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Neurological Lyme

Susan Kane Patton, Bailey Phillips
Evidence-based strategies for nurses. ABSTRACT: Lyme disease is recognized as the most common vector-borne disease in the United States. Surveillance data indicate both increasing numbers of Lyme disease cases and geographic expansion of areas where the causative spirochete, Borrelia burgdorferi, can be found. With prompt diagnosis and appropriate treatment in the acute stage, most patients will recover fully. Without treatment, however, the infecting pathogen remains within the body, often producing long-term complications, including musculoskeletal, neurologic, and cardiovascular effects...
March 14, 2018: American Journal of Nursing
Franc Strle, Daša Stupica, Petra Bogovič, Paul Visintainer, Gary P Wormser
Doxycycline is highly effective treatment for early neurologic Lyme borreliosis (NLB). Nineteen studies were reviewed to determine if treatment of patients with erythema migrans with other oral antibiotics would increase the risk for developing NLB. In the eight studies that directly compared doxycycline to another antibiotic, the pooled difference indicated a 0.2% greater risk of developing NLB in doxycycline-treated patients (95% CI: -1.0%, +1.4%; P = 0.77), with an estimated heterogeneity of 0.0%, P = 0...
February 2, 2018: Diagnostic Microbiology and Infectious Disease
Amy L Johnson, Laura K Johnstone, Darko Stefanovski
BACKGROUND: The accuracy of the Lyme multiplex assay for the diagnosis of neuroborreliosis in horses is unknown. HYPOTHESIS/OBJECTIVES: To describe Lyme multiplex results in horses with a postmortem diagnosis of neuroborreliosis. The hypothesis was that paired serum and cerebrospinal fluid (CSF) results and a CSF : serum ratio would allow differentiation of horses with neuroborreliosis from those with other neurologic diseases. ANIMALS: Ninety horses that had neurologic examinations, serum and CSF Lyme multiplex analyses, and postmortem examination of the nervous system performed...
February 20, 2018: Journal of Veterinary Internal Medicine
Stephanie Lim, Sakura Kinjo
A subset of patients who had Lyme disease experience postinfectious signs or symptoms called post-treatment Lyme disease syndrome (PTLDS). PTLDS is a chronic condition including pain in joints and muscles, neurological symptoms including demyelinating diseases, peripheral neuropathy, headaches, sleep disturbances, fatigue, and cardiac conditions. We report a case of difficult acute pain management in a patient with PTLDS who underwent dental extractions and required admission to an intensive care unit for pain control...
January 2018: Saudi Journal of Anaesthesia
Larry M Bush, Maria T Vazquez-Pertejo
Lyme disease is the most commonly reported tick-borneillness in the United States. Thecausative spirochete, Borrelia burgdorferi is transmitted by 4 species of Ixodes tick species. Over 90% of US cases occur in northeasternstates from Maine to Virginia, and in Wisconsin, Minnesota, and Michigan. Infection also takes place in northern California and Oregon. Lyme borreliosis is also diagnosed in parts of Europe, China, and Japan. The white-footed mouse is the primary animal reservoir for B. burgdorferi in the U...
February 2, 2018: Disease-a-month: DM
Katsuki Eguchi, Kazuhumi Tsuzaka, Ichiro Yabe, Hidenao Sasaki
A 56-year-old man was sustained ticks at the left axilla and flank. He did not have a rash. About 3 months after the tick bites, he developed back pain, right leg weakness, right abducens nerve palsy, and left facial palsy. Western blot analysis for serum IgM and IgG antibodies against Borrelia were positive. We diagnosed Lyme borreliosis. The patient was treated with antibiotics and steroids, and the symptoms improved. Our findings demonstrate that, even if erythema migrans is not obvious, neuroborreliosis should be considered when neurological signs, such as multiple cranial nerve palsies, are present...
January 31, 2018: Rinshō Shinkeigaku, Clinical Neurology
Angela M Thomm, Anna M Schotthoefer, Alan P Dupuis, Laura D Kramer, Holly M Frost, Thomas R Fritsche, Yvette A Harrington, Konstance K Knox, Sue C Kehl
Powassan virus (POWV) is an emerging tick-borne arbovirus presenting a public health threat in North America. POWV lineage II, also known as deer tick virus, is the strain of the virus most frequently found in Ixodes scapularis ticks and is implicated in most cases of POWV encephalitis in the United States. Currently, no commercial tests are available to detect POWV exposure in tick-borne disease (TBD) patients. We describe here the development and analytical validation of a serologic test panel to detect POWV infections...
January 2018: MSphere
Shangming Zhang, Lucy Q Zhang, Megan Wright, David R Gater
Neuralgic amyotrophy (NA) is a neurological syndrome of unknown etiology primarily affecting the brachial plexus. We are reporting an unusual case of acute bilateral NA that was possibly secondary to Lyme disease. The patient demonstrated significant functional gains and was discharged home after 2 weeks of inpatient rehabilitation, supporting the role of inpatient rehabilitation in acute NA. In this report, we discussed the diagnosis, electrodiagnostic progression, pain management, goals for inpatient rehabilitation and overall prognosis of NA...
December 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Tadeusz Płusa
Lyme disease occurs in a variety of clinical manifestations, ranging from skin lesions, through musculoskeletal, neurological, and cardiac syndrome, to severe irreversible lesions. Borrelia burgdorferi's organotropy has an impact on the development of the disease. In initial management, it is important to implement effective treatment to prevent further progression of infection. Dominant skin lesions should be differentiated in detail. In the form of disseminated disease complex of clinical syndromes is observed but it requires of confirmation in immunoassays...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
O Monteventi, M Steinlin, M Regényi, E Roulet-Perez, P Weber, J Fluss
BACKGROUND: Cerebrovascular complications of Lyme neuroborreliosis (LNB) are poorly documented in the paediatric population. METHODS: We performed a retrospective analysis from prospectively registered cases of acute ischemic stroke (AIS) from the Swiss NeuroPaediatric Stroke Registry (SNPSR) from 2000 to 2015. Only cases with serologically confirmed LNB were included. In addition, a literature review on paediatric stroke cases secondary to Lyme neuroborreliosis in the same time frame was performed...
January 2018: European Journal of Paediatric Neurology: EJPN
Fredrikke Christie Knudtzen, Nanna Skaarup Andersen, Thøger Gorm Jensen, Sigurdur Skarphédinsson
Background: Despite a well-described symptomatology, treatment delay and sequelae are common in patients with Lyme neuroborreliosis (LNB). The aim of this study was to contribute to the knowledge about the symptomatology and epidemiology of LNB. Methods: We conducted a retrospective study of all LNB cases verified by a positive Borrelia intrathecal antibody index test performed at the Department of Microbiology, Odense University Hospital, Denmark, from 1995 through 2014...
October 16, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Elisa Kortela, Jukka Hytönen, Jussi Numminen, Margit Overmyer, Harri Saxen, Jarmo Oksi
Introduction. Lyme borreliosis is a multisystem tick-borne disease caused by Borrelia burgdorferi. Neurological manifestations are reported in up to 15 % of adult patients with Lyme disease, while the frequency among children is higher. The most common manifestations are painful radiculopathy, facial nerve paresis and lymphocytic meningitis. Epileptic seizures and cerebral vasculitis with stroke or aneurysms are very rare complications. Case presentation. We describe a paediatric patient with sensorineural auditory dysfunction, headache, fatigue and epileptic seizures as sequelae of meningoencephalitis/Lyme neuroborreliosis (LNB) caused by B...
April 2017: JMM Case Reports
Aurélie Velay, Morgane Solis, Wallys Kack-Kack, Pierre Gantner, Marianne Maquart, Martin Martinot, Olivier Augereau, Dominique De Briel, Pierre Kieffer, Caroline Lohmann, Jean Dominique Poveda, Emmanuelle Cart-Tanneur, Xavier Argemi, Isabelle Leparc-Goffart, Sylvie de Martino, Benoit Jaulhac, Sophie Raguet, Marie-Josée Wendling, Yves Hansmann, Samira Fafi-Kremer
OBJECTIVES: Tick-borne encephalitis virus (TBEV) is a zoonotic agent causing severe encephalitis. In 2016, in Northeastern France, we faced a TBEV infection increase, leading to a warning from the Regional Health Agency. Here, we report the confirmed TBE cases diagnosed between January 2013 and December 2016, with particular emphasis on the year 2016. METHODS: A total of 1643 blood and cerebrospinal fluid (CSF) samples from everywhere in France, corresponding to 1460 patients, were prospectively tested for anti-TBEV-specific IgM and IgG antibodies by ELISA...
September 28, 2017: Ticks and Tick-borne Diseases
Jiaru Yang, Xinlin Han, Aihua Liu, Fukai Bao, Yun Peng, Lüyan Tao, Mingbiao Ma, Ruolan Bai, Xiting Dai
Lyme neuroborreliosis (LNB), which is the most common neurological manifestation of Lyme disease (LD), seriously impairs both the central and peripheral nervous systems. Current LNB diagnostic methods and criteria are not very effective. Recently, several studies have indicated that a high concentration of the chemokine CXC ligand 13 (CXCL13) in cerebrospinal fluid (CSF) could be used as a new biomarker for the diagnosis of LNB. Thus, we carried out a meta-analysis to systematically analyze the data from these studies to evaluate the value of CXCL13 as an LNB biomarker...
October 2017: Journal of Interferon & Cytokine Research
B Kříž, M Malý, M Daniel
STUDY OBJECTIVE: The objective was to analyse and evaluate a cohort of Lyme borreliosis (LB) patients with neuroborreliosis (LNB) hospitalised in the Czech Republic in 2003-2013. MATERIAL AND METHODS: Data analysed in this study were obtained from the National Register of Hospitalised Patients, which is a nationwide population register maintained at the Institute of Health Information and Statistics of the Czech Republic. Data collection from all departments of bed care establishments are regularly processed every year...
2017: Epidemiologie, Mikrobiologie, Imunologie
Heidelore Hofmann, Volker Fingerle, Klaus-Peter Hunfeld, Hans-Iko Huppertz, Andreas Krause, Sebastian Rauer, Bernhard Ruf
This guideline of the German Dermatology Society primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It has received consensus from 22 German medical societies and 2 German patient organisations. It is the first part of an AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V.) interdisciplinary guideline: "Lyme Borreliosis - Diagnosis and Treatment, development stage S3". The guideline is directed at physicians in private practices and clinics who treat Lyme borreliosis...
2017: German Medical Science: GMS E-journal
Jennifer A Caine, Yi-Pin Lin, Julie R Kessler, Hiromi Sato, John M Leong, Jenifer Coburn
Borrelia burgdorferi (Bb) is the causative agent of Lyme disease in the United States, a disease that can result in carditis, and chronic and debilitating arthritis and/or neurologic symptoms if left untreated. Bb survives in the midgut of the Ixodes scapularis tick, or within tissues of immunocompetent hosts. In the early stages of infection, the bacteria are present in the bloodstream where they must resist clearance by the innate immune system of the host. We have found a novel role for outer surface protein C (OspC) from B...
December 2017: Cellular Microbiology
Sándor Szekeres, András Lakos, Gábor Földvári
Borrelia miyamotoi is a recently described relapsing fever spirochete transmitted by ticks of the Ixodes ricinus complex. This pathogen is different from Borrelia burgdorferi sensu lato (the Lyme borreliosis spirochetes) in its epidemiology, ecology and also genetics. Over 50 patients have been described worldwide with Borrelia miyamotoi disease, and three immunocompromised patients were reported with neurological symptoms. Our knowledge about Borrelia miyamotoi infection in ticks and its distribution in different habitats and also the mechanism of the infection is limited...
July 2017: Orvosi Hetilap
Cees C van den Wijngaard, Agnetha Hofhuis, Mariana Simões, Ente Rood, Wilfrid van Pelt, Herve Zeller, Wim Van Bortel
Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe. Erythema migrans (EM), an early, localised skin rash, is its most common presentation. Dissemination of the bacteria can lead to more severe manifestations including skin, neurological, cardiac, musculoskeletal and ocular manifestations. Comparison of LB incidence rates in the European Union (EU)/European Economic Area (EEA) and Balkan countries are difficult in the absence of standardised surveillance and reporting procedures. We explored six surveillance scenarios for LB surveillance in the EU/EEA, based on the following key indicators: (i) erythema migrans, (ii) neuroborreliosis, (iii) all human LB manifestations, (iv) seroprevalence, (v) tick bites, and (vi) infected ticks and reservoir hosts...
July 6, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Matteo D'Alessandro, Anna Loy, Elio Castagnola
PURPOSE OF REVIEW: Lyme disease is a tick-borne zoonosis transmitted through a bite of a tick carrying a spirochete belonging to Borrelia species. In the last 20 years, the reported incidence of Lyme disease is increased by three times in Europe. Clinically, the illness develops through a primary stage with a typical skin rash (erythema marginatum), then a secondary stage with possible neurologic or cardiac involvement. The last stage (chronic Lyme disease) is mainly represented by arthritis or late neurological complications but nowadays is rarely seen due to precocious antibiotic use...
August 2017: Current Infectious Disease Reports
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