scholarly journals Jarisch-Herxheimer reaction during therapy of neuroborreliosis

Praxis medica ◽  
2020 ◽  
Vol 49 (1-2) ◽  
pp. 49-52
Author(s):  
Snežana Knežević ◽  
Jelena Vulović ◽  
Marijana Jandrić-Kočić
Keyword(s):  
Magnetic Resonance ◽  
Lyme Disease ◽  
Neurological Disorders ◽  
Axonal Degeneration ◽  
Underlying Disease ◽  
Symptomatic Therapy ◽  
Respiratory Problems ◽  
Memory Disorder ◽  
Appropriate Care ◽  
Disease Case

Introduction. Jarisch-Herxheimer reaction implies trembling, headache, temperature, rash, meningitis, respiratory problems, liver, kidney and heart dysfunction during antibiotic treatment of Lyme disease. Case outline. A 47-year-old patient in May 2016 had circular redness on the thigh, fatigue, myalgia, nausea and headache. Borrelia Burgdorferi IgM antibodies were positive. She took doxycycline 200 mg/day, four weeks. Western blot IgM and IgG were positive as well. Retreated with Azithromycin, 500 mg/day, three weeks. Next year, there was a sleep and memory disorder, fatigue, dizziness, right leg paresthesia and burning in the soles, muscle weakness, decreased sensitivity and right foot hyperreflexia. Electromyography showed axonal degeneration of the peroneus and the tibialis. Pleocytosis (5 leucocytes/mm³) and intrathecal IgG were found. Magnetic resonance of the head in order. Neuroborreliosis was diagnosed and treatment included ceftriaxone, 2 grams/day, three weeks. After the second dose, trembling, myalgia, headache, nausea, flushed nose, dizziness and nausea started. Temperature 37.8°C. No changes on the skin. The antibiotic was not interrupted, symptomatic therapy was administered, and after two days the symptoms stopped. Neurological disorders have not completely disappeared. Titre antibodies still present. Conclusion. Jarisch-Herxheimer reaction occurs in 7.0-30.0% of patients treated for Lyme disease. Causes are multifactorial. Spirochetes release toxins, hypersensitivity is present, phagocytes destroy agents, complements and cytokines are activated. It is often not recognized. Tremor, fever, myalgia and skin rashes are present before the antibiotic, and the worsening is attributed to the underlying disease or allergy. Doctors should expect it during the treatment of spirochete-related diseases and provide appropriate care.

scholarly journals Application of deep learning in detecting neurological disorders from magnetic resonance images: a survey on the detection of Alzheimer’s disease, Parkinson’s disease and schizophrenia

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Manan Binth Taj Noor ◽  
Nusrat Zerin Zenia ◽  
M Shamim Kaiser ◽  
Shamim Al Mamun ◽  
Mufti Mahmud
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Deep Learning ◽  
Magnetic Resonance ◽  
Neurological Disorders ◽  
Magnetic Resonance Images ◽  
Future Research ◽  
Comparative Performance

Abstract Neuroimaging, in particular magnetic resonance imaging (MRI), has been playing an important role in understanding brain functionalities and its disorders during the last couple of decades. These cutting-edge MRI scans, supported by high-performance computational tools and novel ML techniques, have opened up possibilities to unprecedentedly identify neurological disorders. However, similarities in disease phenotypes make it very difficult to detect such disorders accurately from the acquired neuroimaging data. This article critically examines and compares performances of the existing deep learning (DL)-based methods to detect neurological disorders—focusing on Alzheimer’s disease, Parkinson’s disease and schizophrenia—from MRI data acquired using different modalities including functional and structural MRI. The comparative performance analysis of various DL architectures across different disorders and imaging modalities suggests that the Convolutional Neural Network outperforms other methods in detecting neurological disorders. Towards the end, a number of current research challenges are indicated and some possible future research directions are provided.

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

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.

Life-threatening conditions in pericarditis of different etiologies: diagnosis and treatment

2019 ◽  
pp. 40-45
Author(s):  
A. Ya. Kosonogov ◽  
S. V. Nemirova ◽  
V. I. Pozdishev ◽  
A. B. Nikolskiy ◽  
K. A. Kosonogov ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Postoperative Period ◽  
Underlying Disease ◽  
Electrolyte Balance ◽  
Symptomatic Therapy ◽  
Electrolyte Disorders ◽  
Results Of Treatment ◽  
Cardiac Compression ◽  
Pericardial Diseases ◽  
Life Threatening

Purpose of the study: to analyze the etiology, diagnostic criteria and results of treatment of life-threatening conditions in pericarditis of different etiologies (based on our clinic materials).Materials and methods. The study included cases of hospitalization of patients with a diagnosis of «Pericarditis» and ICD-10 codes for pericardial diseases for the period from 2009 to 2018. In the course of the work, the history and clinical picture of the disease, laboratory and radiation research methods were analyzed. All patients started treatment of the underlying disease and performed symptomatic therapy, including those aimed at restoring hemodynamics and normalizing water and electrolyte disorders, stopping inflammation and auto-aggression of the immune system. When signs of compression/cardiac tamponade were detected, pericardiocentesis was performed, according to indications, drainage/fenestration of the cardiac sac, pericardiotomy were performed. In the postoperative period was carried out antibacterial and symptomatic therapy.Results. Life-threatening diseases of the pericardium accounted for 32,03% of all patients treated in the hospital for pericarditis. The most frequently detected signs of a hemodynamically significant compression and cardiac tamponade, less often purulent and constrictive P. Isolated 25 patients underwent closed drainage with pericardiocentesis, in 1 case the drainage was supplemented with f ibrinolytic therapy. Sanitation of the cavity and fenestration of the pericardium were carried out in 11 patients, pericardiotomy with notched drainage in 2 patients, thoracotomy with pericardiectomy – 4. In the postoperative period, the symptoms of inflammation were reduced, the level of cardiac enzymes decreased, the electrolyte balance stabilized. Most patients noted a distinct regression of the symptoms of pericarditis and cardiac compression. Recurrent P was noted in 5 cases, deaths occurred in 4 cases (8,16%).Conclusion. Early verification of the diagnosis and timely decompression of the heart with fractional evacuation of the exudate or pericardectomy with respect to the sequence of release of the heart chambers from adhesions and adhesions against the background of complex therapy allows to achieve positive dynamics, and fenestration of the cardiac bag with the formation of a sufficiently sized opening during recurrent fluid accumulation or intrapericardial fibrin. development of severe complications of pericarditis even in patients with multiple concomitant diseases evanii and oncopathology.

Dermatomyositis Associated with Lyme Disease: Case Report and Review of Lyme Myositis

1994 ◽  
Vol 18 (2) ◽  
pp. 166-171 ◽  
Author(s):  
H. W. Horowitz ◽  
K. Sanghera ◽  
N. Goldberg ◽  
D. Pechman ◽  
R. Kamer ◽  
...  
Keyword(s):  
Case Report ◽  
Lyme Disease ◽  
Disease Case

scholarly journals Are neuropsychiatric symptoms in dementia linked to CSF biomarkers of synaptic and axonal degeneration?

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Victor Bloniecki ◽  
Henrik Zetterberg ◽  
Dag Aarsland ◽  
Patrizia Vannini ◽  
Hlin Kvartsberg ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Axonal Degeneration ◽  
Neuropsychiatric Symptoms ◽  
Underlying Disease ◽  
Csf Biomarkers ◽  
Neurofilament Light ◽  
Csf Levels ◽  
Low Levels ◽  
T Tau ◽  
The Relationship

Abstract Background The underlying disease mechanism of neuropsychiatric symptoms (NPS) in dementia remains unclear. Cerebrospinal fluid (CSF) biomarkers for synaptic and axonal degeneration may provide novel neuropathological information for their occurrence. The aim was to investigate the relationship between NPS and CSF biomarkers for synaptic (neurogranin [Ng], growth-associated protein 43 [GAP-43]) and axonal (neurofilament light [NFL]) injury in patients with dementia. Methods A total of 151 patients (mean age ± SD, 73.5 ± 11.0, females n = 92 [61%]) were included, of which 64 had Alzheimer’s disease (AD) (34 with high NPS, i.e., Neuropsychiatric Inventory (NPI) score > 10 and 30 with low levels of NPS) and 18 were diagnosed with vascular dementia (VaD), 27 with mixed dementia (MIX), 12 with mild cognitive impairment (MCI), and 30 with subjective cognitive impairment (SCI). NPS were primarily assessed using the NPI. CSF samples were analyzed using enzyme-linked immunosorbent assays (ELISAs) for T-tau, P-tau, Aβ1–42, Ng, NFL, and GAP-43. Results No significant differences were seen in the CSF levels of Ng, GAP-43, and NFL between AD patients with high vs low levels of NPS (but almost significantly decreased for Ng in AD patients < 70 years with high NPS, p = 0.06). No significant associations between NPS and CSF biomarkers were seen in AD patients. In VaD (n = 17), negative correlations were found between GAP-43, Ng, NFL, and NPS. Conclusion Our results could suggest that low levels of Ng may be associated with higher severity of NPS early in the AD continuum (age < 70). Furthermore, our data may indicate a potential relationship between the presence of NPS and synaptic as well as axonal degeneration in the setting of VaD pathology.

scholarly journals Simultaneous involvement of optic and abducens nerves by Lyme disease: Case report with review of the literature

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Iman Dabiri ◽  
Ahmet Z. Burakgazi
Keyword(s):  
Case Report ◽  
Lyme Disease ◽  
False Negative ◽  
Diagnostic Process ◽  
Review Of The Literature ◽  
Ocular Manifestations ◽  
First Case ◽  
Clinical Presentations ◽  
Disease Case ◽  
Wide Range

Ocular manifestations of Lyme disease (LD) remain a rare feature of the disease, but it may present a wide range of clinical presentations with different combinations. LD related optic neuritis or cranial nerve (CN) six palsy have been reported in the literature. However, this is the first case report of simultaneous involvement of CN 2 and CN 6 in a patient with LD. The diagnosis of LD can be challenging and initial laboratory tests can be a false negative. It is paramount important to repeat the diagnostic test if clinical suspicious is ongoing. With this case, we aim to increase awareness of clinicians for possible ocular manifestations of LD and its complex diagnostic process.

scholarly journals The challenge of neuroimaging during pregnancy

2019 ◽  
Vol 8 (11) ◽  
pp. 4376
Author(s):  
Kariman Suel Ghazal ◽  
Abdul Rahman Shatila
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Cerebral Edema ◽  
Neurological Disorders ◽  
Resonance Imaging ◽  
Female Reproduction ◽  
Cerebellar Hemorrhage ◽  
Neurologic Disorders

Background: Central nervous system conditions may affect every aspect of female reproduction from fertility to lactation. The objective of this study was to examine the performance of computed tomography and magnetic resonance imaging in the diagnosis of maternal neurologic disorders and to examine the outcome of pregnancies complicated by abnormal neurologic imaging.Methods: Retrospective observational study of 20 parturients presenting with severe neurologic symptoms (January 2006 to January 2016).Results: Abnormal neuro-radiological findings were found. Only 10% of the computed tomography-scans were normal. Both magnetic resonance imaging and computed tomography that were performed in all cases showed cerebral edema (90%) with different degrees, thereby cerebral edema was the predominant lesion. Pertaining to its localization, 65% were localized in the parietal or occipital area, 10% in the paraventricular area, and 10% were diffused. Also, 35% showed intracerebral hemorrhage and 10% showed cerebellar hemorrhage. The incidence of neurological disorders in pregnancy and puerperium was high. Epilepsy and headache were the most common primary and secondary neurological disorders.Conclusions: The role of neuroimaging in diagnosing neurological disorders is crucial for prevention of severe complications.

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