Black-white differences in the clinical manifestations and timing of initial Lyme disease diagnoses

Background/Aim. Despite numerous research of Lyme disease (LD), there are still many concerns about environmental of infectious agent of LD, as well as its prophylaxis, diagnosis and treatment. The aim of this work was to determine the risk of LD in relation to the way of removing ticks and duration of tick attachment. Methods. In the period from 2000 to 2007 a prospective study was conducted including persons with tick bite referred to the Institute of Epidemiology, Military Medical Academy, and followed for the occurrence of early Lyme disease up to six months after a tick bite. Epidemiological questionnaire was used to collect relevant information about the place and time of tick bites, the way of a removing tick, duration of tick attachment, remnants of a tick left in the skin (parts of the mouth device) and the signs of clinical manifestations of LD. Duration of tick attachment was determined on the basis of size of engorged tick and epidemiological data. Removed ticks were determined by the key of Pomerancev. Professional removing of attached tick was considered to be removing of tick with mechanical means by healthcare personnel. Fisher's exact test, Chi squares test and calculation of the relative risk (RR) were used for data analysis. Results. Of 3 126 patients with tick bite, clinical manifestations of LD were demonstrated in 19 (0.61%). In the group of subjects (n = 829) in which a tick was not removed professionally there were 17 (2.05%) cases with LD, while in the group of respondents (n=2 297) in who a tick was removed professionally there were 2 (0.09%) cases with LD after tick bite (RR, 23.55; p < 0.0001). The disease was most frequent in the group of respondents with incompletely and unprofessionally removed ticks (2.46%). In the groups of patients with unprofessionally but completely removed ticks LD occurred in 0.89%, while in the group of subjects with a tick removed by an expert, but incompletely in 0.78% cases. The disease occurred rarely in the group with a tick removed completely and professionally (0.05%). There was no case of LD in the group of patients with a tick removed within 24 hours. The longer time of exposure after 24 hours, the higher absolute risk of disease was reported. Conclusion. In prevention of Lyme disease it is important to urgent remove a tick, to use a correct procedure of removing and to remove the whole tick without any remnants.

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Clinical and diagnostic manifestations of tickborne mixed infection in combination with COVID-19

Russian Clinical Laboratory Diagnostics ◽

10.51620/0869-2084-2021-66-11-689-694 ◽

2021 ◽

Vol 66 (11) ◽

pp. 689-694

Author(s):

A. L. Shutikova ◽

G. N. Leonova ◽

A. F. Popov ◽

M. Yu. Shchelkanov

Keyword(s):

Lyme Disease ◽

Erythema Migrans ◽

Clinical Manifestations ◽

Underlying Disease ◽

Laboratory Diagnostics ◽

Igg Antibodies ◽

Serum Samples ◽

Igm Antibodies ◽

Chronic Encephalitis ◽

Tbev Strain

The coexistence of various pathogens inside the patient’s body is one of the poorly studied and current issues. The aim of the study is to identify the relationship between the indicators of complex laboratory diagnostics and the clinical manifestations of a mixed disease during subsequent infection with the SARS-CoV-2 virus using the example of a case of chronic encephalitis-borreliosis infection. Seven blood serum samples were collected from the patient over the course of a year. For the etiological verification of the causative agents of TBE, Lyme disease and COVID-19, the methods of ELISA and PCR diagnostics were used. The patient was diagnosed with Lyme disease on the basis of the detection of IgG antibodies to Borrelia 5 months after the onset of the disease, since she denied the tick bite. In the clinical picture, there was an articular syndrome and erythema migrans. Later, IgG antibodies to the TBEV were found in the blood. Throughout the study, IgM antibodies to Borrelia were not detected. The exacerbation of Lyme disease could be judged by the clinical manifestations of this disease and by the growth of specific IgG antibodies. A feature of this case was that during an exacerbation of the Lyme disease, an infection with the SARS-CoV-2 virus occurred. Treatment (umifenovir, hydroxychloroquine, azithromycin, ceftriaxone) was prescribed, which improved the condition of the underlying disease, decreased joint pain, decreased IgG levels to borrelia. However, during this period, serological markers of TBEV appear: antigen, IgM antibodies, and the titer of IgG antibodies increases. Most likely, this was facilitated by the switching of the immune system to the SARS-CoV-2 virus, with the simultaneous suppression of borrelia with antibiotics and the appointment of hydroxychloroquine, which has an immunosuppressive effect. Despite the activation of the virus, clinical manifestations of TBE were not observed in the patient, which is most likely associated with infection with a weakly virulent TBEV strain. The further course of tick-borne infections revealed the dominant influence of B. burgdorferi in relation to TBEV. Laboratory studies have shown that suppression of the activity of the borreliosis process by etiotropic treatment subsequently led to the activation of the persistent TBEV.

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Immunoblot Analysis of Antibody Binding to Polypeptides of Borrelia burgdorferi in Children with Different Clinical Manifestations of Lyme Disease

Pediatric Research ◽

10.1203/00006450-198910000-00019 ◽

1989 ◽

Vol 26 (4) ◽

pp. 377-382 ◽

Cited By ~ 15

Author(s):

D Nadal ◽

C h Taverna ◽

W H Hitzig

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Clinical Manifestations ◽

Immunoblot Analysis ◽

Antibody Binding

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1204. The Effect of Coinfection with Babesiosis and Lyme Disease on Novel Biomarkers

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1389 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S623-S624

Author(s):

Michael D Lum ◽

Kelsey Reardon ◽

Rachel Spector ◽

Evan Garry ◽

Aikaterini Papamanoli ◽

...

Keyword(s):

Lyme Disease ◽

White Blood Cells ◽

Clinical Manifestations ◽

Peripheral Blood Smear ◽

Disease Diagnosis ◽

University Hospital ◽

Babesia Microti ◽

Indirect Bilirubin ◽

Cdc Guidelines ◽

Novel Biomarkers

Abstract Background Current literature presents conflicting results regarding the clinical manifestations of coinfection with Babesia microti (Babesiosis) and Borrelia burgdorferi (Lyme disease). The aim of this study is to investigate the effect that coinfection with Babesiosis and Lyme Disease has on standard and novel biomarkers markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and procalcitonin (Pc), which may assist in elucidating how these pathogens interact within human hosts. Methods Babesia cases were collected from Stony Brook University Hospital from 2012 to 2019. Cases of Babesia were included if parasites were detected by peripheral blood smear and confirmed by PCR. Lyme disease diagnosis criteria involved 2-tier testing per CDC guidelines. Cases were divided into three cohorts based on if they had CRP, ESR or Pc tested. Cohorts were divided into two groups: Babesiosis alone vs coinfection with Lyme Disease. Median values were analyzed for the following biomarkers across both groups: parasitemia, hemoglobin (Hgb), white blood cells (WBC), platelets, indirect bilirubin (IB), lactate dehydrogenase, ESR, CRP and Pc. Fisher Exact and Wilcoxon Rank sum tests were used and P values < 0.05 were considered statistically significant. Results ESR values trended higher in monoinfection compared to coinfection (50 vs 36 mm/hr, p=0.63). Within this cohort, the coinfection group had significantly lower platelet values compared to monoinfection (52 vs. 75.5 K/uL, p=0.04, Table 1). Within the CRP and Pc cohorts, monoinfection had higher trends of parasitemia compared to coinfection (CRP group: 1.6 vs 0.7%, p=0.14, Pc group: 1.4 vs 0.7% p=1.0, Table 2&3). Pc levels were similar in both groups (1.1 vs 1.2 ng/mL, p=1.0, Table 3). Table 1: Demographics and Biomarkers for Patients with Babesiosis Monoinfection vs. Coinfection with Babesiosis and Lyme Disease that had ESR Measured. Table 2: Demographics and Biomarkers for Patients with Babesiosis Monoinfection vs. Coinfection with Babesiosis and Lyme Disease that had CRP Measured. Table 3: Demographics and Biomarkers for Patients with Babesiosis Alone vs Coinfection with Babesiosis and Lyme Disease that had Procalcitonin Measured. Conclusion Coinfection had significantly lower platelets within the ESR cohort but not in other cohorts. While not statistically significant, monoinfection showed greater trends of ESR and parasitemia, which is consistent with previous studies that suggest that B. burgdorferi may mitigate the effects of B. microti infection. CRP and Pc levels were similar across both groups suggesting that the utility of using novel biomarkers to elucidate the interaction between B. burgdorferi and B. microti during simultaneous infection requires further study. Disclosures All Authors: No reported disclosures

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Lyme disease: Clinical manifestations, diagnosis, and treatment

Seminars in Arthritis and Rheumatism ◽

10.1016/0049-0172(91)90017-t ◽

1991 ◽

Vol 20 (4) ◽

pp. 201-218 ◽

Cited By ~ 26

Author(s):

Daniel W. Rahn

Keyword(s):

Lyme Disease ◽

Clinical Manifestations ◽

Diagnosis And Treatment

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Diagnostic Tools for Borrelia Assessment in Humans

The Open Dermatology Journal ◽

10.2174/1874372201610010062 ◽

2016 ◽

Vol 10 (1) ◽

pp. 62-69 ◽

Cited By ~ 1

Author(s):

Serena Bonin

Keyword(s):

Polymerase Chain Reaction ◽

Lyme Disease ◽

Web Sites ◽

Clinical Manifestations ◽

Review Article ◽

Diagnostic Tools ◽

Chain Reaction ◽

Wide Range ◽

Controversial Topic ◽

Polymerase Chain

Although the etiological agent of Lyme disease has been known since 1980s, diagnosis of Lyme disease is still a controversial topic because of the wide range of clinical manifestations and the limited diagnostic tools available to assessBorreliain humans.The most used diagnostic tool for Lyme disease is currently serology, but also Polymerase chain reaction (PCR) and other methods are often used to proveBorreliainfection in different patients’ specimens. The present article deals with most of the diagnostic tools used in clinical practice for Lyme disease detection in human samples. Direct and indirect specific methods forBorreliainfection detection will be discussed.The most recent peer reviewed publications as well as original results from our study and information provided by companies’ web sites have been analyzed to compile this review article.

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Lyme Borreliosis as Cause of Myocarditis: A Case Report and a Review of the Literature

RA Journal Of Applied Research ◽

10.47191/rajar/v7i12.16 ◽

2021 ◽

Vol 07 (12) ◽

Author(s):

Yousra Serroukh ◽

Keyword(s):

Case Report ◽

Lyme Disease ◽

Lyme Borreliosis ◽

Clinical Manifestations ◽

Left Ventricular ◽

Review Of The Literature ◽

Conduction Disorders ◽

Lyme Carditis ◽

The Subject ◽

Cardiac Manifestation

lyme borreliosis (LB) is the most common tick-born disease in the Northern Hemisphere. During early disseminated Lyme disease, cardiac manifestation can occur. including acute conduction disorders, atrioventricular block, acute myopericarditis or left ventricular dysfunction and rarely cardiomegaly or fatal pericarditis. We report a case of a patient with isolated Lyme myocarditis manifested by acute heart failure with atrial fibrillation and review of the literature on the subject. The interested of this case report is to show the need to acquire the reflex to think about a lyme carditis when patients in endemic areas come to attention with cardiovasculair symtoms, even in the absence of others concurerenr clinical manifestations of early lyme disease.

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Nervous System Lyme Disease

10.1093/med/9780199937837.003.0159 ◽

2017 ◽

Cited By ~ 1

Author(s):

John J. Halperin

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Lyme Disease ◽

Borrelia Burgdorferi ◽

Clinical Manifestations ◽

Cerebrospinal Fluid Examination ◽

The Central Nervous System ◽

Cranial Neuropathies ◽

Lymphocytic Meningitis

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.

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The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America

Clinical Infectious Diseases ◽

10.1086/508667 ◽

2006 ◽

Vol 43 (9) ◽

pp. 1089-1134 ◽

Cited By ~ 1210

Author(s):

Gary P. Wormser ◽

Raymond J. Dattwyler ◽

Eugene D. Shapiro ◽

John J. Halperin ◽

Allen C. Steere ◽

...

Keyword(s):

Lyme Disease ◽

Infectious Diseases ◽

Health Care Providers ◽

Treatment Guidelines ◽

Clinical Manifestations ◽

Previous Treatment ◽

Care Providers ◽

Human Granulocytic Anaplasmosis ◽

Treatment And Prevention ◽

Granulocytic Anaplasmosis

Abstract Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:1–14). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of post–Lyme disease syndrome is proposed.

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