become essential for research and clinical efforts to be diverted to the region. The Texas A&M College of Veterinary Medicine and Biomedical Sciences Lyme Lab has been investigating the ecology of Lyme disease in Texas and developing a pan-specific serological test for Lyme diagnosis. This report aimed to exposure materials and raise awareness of Lyme disease to healthcare providers. PMID:27478852

  2. Lyme carditis. Electrophysiologic and histopathologic study

    Reznick, J.W.; Braunstein, D.B.; Walsh, R.L.; Smith, C.R.; Wolfson, P.M.; Gierke, L.W.; Gorelkin, L.; Chandler, F.W.

    1986-11-01

    To further define the nature of Lyme carditis, electrophysiologic study and endomyocardial biopsy were performed in a patient with Lyme disease, whose principal cardiac manifestation was high-degree atrioventricular block. Intracardiac recording demonstrated supra-Hisian block and complete absence of an escape mechanism. Gallium 67 scanning demonstrated myocardial uptake, and right ventricular endomyocardial biopsy revealed active lymphocytic myocarditis. A structure compatible with a spirochetal organism was demonstrated in one biopsy specimen. It is concluded that Lyme disease can produce active myocarditis, as suggested by gallium 67 imaging and confirmed by endomyocardial biopsy. Furthermore, the presence of high-grade atrioventricular block in this disease requires aggressive management with temporary pacemaker and corticosteroid therapy.

  3. Lyme hastalıgı

    YEMİŞ, Mücahit; Mete, Bilgul; Balkan, Ilker Inanc

    2013-01-01

    Kuzey yarım kürede en sık görülen zoonotik hastalıklardan biri olan Lyme hastalığı, spiroketlerin neden olduğu ve vücutta birden çok sistemi tutabilen bir hastalıktır. Kuzey Amerika’da hastalığa Borrelia burgdorferi neden olurken kuzey yarım kürenin diğer bölgelerinde farklı Borrelia türleri hastalık etkeni olabilmektedir. Tüm spiroketler gibi Lyme hastalığının da evreleri vardır ve klinik tablo her evrede farklıdır. Genellikle oral doksisiklin tedavisi ile tedaviye iyi cevap veren Lyme hasta...

  4. Lyme carditis. Electrophysiologic and histopathologic study

    To further define the nature of Lyme carditis, electrophysiologic study and endomyocardial biopsy were performed in a patient with Lyme disease, whose principal cardiac manifestation was high-degree atrioventricular block. Intracardiac recording demonstrated supra-Hisian block and complete absence of an escape mechanism. Gallium 67 scanning demonstrated myocardial uptake, and right ventricular endomyocardial biopsy revealed active lymphocytic myocarditis. A structure compatible with a spirochetal organism was demonstrated in one biopsy specimen. It is concluded that Lyme disease can produce active myocarditis, as suggested by gallium 67 imaging and confirmed by endomyocardial biopsy. Furthermore, the presence of high-grade atrioventricular block in this disease requires aggressive management with temporary pacemaker and corticosteroid therapy

  5. Lyme carditis mimicking giant cell arteritis

    Krati Chauhan

    2015-10-01

    Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

  6. Lyme disease in the United Kingdom.

    Dubrey, Simon W; Bhatia, Ajay; Woodham, Sarah; Rakowicz, Wojtek

    2014-01-01

    Lyme disease, while still an uncommon disease in the UK, is on the increase. Case numbers have increased by 3.6-fold since 2001, with over 950 cases reported by the Health Protection Agency (HPA) in 2011, compared with less than 500 cases annually pre-2004. HPA indications of the true incidence are suggested to be closer to 3000 cases/year, of which around 82% of cases are indigenously acquired. Three genospecies, Borrelia burgdorferi sensu stricto, Borrelia afzelli and Borrelia garinii, represent the predominant pathogenic variants in the UK. Erythema migrans is the commonest manifestation, occurring in 60%-91% of cases. In the UK, neuroborelliosis is the most common complication, while myocarditis is unusual, and death from either conduction disease or carditis is extremely rare. The role of Borrelia infection in chronic dilated cardiomyopathy in the UK remains unproven. Controversy over the existence of either 'chronic Lyme disease' and/or 'post-Lyme disease syndrome' continues unabated. National medical societies, patient advocacy groups, insurance companies, lawyers, doctors, the private health medical sector and scientific journals have all become embroiled in this bitter controversy. New developments include diagnostic tests able to detect Lyme disease at an earlier stage, shorter durations of antibiotic therapy and potential advances in vaccines against Borrelia. PMID:24198341

  7. Lyme Disease: Implications for Health Educators.

    Harbit, Maryanne Drake; Willis, Dawn

    1990-01-01

    Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

  8. Lyme Disease: A Challenge for Outdoor Educators.

    Whitcombe, Mark

    1989-01-01

    Describes signs and symptoms of Lyme disease; life cycle and feeding habits of the deer tick (Ixodes dammini), which transmits the spirochete bacterium; tick control measures; outdoor precautions; and veterinary considerations. Discusses the disease's potential impact on outdoor education, and suggests a reasoned, nonhysterical approach. Contains…

  9. The dynamic proteome of Lyme disease Borrelia.

    Norris, Steven J

    2006-01-01

    The proteome of the spirochete bacterium Borrelia burgdorferi, the tick-borne agent of Lyme disease, has been characterized by two different approaches using mass spectrometry, providing a launching point for future studies on the dramatic changes in protein expression that occur during transmission of the bacterium between ticks and mammals. PMID:16563176

  10. The dynamic proteome of Lyme disease Borrelia

    Norris, Steven J

    2006-01-01

    The proteome of the spirochete bacterium Borrelia burgdorferi, the tick-borne agent of Lyme disease, has been characterized by two different approaches using mass spectrometry, providing a launching point for future studies on the dramatic changes in protein expression that occur during transmission of the bacterium between ticks and mammals.

  11. Enfermedad de Lyme (Borreliosis de Lyme en Costa Rica Lyme disease in Costa Rica, a case report

    Ricardo Boza-Cordero

    2011-01-01

    Full Text Available La enfermedad de Lyme o borreliosis de Lyme es una zoonosis transmitida por garrapatas del género Ixodes y producida por la espiroqueta Borrelia burgdorferi. Ha sido descrita principalmente en Norteamérica, Europa y Asia, y se caracteriza clínicamente por una presentación en tres etapas: inicial con eritema migrans que comienza alrededor de la picadura de la garrapata; infección diseminada con fiebre, ataque al estado general, artritis migratoria, linfadenopatías, alteraciones neurológicas y hepatitis; y la forma crónica, caracterizada por artritis, periostitis, encefalomielitis crónica y polirradiculopatía, entre otras manifestaciones. En Costa Rica se desconocen notificaciones de pacientes con esta patología, por lo que se presenta el caso de una mujer adulta que tras un viaje al Estado de La Florida en los Estados Unidos, presentó cuadro clínico y serológico compatible con la forma leve de la enfermedad de Lyme. Se discuten los hallazgos y se alerta sobre la posibilidad de diagnosticar esta zoonosis, dado el auge del turismo ecológico en estos días.Lyme disease or Lyme borreliosis is a zoonosis transmitted by the Ixodes ticks and caused by a spirochete Borrelia burgdorferi. It has been reported mostly in North America, Europe and Asia and is clinically characterized by a presentation on 3 stages, starting with erythema migrans that begins around the tick bite. Disseminated infection with fever, migratory arthritis, lymphadenopathy, neurological alterations and hepatitis and the chronic phase characterized by arthritis, periostitis, chronic encephalomielitis, polyradiculopathy amongst other manifestations. In Costa Rica, we know of no reports of patients with this disease, so we herein present the case of an woman who, after a trip to the state of Florida, presented clinical and serological alterations compatible with the mild form of Lyme disease. The findings are discussed and also we alert to the possibility of diagnosing

  12. Adult-onset opsoclonus-myoclonus-ataxia syndrome as a manifestation of brazilian lyme disease-like syndrome: a case report and review of literature

    Angelina Maria Martins Lino

    2014-03-01

    Full Text Available Described in 1962, the opsoclonus-myoclonus-ataxia syndrome (OMAS is a rare, neurologically debilitating disorder with distinct characteristics that may begin in childhood or adult life. Although many cases remain without etiological diagnosis, others are related to neoplasms and infectious diseases. We report a 41-year-old previously healthy male with an 8-day history of headache, vertigo, nausea, vomiting, and nystagmus. After a normal brain computed tomography and lymphocytic pleocytosis in cerebral spinal fluid (CSF, intravenous acyclovir therapy was initiated in the emergency room. On the third day of hospitalization, the diagnosis of OMAS was made based on the presence of chaotic and irregular eye movements, dysarthric speech, gait instability, generalized tremor, and myoclonic jerks. In the face of his neurological worsening, ampicillin followed by nonspecific immunotherapy (methylprednisolone and intravenous immunoglobulin was prescribed, with mild clinical improvement. After a thorough laboratory workup, the definite diagnosis of neuroborreliosis was established and ceftriaxone (4 g/daily/3wks and doxycycline (200 mg/day/2 mo was administered. Toward the end of the ceftriaxone regimen, the neurologic signs substantially improved. We believe this to be the first case description of OMAS as clinical presentation of Brazilian Lyme disease-like syndrome (Baggio-Yoshinari syndrome.

  13. False Positive Lyme Disease IgM Immunoblots in Children.

    Lantos, Paul M; Lipsett, Susan C; Nigrovic, Lise E

    2016-07-01

    In our cross-sectional sample of 7289 serologic tests for Lyme disease, we identified 167 instances of a positive IgM immunoblot but a negative IgG immunoblot test result. Considering that only 71% (95% CI 64%-78%) of patients had Lyme disease, a positive IgM immunoblot alone should be interpreted with caution to avoid over-diagnosis of Lyme disease. PMID:27157898

  14. BORRELİA VE LYME HASTALIĞI

    İŞERİ, Latife; DURMAZ, Bengül

    2000-01-01

    Center for Disease Control and Prevention (CDC) has reported that Lyme disease has affected millions of people in recent years. Lyme disease is associated with many clinical manifestations such as skin, musculoskeletal, nervous system and cardiac involvements. Borrella burgdorferi Is the etioiogic agent for Lyme disease and is transmitted by Ixoides ticks. Many studies related to structure and antigenic characteristics of B. Burgdorferi, and epidemiology, clinical feature, and laborator...

  15. General practitioner reported incidence of Lyme carditis in the Netherlands

    Hofhuis, A.; Arend, S.M.; Davids, C.J.; Tukkie, R.; van Pelt, W.

    2015-01-01

    Background Between 1994 and 2009, incidence rates of general practitioner (GP) consultations for tick bites and erythema migrans, the most common early manifestation of Lyme borreliosis, have increased substantially in the Netherlands. The current article aims to estimate and validate the incidence of GP-reported Lyme carditis in the Netherlands. Methods We sent a questionnaire to all GPs in the Netherlands on clinical diagnoses of Lyme borreliosis in 2009 and 2010. To validate and adjust the...

  16. Triple-phase bone image abnormalities in Lyme arthritis

    Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M. (Hahnemann Univ. Hospital, Philadelphia, PA (USA))

    1989-10-01

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities.

  17. Triple-phase bone image abnormalities in Lyme arthritis

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

  18. MRI features of Lyme arthritis of the hips

    Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

  19. MRI features of Lyme arthritis of the hips

    Amini, Behrang [Maimonides Medical Center, Department of Surgery, Brooklyn, NY (United States); Geller, Matthew D. [New York College of Osteopathic Medicine, Old Westbury, NY (United States); Mathew, Manesh; Gerard, Perry [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States)

    2007-11-15

    Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

  20. Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia

    Palmieri JR

    2013-12-01

    Full Text Available James R Palmieri,1 Scott King,1 Matthew Case,1 Arben Santo21Department of Microbiology, Infectious and Emerging Diseases, 2Department of Pathology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USAAbstract: A 50-year-old woman from Pulaski, Virginia, presented to a local clinic with headaches, fever, generalized joint pain, excessive thirst and fluid intake, and a progressing rash on her back. On physical examination, she had a large circular red rash on her back with a bull's-eye appearance, 16 × 18 cm in diameter. Serologic tests confirmed a diagnosis of Lyme disease. The patient could recall a walk through the woods 3 weeks prior, although she never noticed a tick on her body. Following a prolonged course of antibiotics, this case report presents a patient with ongoing symptoms consistent with post-treatment Lyme disease.Keywords: arthritis, chronic Lyme disease (CLD, ELISA, erythema migrans, ixodid ticks, Lyme disease, post-treatment Lyme disease syndrome (PTLDS, Western blotting

  1. Prevalence of Lyme disease among forestry workers

    Piotr Paweł Kocbach

    2014-06-01

    Full Text Available Background: The aim of the study is to assess the incidence of Lyme disease, established diagnosis based on medical history and clinical symptoms, serology, duration of exposure in the workplace and occupational disease certification among forestry workers in selected districts of the Warmia and Mazury region. Material and Methods: The study consisted of annual screening of 332 employees in 6 forest districts under the supervision of the Health Center Medica in Ostróda. Serological tests were performed in all serum samples and IgG and IgM antibodies were determined by ELISA test. Positive results were confirmed by Western-blot test. Diagnosis was made based on medical history and clinical symptoms. Results were presented by the division of selected forest districts, gender, duration of exposure in the workplace and genospecies of spirochete Borrelia responsible for the disease development. Results: Lyme disease incidence was found in all selected forest districts. Positive results in Western-blot test were determined in 120 people (63.1% of all the surveyed. However, after taking a detailed medical history of the patients Lyme disease was diagnosed in 91 people which makes 27.4% of all the examined. Among patients with diagnosed disease, IgG antibodies were found in 76 people, IgM in 25 people, while both IgM and IgG in 10 people. There was also variation in the involvement of genospecies generating the disease; spirochete B. afzeli – 46% for IgG antibodies, whereas spirochete B. burgdorferi – 50% of all cases for IgM antibodies. At the same time the relationship between the extended duration of occupational exposure to tick bites and the increased incidence of Lyme disease was confirmed, indicating the group of workers employed for at least 25 years. Conclusions: Forestry districts of the Warmia and Mazury region, creates extremely dangerous occupational conditions because of exposure to tick bites. At the same time the duration of

  2. Five-Antigen Fluorescent Bead-Based Assay for Diagnosis of Lyme Disease.

    Embers, Monica E; Hasenkampf, Nicole R; Barnes, Mary B; Didier, Elizabeth S; Philipp, Mario T; Tardo, Amanda C

    2016-04-01

    The systematically difficult task of diagnosing Lyme disease can be simplified by sensitive and specific laboratory tests. The currently recommended two-tier test for serology is highly specific but falls short in sensitivity, especially in the early acute phase. We previously examined serially collected serum samples fromBorrelia burgdorferi-infected rhesus macaques and defined a combination of antigens that could be utilized for detection of infection at all phases of disease in humans. The fiveB. burgdorferiantigens, consisting of OspC, OspA, DbpA, OppA2, and the C6 peptide, were combined into a fluorescent cytometric bead-based assay for the detection ofB. burgdorferiantigen-specific IgG antibodies. Samples from Lyme disease patients and controls were used to determine the diagnostic value of this assay. Using this sample set, we found that our five-antigen multiplex IgG assay exhibited higher sensitivity (79.5%) than the enzyme immunoassay (EIA) (76.1%), the two-tier test (61.4%), and the C6 peptide enzyme-linked immunosorbent assay (ELISA) (77.2%) while maintaining specificity over 90%. When detection of IgM was added to the bead-based assay, the sensitivity improved to 91%, but at a cost of reduced specificity (78%). These results indicate that the rational combination of antigens in our multiplex assay may offer an improved serodiagnostic test for Lyme disease. PMID:26843487

  3. Imbalanced presence of Borrelia burgdorferi s.l. multilocus sequence types in clinical manifestations of Lyme borreliosis.

    Coipan, E Claudia; Jahfari, Setareh; Fonville, Manoj; Oei, G Anneke; Spanjaard, Lodewijk; Takumi, Katsuhisa; Hovius, Joppe W R; Sprong, Hein

    2016-08-01

    In this study we used typing based on the eight multilocus sequence typing scheme housekeeping genes (MLST) and 5S-23S rDNA intergenic spacer (IGS) to explore the population structure of Borrelia burgdorferi sensu lato isolates from patients with Lyme borreliosis (LB) and to test the association between the B. burgdorferi s.l. sequence types (ST) and the clinical manifestations they cause in humans. Isolates of B. burgdorferi from 183 LB cases across Europe, with distinct clinical manifestations, and 257 Ixodes ricinus lysates from The Netherlands, were analyzed for this study alone. For completeness, we incorporated in our analysis also 335 European B. burgdorferi s.l. MLST profiles retrieved from literature. Borrelia afzelii and Borrelia bavariensis were associated with human cases of LB while Borrelia garinii, Borrelia lusitaniae and Borrelia valaisiana were associated with questing I. ricinus ticks. B. afzelii was associated with acrodermatitis chronica atrophicans, while B. garinii and B. bavariensis were associated with neuroborreliosis. The samples in our study belonged to 251 different STs, of which 94 are newly described, adding to the overall picture of the genetic diversity of Borrelia genospecies. The fraction of STs that were isolated from human samples was significantly higher for the genospecies that are known to be maintained in enzootic cycles by mammals (B. afzelii, B. bavariensis, and Borrelia spielmanii) than for genospecies that are maintained by birds (B. garinii and B. valaisiana) or lizards (B. lusitaniae). We found six multilocus sequence types that were significantly associated to clinical manifestations in humans and five IGS haplotypes that were associated with the human LB cases. While IGS could perform just as well as the housekeeping genes in the MLST scheme for predicting the infectivity of B. burgdorferi s.l., the advantage of MLST is that it can also capture the differential invasiveness of the various STs. PMID:27125686

  4. Unique expression of chronic Lyme disease and Jarisch-Herxheimer reaction to doxycycline therapy in a young adult.

    Haney, Chad; Nahata, Milap C

    2016-01-01

    I am a 24-year-old male who was diagnosed with chronic Lyme disease after 4 years of multiple, non-specific symptoms. I have written this case as first author with my faculty mentor listed as the coauthor. The objective of this report is to highlight the experience with doxycycline treatment. In 2007, at around age 19 years, I had an acute onset of sore throat, tonsillitis, low-grade fever, stiff upper back and neck muscles, migraines and severely stiff, cracking jaw joints. This led to >24 medical visits, multitudes of tests and examinations, and exploratory surgery over the next 3 years. In 2011, a Lyme-literate medical doctor (LLMD) diagnosed me with chronic Lyme disease. I started taking doxycycline 100 mg by mouth every 12 hours, leading to atypical sequences of events deemed a Jarisch-Herxheimer reaction by a LLMD. This case highlights the unique clinical expression of chronic Lyme disease and the Jarisch-Herxheimer response to doxycycline. PMID:27440843

  5. 77 FR 6465 - Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT

    2012-02-08

    ... SECURITY Coast Guard 33 CFR Part 117 Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT... of the Old Saybrook-Old Lyme RR Bridge, mile 3.4, across the Connecticut River at Old Lyme... INFORMATION: The Old Saybrook-Old Lyme RR Bridge at mile 3.4, across the Connecticut River at Old...

  6. A Lyme Disease Case Study and Individualized Healthcare Plan

    Cavendish, Roberta

    2003-01-01

    The Atlantic and Pacific coasts are the boundaries of Lyme disease with the Northeastern and Midwestern regions of the United States continuing to report the majority of cases. New reported cases of Lyme disease doubled from 1991 to 2001 according to statistics published by the Centers for Disease Control and Prevention (CDC, 2002). Within that…

  7. Lyme borreliosis : reviewing potential vaccines, clinical aspects and health economics

    Smit, Renata; Postma, Maarten J.

    2015-01-01

    Lyme borreliosis (LB) is a multisystem infectious disease with a growing burden in many parts of North America, Asia and Europe. Persistent infection of LB can usually be treated effectively with antibiotic therapy, but it may be followed by post-treatment Lyme disease syndrome. Therefore, it is imp

  8. TOWARDS LANDSCAPE DESIGN GUIDELINES FOR REDUCING LYME DISEASE RISK

    Incidence of Lyme disease in the United States continues to grow. Low-density development is also increasing in endemic regions, raising questions about the relationship between development pattern and disease. This study sought to model Lyme disease incidence rate using quanti...

  9. Lyme Myocarditis Presenting as Chest Pain in an Adolescent Girl.

    Fishe, Jennifer N; Marchese, Ronald F; Callahan, James M

    2016-07-01

    A previously healthy adolescent girl presented to the emergency department with new onset chest and right upper quadrant abdominal pain. Laboratory studies and imaging were consistent with myocarditis. She developed heart block after admission and required stabilization in the cardiac intensive care unit. Lyme serology returned positive, and her condition was diagnosed as Lyme disease-associated myocarditis. PMID:26945194

  10. Reduction in the number of patients with neuroborreliosis, following a significant reduction in roe deer abundance on the island of Funen

    Andersen, Nanna Skaarup; Moestrup Jensen, Per; Skarphédinson, Sigurdur;

    Objectives The Roe deer (Capreolus capreolus) population on the island of Funen, Denmark has since the year 2002, been suffering from increased mortality. The underlying cause has so far been connected to symptoms of diarrhea and malnutrition of unknown etiology and there has been a 50% reduction...... in the annual hunting bag, mirroring the existing abundance of roe deer. It is well established that the abundance of the tick Ixodes ricinus, - the vector of Borrelia burgdorferi sl in Europe,- is correlated with the abundance of roe deer. Since tick abundance correlates with human cases of...... neuroborreliosis, it can be expected that changes in roe deer densities lead to changes in human neuroborreliosis cases in the region. Due to sizable reduction in roe deer abundance on the island of Funen, it was hypothesized that the number of I. ricinus must have declined and thereby the number of patients with...

  11. Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis.

    Burakgazi, Ahmet Z; Henderson, Carl S

    2016-01-01

    Optic neuritis (ON) is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ocular manifestation of Lyme disease (LD) and only a few cases have been published in the literature. Lyme ON is very rare but should be included in the differential diagnosis in unexplained cases, particularly in Lyme endemic areas. Careful and detailed examination and investigation are warranted to make the diagnosis. We report this case to increase awareness of clinicians to include Lyme disease in differential diagnosis of ON for unexplained cases of ON. Herein we present a unique case with a unilateral ON caused by LD along with pre- and posttreatment findings and literature review. PMID:26953086

  12. Doxycycline-mediated effects on persistent symptoms and systemic cytokine responses post-neuroborreliosis: a randomized, prospective, cross-over study

    Sjöwall Johanna; Ledel Anna; Ernerudh Jan; Ekerfelt Christina; Forsberg Pia

    2012-01-01

    Abstract Background Persistent symptoms after treatment of neuroborreliosis (NB) are well-documented, although the causative mechanisms are mainly unknown. The effect of repeated antibiotic treatment has not been studied in detail. The aim of this study was to determine whether: (1) persistent symptoms improve with doxycycline treatment; (2) doxycycline has an influence on systemic cytokine responses, and; (3) improvement of symptoms could be due to doxycycline-mediated immunomodulation. Meth...

  13. Cross-reactivity between Lyme and syphilis screening assays: Lyme disease does not cause false-positive syphilis screens.

    Patriquin, Glenn; LeBlanc, Jason; Heinstein, Charles; Roberts, Catherine; Lindsay, Robbin; Hatchette, Todd F

    2016-03-01

    Increased rates of Lyme disease and syphilis in the same geographic area prompted an assessment of screening test cross-reactivity. This study supports the previously described cross-reactivity of Lyme screening among syphilis-positive sera and reports evidence against the possibility of false-positive syphilis screening tests resulting from previous Borrelia burgdorferi infection. PMID:26707064

  14. DNA characterization of Lyme disease spirochetes.

    Schmid, G P; Steigerwalt, A G; Johnson, S; Barbour, A G; Steere, A. C.; Robinson, I M; Brenner, D J

    1984-01-01

    Lyme disease spirochetes (LDS) have phenotypic characteristics of both treponemes and borreliae. To ascertain whether one or more species of LDS exist, as well as their taxonomic status, we determined the DNA base (G + C) content for three strains of LDS, the DNA relatedness of ten strains isolated in the United States or Europe, and the DNA relatedness of LDS to other spirochetes. The G + C content of the three LDS strains was 28.1-29.0 mol%, most similar to those of Borellia hermsii (30.6 m...

  15. Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

    Jones William

    2010-11-01

    Full Text Available Abstract Background A sensitive and analytically specific nucleic acid amplification test (NAAT is valuable in confirming the diagnosis of early Lyme disease at the stage of spirochetemia. Findings Venous blood drawn from patients with clinical presentations of Lyme disease was tested for the standard 2-tier screen and Western Blot serology assay for Lyme disease, and also by a nested polymerase chain reaction (PCR for B. burgdorferi sensu lato 16S ribosomal DNA. The PCR amplicon was sequenced for B. burgdorferi genomic DNA validation. A total of 130 patients visiting emergency room (ER or Walk-in clinic (WALKIN, and 333 patients referred through the private physicians' offices were studied. While 5.4% of the ER/WALKIN patients showed DNA evidence of spirochetemia, none (0% of the patients referred from private physicians' offices were DNA-positive. In contrast, while 8.4% of the patients referred from private physicians' offices were positive for the 2-tier Lyme serology assay, only 1.5% of the ER/WALKIN patients were positive for this antibody test. The 2-tier serology assay missed 85.7% of the cases of early Lyme disease with spirochetemia. The latter diagnosis was confirmed by DNA sequencing. Conclusion Nested PCR followed by automated DNA sequencing is a valuable supplement to the standard 2-tier antibody assay in the diagnosis of early Lyme disease with spirochetemia. The best time to test for Lyme spirochetemia is when the patients living in the Lyme disease endemic areas develop unexplained symptoms or clinical manifestations that are consistent with Lyme disease early in the course of their illness.

  16. Lyme disease in the differential diagnosis of rheumatoid arthritis

    Ahmet Karadağ

    2016-03-01

    Full Text Available Clinically, there are some differences between rheumatoid arthritis (RA and Lyme disease. Although Lyme arthritis exhibits marked differences from RA, it can cause erosion at joint due to chronic proliferative synovitis as similar to RA. In the literature, a case was reported where both entities were seen together. In this manuscript, we aimed to present a case with symmetric arthritis at small hand joints and arthralgia at wrist that mimicked RA but diagnosed as Lyme disease by history, clinical presentation and laboratory findings, and successfully treated.

  17. Tick Talk: Block Tick Bites and Lyme Disease

    ... External link, please review our exit disclaimer . Subscribe Tick Talk Block Tick Bites and Lyme Disease When warm weather arrives, ... to protect yourself and your loved ones from ticks that often lurk in tall grass, thick brush, ...

  18. Vaccination against Lyme disease: Are we ready for it?

    Kaaijk, Patricia; Luytjes, Willem

    2016-03-01

    Lyme disease is the most common tick-borne illness in the Northern hemisphere and is caused by spirochetes of the Borrelia burgdorferi sensu lato complex. A first sign of Borrelia infection is a circular skin rash, erythema migrans, but it can develop to more serious manifestations affecting skin, nervous system, joints, and/or heart. The marked increase in Lyme disease incidence over the past decades, the severity of the disease, and the associated high medical costs of, in particular, the persistent forms of Lyme disease requires adequate measures for control. Vaccination would be the most effective intervention for prevention, but at present no vaccine is available. In the 1990s, 2 vaccines against Lyme disease based on the OspA protein from the predominant Borrelia species of the US showed to be safe and effective in clinical phase III studies. However, failed public acceptance led to the demise of these monovalent OspA-based vaccines. Nowadays, public seem to be more aware of the serious health problems that Lyme disease can cause and seem more ready for the use of a broadly protective vaccine. This article discusses several aspects that should be considered to enable the development and implementation of a vaccine to prevent Lyme disease successfully. PMID:26337648

  19. Assessing peridomestic entomological factors as predictors for Lyme disease

    Connally, N.P.; Ginsberg, H.S.; Mather, T.N.

    2006-01-01

    The roles of entomologic risk factors, including density of nymphal blacklegged ticks (Ixodes scapularis), prevalence of nymphal infection with the etiologic agent (Borrelia burgdorferi), and density of infected nymphs, in determining the risk of human Lyme disease were assessed at residences in the endemic community of South Kingstown, RI. Nymphs were sampled between May and July from the wooded edge around 51 and 47 residential properties in 2002 and 2003, respectively. Nymphs were collected from all residences sampled. Tick densities, infection rates, and densities of infected nymphs were all significantly higher around homes reporting Lyme disease histories in 2003, while only infection rates were significantly higher in 2002. However, densities of infected nymphs did not significantly predict the probability of Lyme disease at a residence (by logistic regression) in either year. There were no significant differences in entomologic risk factors between homes with state-confirmed Lyme disease histories and homes with self-reported cases (not reported to the state health department). Therefore, although entomologic risk factors tended to be higher at residences with cases of Lyme disease, entomological indices, in the absence of human behavior measures, were not useful predictors of Lyme disease at the scale of individual residences in a tick-endemic community.

  20. Lyme disease in a child presenting with bilateral facial nerve palsy: MRI findings and review of the literature

    Vanzieleghem, B.; Lemmerling, M.; Achten, E.; Vanlangenhove, P.; Kunnen, M. [Dept. of Radiology, University Hospital Gent (Belgium); Carton, D.; Matthys, E. [Dept. of Pediatrics, University Hospital Gent (Belgium)

    1998-11-01

    We report a 7-year-old boy with neuroborreliosis presenting with headache and bilateral facial nerve palsy. MRI demonstrated tentorial and bilateral facial and trigeminal nerve enhancement. (orig.) With 1 fig., 22 refs.

  1. A nonlocal spatial model for Lyme disease

    Yu, Xiao; Zhao, Xiao-Qiang

    2016-07-01

    This paper is devoted to the study of a nonlocal and time-delayed reaction-diffusion model for Lyme disease with a spatially heterogeneous structure. In the case of a bounded domain, we first prove the existence of the positive steady state and a threshold type result for the disease-free system, and then establish the global dynamics for the model system in terms of the basic reproduction number. In the case of an unbound domain, we obtain the existence of the disease spreading speed and its coincidence with the minimal wave speed. At last, we use numerical simulations to verify our analytic results and investigate the influence of model parameters and spatial heterogeneity on the disease infection risk.

  2. Swimming Dynamics of the Lyme Disease Spirochete

    Vig, Dhruv K.; Wolgemuth, Charles W.

    2012-11-01

    The Lyme disease spirochete, Borrelia burgdorferi, swims by undulating its cell body in the form of a traveling flat wave, a process driven by rotating internal flagella. We study B. burgdorferi’s swimming by treating the cell body and flagella as linearly elastic filaments. The dynamics of the cell are then determined from the balance between elastic and resistive forces and moments. We find that planar, traveling waves only exist when the flagella are effectively anchored at both ends of the bacterium and that these traveling flat waves rotate as they undulate. The model predicts how the undulation frequency is related to the torque from the flagellar motors and how the stiffness of the cell body and flagella affect the undulations and morphology.

  3. Borrelia burgdorferi aggrecanase activity: more evidence for persistent infection in Lyme disease

    Stricker, Raphael B.; Johnson, Lorraine

    2013-01-01

    Lyme disease is the most common tickborne illness in the world today. A recent study describes for the first time an enzyme produced by the spirochetal agent of Lyme disease, Borrelia burgdorferi, that cleaves aggrecan, a proteoglycan found in joints and connective tissue. Discovery of the spirochetal aggrecanase raises many questions about the pathogenesis of Lyme arthritis and lends support to the concept of persistent B. burgdorferi infection in patients with chronic Lyme disease symptoms.

  4. Lyme disease following a dog bite – was there a tick?

    Owen, David

    2011-01-01

    Lyme disease is the most common tick borne infection in temperate zones and the reported incidence of the condition is increasing. Erythema migrans is one of the few clinical signs of Lyme disease and is usually indicative of recently acquired infection. A case is presented of Lyme disease with erythema migrans which followed shortly after a dog bite. The author is not aware of any previously reported similar case. The author considers that the development of Lyme disease in the case was most...

  5. Geographic Expansion of Lyme Disease in the Southeastern United States, 2000–2014

    Lantos, Paul M.; Nigrovic, Lise E.; Auwaerter, Paul G.; Fowler, Vance G.; Ruffin, Felicia; Brinkerhoff, R. Jory; Reber, Jodi; Williams, Carl; Broyhill, James; Pan, William K; Gaines, David N.

    2015-01-01

    Background.  The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods.  We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographi...

  6. 75 FR 42608 - Safety Zone; Lyme Community Days, Chaumont Bay, NY

    2010-07-22

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Lyme Community Days, Chaumont Bay, NY... temporary safety zone for Lyme Community Days Fireworks on Chaumont Bay, Lyme, New York. All vessels are... on viewing the docket, call Renee V. Wright, Program Manager, Docket Operations, telephone...

  7. 76 FR 35978 - Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT

    2011-06-21

    ... SECURITY Coast Guard 33 CFR Part 117 Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT... of the Amtrak Railroad Bridge at mile 3.4, across the Connecticut River at Old Lyme, Connecticut. The... INFORMATION: The Amtrak Railroad Bridge, across the Connecticut River at mile 3.4, at Old Lyme,...

  8. Misdiagnosis of early Lyme disease as the summer flu

    John N. Aucott

    2011-09-01

    Full Text Available Lyme disease is often identified by the hallmark erythema migrans rash, but not all early cases present with a rash. In other cases the rash may be unseen or unrecognized by a physician. In these situations, Lyme disease is difficult to diagnose because it masquerades as a non-specific viral-like illness. The seasonal peak of Lyme disease ranging from May through September overlaps with that of viral illnesses such as enteroviral infections, West Nile virus, and in rare years such as 2009, early influenza season. We present a case of a patient with Lyme disease who was initially misdiagnosed with influenza A during the summer of 2009. Because of the diagnostic importance of recognizing the erythema migrans rash, physicians in endemic regions should always ask about new rashes or skin lesions and perform a thorough physical examination when patients present over the summer with viral-like symptoms. Even when no rash is evident, Lyme disease should be considered if these symptoms persist or worsen without a specific diagnosis.

  9. Will Culling White-Tailed Deer Prevent Lyme Disease?

    Kugeler, K J; Jordan, R A; Schulze, T L; Griffith, K S; Mead, P S

    2016-08-01

    White-tailed deer play an important role in the ecology of Lyme disease. In the United States, where the incidence and geographic range of Lyme disease continue to increase, reduction of white-tailed deer populations has been proposed as a means of preventing human illness. The effectiveness of this politically sensitive prevention method is poorly understood. We summarize and evaluate available evidence regarding the effect of deer reduction on vector tick abundance and human disease incidence. Elimination of deer from islands and other isolated settings can have a substantial impact on the reproduction of blacklegged ticks, while reduction short of complete elimination has yielded mixed results. To date, most studies have been conducted in ecologic situations that are not representative to the vast majority of areas with high human Lyme disease risk. Robust evidence linking deer control to reduced human Lyme disease risk is lacking. Currently, there is insufficient evidence to recommend deer population reduction as a Lyme disease prevention measure, except in specific ecologic circumstances. PMID:26684932

  10. Ocular Lyme borreliosis as a rare presentation of unilateral vision loss.

    Patterson-Fortin, Jeffrey; Kohli, Anita; Suarez, Maria J; Miller, P Elliott

    2016-01-01

    Ocular Lyme borreliosis is a rare manifestation of Lyme disease. We describe a case of an 80-year-old woman who presented with a 1-month history of unilateral painless central vision loss. Based on a temporal artery biopsy, she was initially diagnosed with giant cell arteritis and treated with a 3-day course of high-dose intravenous steroids. A more detailed history uncovered multiple previous treatments for Lyme disease and residence in an endemic Lyme area. The patient was subsequently diagnosed with ocular Lyme borreliosis and treated with intravenous antibiotics. After 5 weeks of treatment, unilateral vision loss did not progress and optic disc oedema resolved. PMID:27113793

  11. Disruption of bbe02 by Insertion of a Luciferase Gene Increases Transformation Efficiency of Borrelia burgdorferi and Allows Live Imaging in Lyme Disease Susceptible C3H Mice.

    Kamfai Chan

    Full Text Available Lyme disease is the most prevalent tick-borne disease in North America and Europe. The causative agent, Borrelia burgdorferi persists in the white-footed mouse. Infection with B. burgdorferi can cause acute to persistent multisystemic Lyme disease in humans. Some disease manifestations are also exhibited in the mouse model of Lyme disease. Genetic manipulation of B. burgdorferi remains difficult. First, B. burgdorferi contains a large number of endogenous plasmids with unique sequences encoding unknown functions. The presence of these plasmids needs to be confirmed after each genetic manipulation. Second, the restriction modification defense systems, including that encoded by bbe02 gene lead to low transformation efficiency in B. burgdorferi. Therefore, studying the molecular basis of Lyme pathogenesis is a challenge. Furthermore, investigation of the role of a specific B. burgdorferi protein throughout infection requires a large number of mice, making it labor intensive and expensive. To overcome the problems associated with low transformation efficiency and to reduce the number of mice needed for experiments, we disrupted the bbe02 gene of a highly infectious and pathogenic B. burgdorferi strain, N40 D10/E9 through insertion of a firefly luciferase gene. The bbe02 mutant shows higher transformation efficiency and maintains luciferase activity throughout infection as detected by live imaging of mice. Infectivity and pathogenesis of this mutant were comparable to the wild-type N40 strain. This mutant will serve as an ideal parental strain to examine the roles of various B. burgdorferi proteins in Lyme pathogenesis in the mouse model in the future.

  12. Lyme Disease: Is It or Is It Not?

    BL Johnston

    2005-01-01

    Full Text Available This past summer, Lyme disease was the topic of a Focus section in the Globe and Mail (1. In this section, the reporter described her experience of having physicians unable and then unwilling to diagnose her symptoms of "skin on fire, dizziness and chest pains, twitching muscles, and trouble keeping balance" as Lyme disease following a tick bite three years previously on Prince Edward Island. She reported finding support for her diagnosis after obtaining a positive test from a California laboratory and after seeing approximately 20 physicians. In her article, she speaks to the controversy surrounding the diagnosis and treatment of Lyme disease, and the tension it creates between those who believe they have it and the physicians they see.

  13. Detecting Lyme disease using antibody-functionalized carbon nanotubes

    Dailey, Jennifer; Lerner, Mitchell; Goldsmith, Brett; Brisson, Dustin; Johnson, A. T. Charlie

    2011-03-01

    We combine antibodies for Lyme flagellar protein with carbon nanotube transistors to create an electronic sensor capable of definitive detection of Lyme disease. Over 35,000 cases of Lyme disease are reported in the United States each year, of which more than 23 percent are originally misdiagnosed. Rational design of the coupling of the biological system to the electronic system gives us a flexible sensor platform which we can apply to several biological systems. By coupling these antibodies to carbon nanotubes in particular, we allow for fast, sensitive, highly selective, electronic detection. Unlike antibody or biomarker detection, bacterial protein detection leads to positive identification of both early and late stage bacterial infections, and is easily expandable to environmental monitoring.

  14. Proof That Chronic Lyme Disease Exists

    Daniel J. Cameron

    2010-01-01

    Full Text Available The evidence continues to mount that Chronic Lyme Disease (CLD exists and must be addressed by the medical community if solutions are to be found. Four National Institutes of Health (NIH trials validated the existence and severity of CLD. Despite the evidence, there are physicians who continue to deny the existence and severity of CLD, which can hinder efforts to find a solution. Recognizing CLD could facilitate efforts to avoid diagnostic delays of two years and durations of illness of 4.7 to 9 years described in the NIH trials. The risk to society of emerging antibiotic-resistant organisms should be weighed against the societal risks associated with failing to treat an emerging population saddled with CLD. The mixed long-term outcome in children could also be examined. Once we accept the evidence that CLD exists, the medical community should be able to find solutions. Medical professionals should be encouraged to examine whether: (1 innovative treatments for early LD might prevent CLD, (2 early diagnosis of CLD might result in better treatment outcomes, and (3 more effective treatment regimens can be developed for CLD patients who have had prolonged illness and an associated poor quality of life.

  15. Anti-inflammatory effects of dexamethasone and meloxicam on Borrelia burgdorferi-induced inflammation in neuronal cultures of dorsal root ganglia and myelinating cells of the peripheral nervous system

    Ramesh, Geeta; Meisner, Olivia C.; Philipp, Mario T.

    2015-01-01

    Background Lyme neuroborreliosis (LNB), caused by the spirochete Borrelia burgdorferi (Bb), could result in cognitive impairment, motor dysfunction, and radiculoneuritis. We hypothesized that inflammation is a key factor in LNB pathogenesis and recently evaluated the effects of dexamethasone, a steroidal anti-inflammatory drug, and meloxicam a non-steroidal anti-inflammatory drug (NSAID), in a rhesus monkey model of acute LNB. Dexamethasone treatment significantly reduced the levels of immune...

  16. Conspicuous impacts of inconspicuous hosts on the Lyme disease epidemic

    Brisson, Dustin; Dykhuizen, Daniel E.; Ostfeld, Richard S.

    2007-01-01

    Emerging zoonotic pathogens are a constant threat to human health throughout the world. Control strategies to protect public health regularly fail, due in part to the tendency to focus on a single host species assumed to be the primary reservoir for a pathogen. Here, we present evidence that a diverse set of species can play an important role in determining disease risk to humans using Lyme disease as a model. Host-targeted public health strategies to control the Lyme disease epidemic in Nort...

  17. MRI in Lyme disease of the spinal cord

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  18. MRI in Lyme disease of the spinal cord

    Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C. [Dept. of Diagnostic and Therapeutic Neuroradiology, Hopital Purpan, Toulouse (France); Albucher, J.F. [Dept. of Neurology, Hopital Purpan, Toulouse (France)

    2001-06-01

    We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

  19. Dissecting Lyme borreliosis; Clinical aspects, pathogenesis and prevention

    J. Coumou

    2016-01-01

    Lyme borreliosis (LB) is the most prevalent vector-borne disease in Western Europe and Northeastern parts of the USA. The causative agents of LB are spirochetes belonging to the Borrelia burgdorferi sensu lato group, which are transmitted by Ixodes ticks. Since the late 1970’s, researchers in the Un

  20. First Case of Lyme Arthritis Involving a Prosthetic Knee Joint

    Wright, William F.; Oliverio, James A.

    2016-01-01

    Borrelia burgdorferi sensu stricto is the most common tick-borne illness in the United States. Arthritis is usually a mani­festation of late dis­ease but has not been associated with cases of periprosthetic joint infections. We report on a patient who was first diagnosed with periprosthetic joint infection and subsequently Lyme arthritis. PMID:27419168

  1. Lyme Disease in Hispanics, United States, 2000-2013.

    Nelson, Christina A; Starr, J Andrew; Kugeler, Kiersten J; Mead, Paul S

    2016-03-01

    Hispanics comprise a growing portion of the US population and might have distinct risk factors for tickborne diseases. During 2000-2013, a total of 5,473 Lyme disease cases were reported among Hispanics through national surveillance. Hispanics were more likely than non-Hispanics to have signs of disseminated infection and onset during fall months. PMID:26889721

  2. Lyme Disease in Hispanics, United States, 2000–2013

    Starr, J. Andrew; Kugeler, Kiersten J.; Mead, Paul S.

    2016-01-01

    Hispanics comprise a growing portion of the US population and might have distinct risk factors for tickborne diseases. During 2000–2013, a total of 5,473 Lyme disease cases were reported among Hispanics through national surveillance. Hispanics were more likely than non-Hispanics to have signs of disseminated infection and onset during fall months. PMID:26889721

  3. Aantal ziekte van Lyme gevallen bijna verviervoudigd in 15 jaar

    Snijders, L.; Vliet, van A.J.H.

    2010-01-01

    Het tekenseizoen begint weer. Dit is op natuurkalender.nl goed te zien aan de stijging van het aantal doorgegeven tekenbeten. Dit jaar zullen weer vele tienduizenden mensen gebeten worden. Bij ongeveer een op de 70 ontstaat daarbij de ziekte van Lyme. Het RIVM meldde dat huisartsen in 2009 bij 22.00

  4. Effects of Forest Fragmentation on Human Risk of Lyme Disease

    Percent forest-herbaceous edge repeatedly explained most of the variability in reported Lyme disease rates within a rural-to-urban study gradient across central Maryland and southeastern Pennsylvania. A one-percent increase in forest-herbaceous edge was associated with an increas...

  5. Absence of Lyme disease spirochetes in larval ixodes ricinus ticks

    Richter, D.; Debski, A.; Hubálek, Zdeněk; Matuschka, F.-R.

    2012-01-01

    Roč. 12, č. 1 (2012), s. 21-27. ISSN 1530-3667 Grant ostatní: 6th Framework Programme(XE) GOCE-2003-010284 EDEN Institutional research plan: CEZ:AV0Z60930519 Keywords : blood meal * Borrelia * Ixodes * Lyme disease * Vertical transmission Subject RIV: EE - Microbiology, Virology Impact factor: 2.277, year: 2012

  6. Pharmacist initiation of postexposure doxycycline for Lyme disease prophylaxis.

    Jackson, Anita N; Orr, K Kelly; Bratberg, Jeffrey P; Silverblatt, Frederic

    2014-01-01

    OBJECTIVES To enhance public access to prophylaxis for Lyme disease following an identified Ixodes scapularis tick bite through pharmacist-initiated antibiotic therapy and to assess patient satisfaction with the pharmacy-based service provided. SETTING Independent community pharmacy in Charlestown, RI, from May to October 2012. PRACTICE DESCRIPTION Under a collaborative practice agreement, trained pharmacists at an independent pharmacy identified patients eligible for postexposure antibiotic prophylaxis following attachment and removal of an I. scapularis tick (commonly known as a deer tick) and dispensed two 100 mg tablets of doxycycline. Patients were included if they were 18 years or older, provided informed consent, had an estimated time of tick attachment of 36 hours or more, had the tick removed within 72 hours of visit, denied contraindications to doxycycline therapy, and reported telephone access for follow-up. Patients enrolled in the study protocol were given counseling related to doxycycline, signs and symptoms of Lyme disease, and future tick prevention strategies. PRACTICE INNOVATION Pharmacist initiation of doxycycline prophylaxis has not been described in the literature previously. Successful pharmacist initiation of antibiotic prophylaxis may have broader implications for states with endemic Lyme disease or other infectious disease public health concerns. MAIN OUTCOME MEASURES Patient self-reported adverse outcomes and satisfaction with the pharmacy-based service. RESULTS Eight patients enrolled in the study and completed the follow-up survey. The results indicated a high level of satisfaction with the pharmacy services provided, with no reports of the subsequent development of Lyme disease symptoms or major adverse events. CONCLUSION The project has expanded to three community pharmacy sites in southern Rhode Island based on this experience. Similar pharmacy-based collaborative practice models should be considered in highly endemic Lyme disease

  7. Strain Variation in Glycosaminoglycan Recognition Influences Cell-Type-Specific Binding by Lyme Disease Spirochetes

    Parveen, Nikhat; Robbins, Douglas; Leong, John M.

    1999-01-01

    Lyme disease, a chronic multisystemic disorder that can affect the skin, heart, joints, and nervous system is caused by Borrelia burgdorferi sensu lato. Lyme disease spirochetes were previously shown to bind glycosaminoglycans (GAGs). In the current study, the GAG-binding properties of eight Lyme disease strains were determined. Binding by two high-passage HB19 derivatives to Vero cells could not be inhibited by enzymatic removal of GAGs or by the addition of exogenous GAG. The other six stra...

  8. Tocilizumab Efficacy in a Patient with Positive Anti-CCP Chronic Lyme Arthritis

    Hirsch, Julianna; Rosner, Itzhak; Rimar, Doron; Kaly, Lisa; Rozenbaum, Michael; Boulman, Nina; Slobodin, Gleb

    2016-01-01

    Context: Lyme arthritis, a manifestation of tick-borne Lyme disease, can prove to be refractory to classic treatment. Case Report: We present a case of a 48-year-old male, diagnosed with chronic Lyme arthritis, refractory to recurrent and prolonged courses of doxycycline, ceftriaxone, as well as hydroxychloroquine and methotrexate. The patient responded partially to tumor necrosis factor (TNF)-alpha blockade by etanercept and, finally, entered long-term remission after his treatment was switched to tocilizumab. Conclusion: Off label treatment by biologic disease modifying antirheumatic drugs can be considered in selected patients with severe antibiotic-resistant Lyme arthritis.C. PMID:27213145

  9. Intentions to receive a potentially available Lyme disease vaccine in an urban sample

    Fogel, Joshua; Kusz, Martin

    2016-01-01

    Objectives: The only human Lyme disease vaccine of LYMErix was voluntarily removed from the market in the United States in 2002 for a number of reasons. A new human Lyme disease vaccine is currently being developed. We would like any future approved human Lyme disease vaccine to be of interest and marketable to consumers. Methods: We surveyed 714 participants to determine variables associated with intentions to receive a Lyme disease vaccine. Predictor variables included demographics, protection motivational theory, Lyme disease knowledge, Lyme disease preventive behaviors, beliefs and perceived health. Results: We found in multivariate linear regression analyses that Asian/Asian American race/ethnicity (p Lyme disease vaccine. Although pharmaceutical companies may benefit by advertising a Lyme disease vaccine to Asian/Asian Americans and South Asians, marketers need to address and use approaches to interest those from other race/ethnicities. Also, marketers need to address the erroneous belief that vaccines are typically not safe in order to interest those with such beliefs to use a Lyme disease vaccine. PMID:27551427

  10. Chronic unremitting headache associated with Lyme disease-like illness

    Pedro Andre Kowacs

    2013-07-01

    Full Text Available The Brazilian Lyme-disease-like illness (BLDLI or Baggio-Yoshinari syndrome is a unique zoonosis found in Brazil. It reproduces all the clinical symptoms of Lyme disease except for the high frequencies of relapse and the presence of autoimmune manifestations. Two cases of borreliosis manifesting with unremitting headache, which is a symptom associated with late-stage BLDLI, were presented. Clinical, therapeutic, and prognostic aspects of the BLDLI and its associated headaches were showed and discussed in this article. BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse one. Special attention should be paid to patients with headaches who have traveled to endemic areas.