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101.
《Expert review of anti-infective therapy》2013,11(11):1307-1310
Whether Borrelia burgdorferi, the causative agent of Lyme disease, can persist after antibiotic therapy is an area of ongoing controversy. In animal models, B. burgdorferi DNA can be detected in tissues after antibiotic therapy as well as by using the natural tick vector to acquire the organism through feeding (xenodiagnosis). Vector arthropods have been successfully used in xenodiagnosis to describe the etiology of infections such as malaria, typhus and Chagas disease. Our recent safety trial of xenodiagnosis demonstrates that ticks may be successfully fed on patients and may help determine the biological basis for post-treatment Lyme disease syndrome. 相似文献
102.
103.
莱姆病在我国的首次报告 总被引:1,自引:0,他引:1
1986年作者在黑龙江省林区观察到莱姆病162例,此病又名伯格多费里疏螺旋体病,系由硬蜱传播,可引起人体多器官病变,早期皮肤病变是慢性游走性红斑,以后可有头痛、颈项强直、面瘫等神经系统症状和心脏、关节损害。免疫学检查发现恢复期病人血清中有高度特异性抗体。对部分现症病人青霉素治疗取得明显疗效。本病例报告系莱姆病在我国的首次报告。 相似文献
104.
105.
Canadian Public Health Laboratory Network 《The Canadian Journal of Infectious Diseases & Medical Microbiology》2007,18(2):145-148
Lyme borreliosis is uncommonly seen in Canada. Most cases have occurred in close proximity to small geographical areas where infected ticks have become established. Although few cases are seen, thousands of patients are tested yearly. Unless patients are carefully selected and an appropriately sensitive and specific testing algorithm is applied, large numbers of patients without Lyme borreliosis will be incorrectly diagnosed. The Canadian Public Health Laboratory Network has developed the present guidelines to assist physicians in assessing patients for Lyme borreliosis, and to help guide the choice and interpretation of laboratory testing. 相似文献
106.
Th. Benke Th. Gasse M. Hittmair-Delazer E. Schmutzhard 《Acta neurologica Scandinavica》1995,91(5):353-357
We studied long-term cognitive deficits in 20 patients with previously diagnosed Lyme borreliosis several years (average 51.6 months) after their acute phase of illness. Compared with an age- and education matched control group Lyme patients revealed deficits of verbal memory, mental flexibility, verbal associative functions and articulation, but performed adequately on tests of intellectual and problem solving skills, sustained attention, visuoconstructive abilities and mental speed. The late cognitive outcome was unrelated to disease variables from the acute stage of illness, but also to the interval elapsed since infection with B.burgdorferi . These and similar observations (Krupp et al. 1991) suggest that the so-called Lyme encephalopathy may be associated with a long-lasting neuropsychological deficit predominantly affecting mnestic functions. 相似文献
107.
Thomas Brinck Klaus Hansen Jes Olesen 《Cephalalgia : an international journal of headache》1993,13(3):207-209
We present two patients with monosymptomatic headache resembling chronic tension-type headache as the first manifestation of Lyme neuroborreliosis. The headache developed over a few days in both cases and lasted for three months in the first case and for two and a half years in the second case before the diagnosis of Lyme neuroborreliosis was made. Neuroimaging and many laboratory investigations did not lead to the diagnosis, which was only established after lumbar puncture. The CSF in both cases showed high protein, lymphocytic pleocytosis and Borrelia burgdorferi-specific intrathecal antibody synthesis. The headache disappeared completely after treatment with penicillin G. In patients suffering from daily headaches which have developed subacutely, Lyme neuroborreliosis should be considered even in the absence of signs of meningeal irritation. A lumbar puncture should be performed more often than is presently customary and the CSF should be examined for pleocytosis as well as Borrelia burgdorferi -specific intrathecal antibody synthesis. 相似文献
108.
M. Millner M. G. Schimek D. Spork M. Schnizer G. Stanek 《European journal of pediatrics》1989,148(6):527-530
A total of 27 children with clinical symptoms indicative of Lyme borreliosis are described, 21 of which were seropositive. CNS symptoms were found in 17 of the seropositive childen (81%). Of these 21, 7 were CSF negative. Another 3 (with Bell's palsy and/or aseptic meningitis) were initially CSF negative but developed specific CSF titres 80, 65 and 120 days after the first lumbar puncture, respectively. Thus, seropositive children with aseptic meningitis and without initial signs of an infectious aetiology should be checked for a neuroborreliosis even when CSF negative in the first lumbar puncture. Antibiotic therapy undertaken in 26 children showed clinical recovery (Sodium penicillin, 300,000–500,000 units/kg per day for 14 days). One developed residual hypoacusis. Comparison of enzyme-linked immunosorbent assay (ELISA) IgG values from 27 cases with those of 30 healthy controls showed that elevated ELISA titres are a good indication of the disease. However, Lyme borreliosis can only be diagnosed correctly if the clinical symptoms conform with specific titres.Abbreviations
Bb
Borrelia burgdorferi
- CNS
central nervous system
- CSF
cerebrospinal fluid
- EBV
Epstein-Barr virus
- ECM
erythema chronicum migrans
- ELISA
enzyme-linked immunosorbent assay
- Ig
immunoglobulin
- Lb
Lyme borreliosis 相似文献
109.
A. Neumann M. Schlesier H. Schneider A. Vogt H. H. Peter 《Rheumatology international》1989,9(3-5):237-241
Summary Using a limiting dilution system, frequencies of Borrelia burgdorferi-reactive T cells were determined in the blood and synovial fluid of four patients with chronic Lyme arthritis (LA), one patient with acrodermatitis chronica atrophicans (ACA), two patients with other inflammatory joint diseases, and two healthy individuals. B. burgdorferi-reactive precursor T cells ranged from 1/750 to 1/8 220 in case of LA and ACA patients and from 1/820 to 1/31 400 in case of controls. In vivo activated B. burgdorferi-reactive T cells were almost absent in control subjects. With one exception, they were detected in LA patients at frequencies ranging from 1/1 300 to 1/15 400. Interestingly, even after successful antibiotic therapy of LA patients, similar frequencies of in vivo activated B. burgdorferi-reactive T cells were observed in the peripheral blood, provided that low cell concentrations were used for culture. At higher cell numbers, the fraction of B. burgdorferi-reactive T cells apparently dropped, suggesting regulatory phenomena. 相似文献
110.
J. Stephen Huff MD Scott A. Syverud MD Mary Anne Tucci MD 《Academic emergency medicine》1995,2(8):751-756
A previously healthy 32-year-old man presented to the ED in complete heart block. Ischemic, infectious, and inflammatory conditions were considered in the differential diagnosis. Management options for complete heart block, the etiology of heart block in young adults, and treatment guidelines are reviewed. 相似文献