Clinical spectrum of Lyme disease

AbstractLyme disease (borreliosis) is one of the most common vector-borne diseases worldwide. Its incidence and geographic expansion has been steadily increasing in the last decades. Lyme disease is caused byBorrelia burgdorferi sensu lato, a heterogeneous group of which three genospecies have been systematically associated to Lyme disease:B. burgdorferi sensu strictoBorrelia afzelii andBorrelia garinii. Geographical distribution and clinical manifestations vary according to the species involved. Lyme disease clinical manifestations may be divided into three stages. Early localized stage is characterized by erythema migrans in the tick bite site. Early disseminated stage may present multiple erythema migrans lesions, borrelial lymphocytoma, lyme neuroborreliosis, carditis, or arthritis. The late disseminated stage manifests with acordermatitis chronica atrophicans, lyme arthritis, and neurological symptoms. Diagnosis is challenging due to the varied clinical manifestations it may present and usually involves a two-step serological approach. In the current review, we present a thorough revision of the clinical manifestations Lyme disease may present. Additionally, history, microbiology, diagnosis, post-treatment Lyme disease syndrome, treatment, and prognosis are discussed.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research

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Authors: Weiss T, Zhu P, White H, Posner M, Wickiser JK, Washington MA, Barnhill J Abstract Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. Although gonococcal arthritis was initially suspected from preliminary laboratory results, a comprehensive evaluation contradicted this diagnosis. Despite antibiotic therapy, asp...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
CONCLUSION: Older children and those with prolonged arthritis, arthritis limited to the knees, or poor initial response to antibiotics are more likely to have antibiotic-refractory disease and treatment-associated toxicity. Children with severe symptoms of systemic inflammation have more favorable outcomes. For children with persistently active Lyme arthritis after 2 antibiotic courses, pediatricians should consider starting antiinflammatory treatment and referring to a pediatric rheumatologist. PMID: 30824653 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
CONCLUSION: IAGC injection appears to be an effective and safe second-line strategy for persistent Lyme arthritis in children, associated with rapid clinical resolution and reduced need for additional treatment. PMID: 30824649 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
Researchers at Johns Hopkins Medicine have developed a PET imaging technique...Read more on AuntMinnie.comRelated Reading: PET's view of tau could explain women's early dementia PET in the paddock New PET tracer could aid melanoma detection PET tracers help guide breast cancer therapies C-11-based PET tracer could benefit arthritis patients
Source: Headlines - Category: Radiology Source Type: news
Treatment of Borrelia burgdorferi-Infected Mice with Apoptotic Cells Attenuates Lyme Arthritis via PPAR-γ. J Immunol. 2019 Jan 30;: Authors: Hilliard KA, Brown CR Abstract Infection of mice with Borrelia burgdorferi causes an inflammatory arthritis that peaks 3-4 wk postinfection and then spontaneously resolves. Although the recruitment of neutrophils is known to drive the development of arthritis, mechanisms of disease resolution remain unclear. Efficient clearance of apoptotic cells (AC) is likely an important component of arthritis resolution. In this article, we show the number of AC increas...
Source: Journal of Immunology - Category: Allergy & Immunology Authors: Tags: J Immunol Source Type: research
Purpose of review To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients. Recent findings The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent revi...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: ORTHOPEDICS: Edited by Daniel W. Green Source Type: research
This study aims to estimate the incidence of the different clinical manifestations of LB in Belgium. The incidence of erythema migrans (EM) was estimated through the network of sentinel general practices at 97.6/100,000 inhabitants (uncertainty interval [UI] 82.0–113.0) for the period 2015 to 2017. This result was used to estimate the incidence of other LB manifestations based on their proportional distribution (ratios) to EM reported in the neighboring countries of Belgium. To estimate these ratios, we performed a systematic review of studies published between February 1, 2008 and January 31, 2018 and pooled the res...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
In Reply Mr Tuttle and Mr Santarella and Dr Sellati cite data from passive surveillance systems as evidence that our statement that erythema migrans develops in 90% or more of patients with Lyme disease was inaccurate. However, multiple large clinical studies have estimated the proportions of pediatric and adult patients with Lyme disease with erythema migrans. These estimates, which are much more reliable because patients were carefully assessed for the presence of erythema migrans, have consistently equaled or exceeded 90%. Lower proportions (eg, 70%) among cases reported to the CDC likely reflect reporting bias toward c...
Source: JAMA - Category: General Medicine Source Type: research
Septic arthritis is a dangerous medical condition associated with significant morbidity and mortality. However, the differential diagnosis can be broad with conditions that mimic this disease and require different evaluation and treatment. This narrative review presents the emergency medicine evaluation and management, as well as important medical conditions that may mimic this disease. Septic arthritis commonly presents with monoarticular joint pain with erythema, warmth, swelling, and pain on palpation and movement. Fever is present in many patients, though most are low grade. Blood testing and imaging may assist with th...
Source: Western Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
ConclusionThe evidence base of biologic markers for A-RLA is limited. However, a range of promising biomarkers have been identified. Cytokines and chemokines related to Th17 pathway together with a number of miRNAs species (miR-146a, miR-155 and let-7a) may be promising candidates in the prediction of A-RLA. A panel of multiple biomarkers may yield clinically relevant prediction of the possible resistance at the time of LA first diagnosis.FundingPublic Health Agency of Canada.
Source: Infectious Diseases and Therapy - Category: Infectious Diseases Source Type: research
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