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molecular genetics of antigenic variation.antigenic variation is one of the most effective strategies developed by parasites to escape immune destruction. it requires a large wardrobe of surface coats and mechanisms to exchange one coat for an unrelated one. the molecular principles of antigenic variation are now largely known in the bacterial species borrelia and neisseria and in the protozoa of the african trypanosome group and these three examples are discussed here by piet borst.19912069675
diagnosing lyme disease: often simple, often difficult.lyme disease has as its hallmark erythema migrans. however, it is only present in about one half of the patients who contract this disease. in its absence, the diagnosis of lyme disease may be difficult. it depends upon a compatible history of exposure and clinical signs and symptoms together with positive results of serologic testing. unfortunately, seronegativity for antibody to the pathogen may occur both during the first six weeks of infection and be chronic due to the reactive antibody bein ...19912070642
lyme disease during pregnancy.lyme disease, caused by infection with borrelia burgdorferi, can affect those exposed to a vector tick. pregnant women are no exception, and such infection places the fetus at risk. it is particularly important to recognize the disease early so that effective therapy may be instituted. although the present patient had a favorable outcome, not all do. clinical diagnosis is especially important since conventional laboratory tests may be inadequate or require lengthy periods of time before a positi ...19912070648
[focus of borreliosis in gisenyi (rwanda)].as a result of the increase of relapsing fever cases in a rural area of west-rwanda, a study of ticks collected in the houses has been performed. ornithodoros moubata specimens were found in large amount. in patients, fever is the most frequent symptom. serological tests performed in the surrounding area of patients with borrelia in the blood are often positive, this confirming the ancient existence of the disease among inhabitants.19912072849
comparative in vitro and in vivo susceptibilities of the lyme disease spirochete borrelia burgdorferi to cefuroxime and other antimicrobial agents.the in vitro and in vivo susceptibilities of the lyme disease pathogen borrelia burgdorferi to cefuroxime were compared with those of several other antibiotics commonly used to treat this disease. cefuroxime demonstrated a higher mbc in vitro (1.0 microgram/ml) than ceftriaxone (0.08 microgram/ml) or erythromycin (0.32 microgram/ml), but the mbc was similar to that of amoxicillin (0.8 microgram/ml) and doxycycline (1.6 micrograms/ml). b. burgdorferi was considerably less susceptible to tetracycl ...19902073103
central nervous system involvement in patients with facial palsy due to borrelial infection.patients with a peripheral facial palsy due to an underlying ixodes-borne borreliosis often have cerebrospinal fluid findings indicating meningeal involvement. the aim of the present study was to identify signs of cns involvement by means of brain-stem evoked response audiometry (bser) in patients with a facial palsy due to borreliosis, as well as in patients with a facial palsy of unknown aetiology. bell's palsy. abnormalities in bser were found to be significantly more common along the borreli ...19902073762
immunological differentiation between neuroborreliosis and multiple sclerosis.neuroborreliosis, a tick-borne spirochaetosis of the central nervous system, is diagnosed by the presence of intrathecally synthesized borrelia burgdorferi-specific antibodies. multiple sclerosis and neuroborreliosis can show similarities in clinical symptoms as well as lymphocytic cell reactions and oligoclonal bands in the isoelectric focusing of cerebrospinal fluid. to differentiate between multiple sclerosis and neuroborreliosis we tested intrathecally synthesized igm and virus antibodies. t ...19902074447
persistence of borrelia burgdorferi and histopathological alterations in experimentally infected animals. a comparison with histopathological findings in human lyme disease.gerbils appear to be susceptible to infection by human isolates of borrelia burgdorferi; we obtained 100% infection. isolation of the b. burgdorferi from different organs six months post infection causes a generalized infection thus demonstrating that borreliae persist in these animals for a long period. spirochetemia was present for 14 days, apparently in two intervals. the borrelia burgdorferi specific antibody titers increased with time after infection thus indicating the persistence of spiro ...19902076905
lyme disease in the highlands.serological results for borrelia burgdorferi were examined for one year. the results suggest a 'pocket' of infection in one highland general practice. in this practice, most of the patients had exposure to tick bites and rashes were frequent. there were difficulties in relating serological results to clinical features and management of some patients.19902077648
association of chronic lyme arthritis with hla-dr4 and hla-dr2 alleles.a small percentage of patients infected with borrelia burgdorferi have chronic lyme arthritis that does not respond to antibiotic therapy. to learn whether genetically determined variations in the host immune response might account for such outcomes, we determined the immunogenetic profiles of 130 patients with various manifestations of lyme disease.19902078208
[anti-borrelia burgdorferi antibodies in chronic erythema migrans, benign lymphadenosis cutis, scleroderma and scleroatrophic lichen].fiftyone patients with a diagnosis of erythema chronicum migrans (ecm), lymphadenosis cutis benigna (labc), systemic progressive sclerosis, localized scleroderma and lichen sclerosus et atrophicans were investigated in order to obtain serological evaluation of borrelia burgdorferi circulating antibodies. in addition sera from 9 patients with pellagroid erythema, prurigo and panniculitis were performed: in these dermatoses there was no evidence of a possible borrelia relationship. indirect immuno ...19902079346
[false positive serological tests for borrelia burgdorferi in patients with primary antiphospholipid syndrome].serological tests for borrelia burgdorferi were carried out in a series of 27 patients with primary antiphospholipid syndrome (papls). the results showed a 14% prevalence of false positive lyme disease serology in this patient population. in patients with papls and false positive serologic tests for borrelia burgdorferi neurological involvement was significantly more common (p = 0.012, fisher's exact test) than in patients with papls without that finding. we insist on the possibility that patien ...19902082109
analysis of t lymphocytes cloned from the synovial fluid and blood of a patient with lyme arthritis.cloned t lymphocytes reactive with borrelia burgdorferi proteins were isolated from a patient with chronic lyme arthritis. all of the t cell clones which proliferated in response to borrelia proteins were cd3 + cd4 + cd8 - tcr alpha beta + and hla-dr restricted. one t cell clone (gn30) exhibited hla-dr-restricted cytotoxic activity against antigen-presenting cells pulsed with borrelia antigen. in response to borrelia antigen, the t cell clones produced tnf-alpha, inf-gamma, and gm-csf. there are ...19902083228
epidemiological and aetiological evidence for transmission of lyme disease by adult ixodes persulcatus in an endemic area in china.involvement of adult ixodes persulcatus ticks in the transmission of lyme disease in hailin county, heilongjiang province, china, is reported. in 1986 from april through august adult i. persulcatus was the dominant tick in this endemic area with an infection rate of 43% for the lyme disease spirochaete, borrelia burgdorferi. the incidence of lyme disease cases presenting the symptom of erythema chronicum migrans (ecm) within this area was correlated with the seasonal abundance of adult i. persul ...19902083990
[lyme disease (review of foreign literature)]. 19902084345
peripheral facial palsy in childhood--lyme borreliosis to be suspected unless proven otherwise.27 consecutive cases with acute peripheral facial palsy were studied for lyme borreliosis. in 16 out of 27 children lyme borreliosis could be diagnosed by detection of specific igm antibodies in csf. csf findings allow a clear distinction according to etiology. all children with facial palsy due to lyme borreliosis revealed lymphocytic csf pleocytosis, whereas in cases of unknown etiology csf was usually normal. bilateral facial palsy occurred only in children with lyme borreliosis. all cases wi ...19902085110
experimental infection of the white-footed mouse with borrelia burgdorferi.laboratory raised white-footed mice (peromyscus leucopus) were inoculated experimentally with live spirochetes (borrelia burgdorferi), the etiologic agent of lyme disease (borreliosis). prior to inoculation, mouse sera were tested with an indirect fluorescent antibody test, and all mice were seronegative. all inoculated mice seroconverted. in tick transmission studies, immature stages of ixodes dammini and dermacentor variabilis attached and fed to repletion on mice, but only i dammini transferr ...19902085225
antigenic cross-reactivity between borrelia burgdorferi, borrelia recurrentis, treponema pallidum, and treponema phagedenis.the antigenic cross-reactivity between different borrelia and treponema species was determined by the indirect immunofluorescence antibody test and sodium dodecyl sulphate-polyacrylamide gel electrophoresis followed by immunoblotting. the protein profiles of borrelia burgdorferi, borrelia recurrentis, treponema pallidum, and treponema phagedenis revealed essential differences. using immunoblotting, rabbit immune sera to b. burgdorferi and b. recurrentis exhibited strong cross-reactivities to het ...19902085371
purification of the borrelia burgdorferi flagellum by use of a monoclonal antibody.the flagellum associated polypeptide p41 is an immunodominant antigen of borrelia burgdorferi in the early and late stages of lyme borreliosis. p41 was prepared by affinity chromatography using monoclonal antibody specific for p41. an immunoglobulin class specific elisa (igm-, igg-elisa) was established with purified p41 as antigen and compared to the conventional elisa with whole cell ultrasonic antigen. whereas the sensitivity of igm- and igg-elisa was comparable in both antigen preparations, ...19902087234
[borrelia burgdorferi infection. i. aspects of basic research, current approach for diagnosis and therapy].in this review article the current concepts on the infection caused by borrelia burgdorferi are presented. the problems associated with the diagnosis and therapy of the borrelia burgdorferi infection are pointed out. a series of monoclonal antibodies recognizing borrelia burgdorferi-associated antigens is presented. in collaborative research projects these antibodies were used for molecular biological (cloning and sequencing of borrelia burgdorferi antigens) and immunological (protection experim ...19902089023
in-vitro susceptibility of borrelia burgdorferi and borrelia hermsii to ten antimicrobial agents.the in-vitro activity of ten antimicrobial agents against four strains of borrelia burgdorferi originating both in the united states and europe and against one isolate of b. hermsii was investigated. ceftriaxone, erythromycin and roxithromycin were the most active drugs against both borrelia species studied, with minimum bactericidal concentrations ranging from 0.015 micrograms/ml to 0.125 micrograms/ml.19902093104
prevalence of borreliae in ixodes ricinus ticks from southern moravia, czechoslovakia.a total of 378 adult ixodes ricinus ticks were collected by flagging vegetation in four localities of two districts (breclav, znojmo) in south moravia and examined microscopically. borreliae were identified in giemsa-stained midgut smears from 32 (i.e. 8.5%) ticks (9.4% females, 7.2% males); the infection rate varied between 0.0 and 11.4% in the four localities examined. among female ticks, significantly more were found to be infected in autumn (19.7%) than in spring (5.8%). dark-field (df) and ...19902093618
detection of serum antibodies against borrelia burgdorferi with some commercially available serological tests.sixty-three sera were analysed for antibodies against borrelia burgdorferi with an in-house indirect immunofluorescence assay. thirty-nine sera were positive (titer greater than or equal to 256), seven borderline (titer 128) and 17 negative (titer less than or equal to 64). these results were compared with results obtained with four different commercial assays for detection of such antibodies. indirect immunofluorescence tests yielded most positive results. the flagellin elisa test detected anti ...19902093855
[reflex sympathetic dystrophy. a new manifestation of lyme disease?].several syndromes derived from the involvement of central and peripheral nervous system and meninges have been reported in the infection by borrelia burgdorferi. the features of autonomic nervous system involvement have received a marginal attention. reflex sympathetic dystrophy is an autonomic picture characterized by regional sympathetic hyperactivity which has not been associated with lyme disease. we report a 16-year-old female with clinical, radiological and scintigraphic features consisten ...19902095902
[skin manifestations of infection by borrelia burgdorferi].interest in lyme's disease is recent in spain. we review the dermatological features of the disease caused by b. burgdorferi, its differential diagnosis and its therapy, with reference to three patients with borrelia burgdorferi infection in whom the diagnosis was made on the basis of the dermatological picture. one patient had migratory erythema developing from the umbilical area, where he had been bitten by a tick. another patient had arthritis of the knee and meningoradiculitis, together with ...19902095903
[antibodies against borrelia burgdorferi in a population group from valladolid]. 19902098134
[isolation and identification of oral spirochaetes and fusobacterium in juvenile periodontitis].periodontal pocket specimens of 40 juveniles periodontitis (jp) and specimens from gingival sulcus in 40 normal juveniles (np) were examined. 25 strains of anaerobic oral spirochaete (62.5%) (17 strains were treponema microdentium, 3 strains macrodentium, 2 strains t orale, 3 strains borrelia) and 21 strains of fusobacterium were isolated in 40 jp. in 40 np, 2 strains of spirochaetes (5%) and 3 strains fusobacterium (7.5%) were found. this study shows that there is a relationship between the inf ...19902098228
antibodies to borrelia burgdorferi in dogs in hokkaido.during 1985 to 1990, serum samples were obtained from 229 healthy dogs. the dogs lived in hokkaido, known to be infested with ticks. an enzyme-linked immunosorbent assay (elisa) was used to detect igg and igm antibodies against borrelia burgdorferi ho14 and hp3, which were isolated from ixodes ovatus and i. persulcatus in the area. igg antibody to b. burgdorferi ho14 was detected in 8.8% (1985), 16.4% (1987) and 18.5% (1990). igm antibody to the bacteria was detected in 1.8% (1987) and 2.5% (199 ...19902098630
characterization of borrelia burgdorferi associated antigens by monoclonal antibodies.in this paper, we present a series of murine mab recognizing b. burgdorferi antigens. the antibodies were characterized by immuno-blotting and immuno-fluorescence studies using isolates of b. burgdorferi from north america and europe, respectively. moreover, reactivity of the antibodies with recombinant b. burgdorferi flagellin and ospa was studied. the results suggest these anti-b. burgdorferi mab as valuable tools for the serological analysis of b. burgdorferi isolates and for affinity-purific ...19902099905
[analysis of anti-borrelia burgdorferi antibodies of the igg/igm classes by the elisa method. i. evaluation of the test and the methodological principles]. 19902100816
[the prevalence of borrelia burgdorferi antibodies in a population at risk].given the increasing interest in lyme borreliosis in our community, and the lack of epidemiological studies in our country, we have considered convenient to analyze the presence of anti-borrelia burgdorferi antibodies in a group of workmen who we have considered at high risk since they carry out their everyday work in an environment infested by ticks. significant antibody titers (= or greater than 1/128) are found in 38% of cases versus 0% in the control group. the significance of these results ...19902102530
serologic survey of selected zoonotic disease agents in black-tailed jack rabbits from western texas.a serologic survey for the agents of rocky mountain spotted fever (rmsf) (rickettsia rickettsii), borrelia spp. including the causative agent for lyme disease (borrelia burgdorferi), and plague (yersinia pestis) was conducted on blood samples collected from 30 and 46 black-tailed jack rabbits (lepus californicus) from an urban environment in lubbock, texas (usa) during winter 1987 and the following spring 1988, respectively. antibody titers to the agents of rmsf and borreliosis were detected in ...19902106044
progressive facial hemiatrophy (parry-romberg syndrome) and borreliosis. 19902107220
lyme disease: a review.in the last decade, lyme borreliosis has emerged as a complex new infection whose distribution is worldwide. the multisystem disorder, which primarily affects the skin, joints, heart and nervous system at different stages, is caused by the tick-borne spirochaete borrelia burgdorferi. after the first weeks of infection almost all patients have a positive antibody response to the spirochaete and serological determinations are currently the most practical laboratory aid in diagnosis. treatment with ...19902107856
lyme carditis in immunodeficient mice during experimental infection of borrelia burgdorferi.recently, we described the severe combined immunodeficiency (scid) mouse as a laboratory model for b. burgdorferi infection. scid mice inoculated with the virulent low-passage tick isolate borrelia burgdorferi zs7 developed a severe pancarditis involving endocardium, myocardium and epicardium in the absence of functional b- or t-cells. soon after inoculation perivascular infiltration was observed, later diffuse infiltration of the interstitium of the subendocardial and subepicardial areas was se ...19902114691
common source outbreak of relapsing fever--california. 19902117241
interaction between parasite and tick vector.interaction of tick vectors with borrelia species including b. burgdorferi, rickettsias and piroplasms has been demonstrated by describing selected phenomena. in particular, the various environments inside the tick vector have been considered, including the midgut lumen, gut epithelial cells, body cavities and tissues. intracellular parasitism occurs in different compartments of the host cell: parasitophorous vacuoles (anaplasma marginale), phagolysosomes (coxiella spp.), cytoplasm (rickettsia, ...19902120142
zoonotic infections in northern ireland farmers.evidence of past zoonotic infection was investigated serologically in randomly selected northern ireland farmers. the percentage of farmers with antibody was: brucella abortus (0.7), leptospira interrogans serovars (8.1), borrelia burgdorferi (14.3), toxoplasma gondii (73.5), coxiella burnetii (28.0), chlamydia psittaci (11.1) and hantavirus (1.2). the results show that northern ireland farmers have been exposed in the past to zoonotic infections. it is not known if these infections contributed ...19902123457
immunization of cattle against theileria parva bovis and their exposure to natural challenge.theileria parva bovis isolates were tested for their immunizing capacity under natural field challenge on willsbridge farm in the highveld of zimbabwe. fifteen susceptible sussex yearlings were immunized with the boleni stock and 15 with a mixture of three isolates from the farm, using tick-derived sporozoite stabilates. no chemoprophylaxis was used. a dose of 0.1 ml of stabilate appeared to be safe in preliminary laboratory experiments, but the reactions were severe in the sussex cattle and one ...19902125158
borrelia burgdorferi in ticks of the canton tessin (switzerland).in the northern alps it is hard to find an ixodes ricinus population which does not harbour borrelia burgdorferi. the infection rates range from 5 to 34% for adults and nymphs to 3.1% for larvae. this study shows that the infection rates on the southern side of the alps are similar, at 25% for adults, 36.2% for nymphs and 3.2% for larvae. with respect to tick species other than i. ricinus, we did not succeed in finding any spirochetes in dermacentor marginatus, haemaphysalis punctata, ixodes hex ...19902132440
lyme disease. a general survey. 19902133980
outer surface protein a (ospa) from the lyme disease spirochete, borrelia burgdorferi: high level expression and purification of a soluble recombinant form of ospa.the ospa gene of borrelia burgdorferi encodes an outer membrane protein which is a major antigen of the lyme disease agent. two sequence-specific sets of oligonucleotide primers were used to specify the amplification of the ospa coding sequence by the polymerase chain reaction. one set allowed the entire ospa sequence to be amplified, while the other primed amplification of a truncated form of ospa lacking the first 17 codons specified by the wild-type ospa structural gene, residues believed to ...19902136237
experimental chronic lyme borreliosis in lewis rats.the course of lyme borreliosis in lew/n rats inoculated intraperitoneally as infants with 10(6) borrelia burgdorferi was followed for 360 days. spirochetes were detected in the blood through 30 days, in the brain through 60 days, and persisted in the spleen, liver, kidneys and articular tissue through 360 days. acute exudative arthritis, tendonitis, and bursitis were evident in multiple joints by day 30. arthritis regressed thereafter but capsular fibrosis and lymphoplasmacytic infiltrates persi ...19902138431
[borrelia sp. in the common tick (ixodes ricinus) from the prague area].in the course of 1988 almost 3000 ticks were collected from various localities on the territory of prague and examined by the method of indirect immunofluorescence (ifa) for the presence of borrelia. the immunity rate of ticks varies between 1.9-22.0%. positive ticks were found also in some areas practically in the centre of the town. these findings indicate the possible contact of the prague population with the infectious agent on the very territory of the town. the authors give a list of poten ...19902139810
lyme borreliosis in selected strains and ages of laboratory mice.the susceptibility of laboratory mice to borrelia burgdorferi was evaluated for selected genotypes and ages. c3h/he, swr, c57bl/6, sjl, and balb/c mice inoculated at age 3 days developed uniformly severe polyarthritis at 30 days after intraperitoneal inoculation. mice inoculated at age 3 weeks also developed polyarthritis, but severity was influenced by genotype, with c3h/he and swr mice the most severely affected. susceptible strains developed higher igg elisa antibody titers to b. burgdorferi ...19902141344
cogan's syndrome and seroreactivity to lyme borreliosis.we document the case of a young woman with bilateral nonluetic, interstitial keratitis, vestibuloauditory problems, and bilateral recurrent facial palsies, who had strongly positive serologic tests of lyme borreliosis. to our knowledge, this is the first reported case of positive serologic tests for borrelia burgdorferi in a patient with cogan's syndrome.19902141863
susceptibility of laboratory rats to isolates of borrelia burgdorferi from different geographic areas.one week old lew/n rats were inoculated with 15 different isolates of borrelia burgdorferi from 3 major north american (northeast, midwest, and pacific) and 1 european endemic areas. at 30 days after inoculation, several tissues were cultured for b. burgdorferi and examined for histopathological changes. sera were tested for igm and igg antibody to b. burgdorferi by an enzyme-linked immunosorbent assay. one or more isolates from each geographic region was recovered by culture and caused arthriti ...19902142584
[occurrence of borrelia antibodies in field hares (lepus europaeus)].using the indirect haemagglutination reaction with an antigenic extract from borrelia recurrentis, the author assessed in the hare the incidence of borrelia antibodies, incl. antibodies against borrelia burgdorferi, the causal agent of lyme borreliosis, a multisystemic disease with natural foci, a disease transmitted mostly by ticks of the genus ixodes. sera of 113 hares from 11 localities in the cssr examined by this method reacted in 41.6% by titres within the range from 1 : 16 to 1 : 512, onl ...19902142623
[persistent leg pain].a 72 year old patient suddenly experienced severe lumbar pain irradiating into the right leg. later on, weakness of the muscles thigh appeared. a thorough radiological investigation which showed degenerative alterations of the vertebral column did not supply an explanation. after a pathological titer against borrelia burgdorferi was found in serum and radiculitis was detected on emg, the diagnosis of lyme-borreliosis of the nervous system could be confirmed by analysis of the cerebrospinal fluid ...19902142797
lyme borreliosis in laboratory animals: effect of host species and in vitro passage of borrelia burgdorferi.the susceptibility of several common laboratory animal species to a known pathogenic isolate of borrelia burgdorferi (n40) was evaluated following intraperitoneal (ip) inoculation of 10(6-8) spirochetes into 3-day-old lewis rats, cd-1 mice, syrian hamsters, and 3-week-old american dutch rabbits. at 30 days, tissues were cultured for spirochetes and examined histologically. all species developed multisystemic infection as well as arthritis and carditis, but disease was most severe in rats and mic ...19902143358
[incidence of borrelia in the common tick (ixodes ricinus) in the area of the city of brno].during the period between july and october 1988 more than 1000 ticks ixodes ricinus were collected at 16 sites in the town of brno and examined by indirect immunofluorescence (ifa) for the presence of borrelia. the positivity of the tick population in 13 localities varied between 0.9-18.6%, ticks from three localities were negative. the results confirm the diffuse character of the presence of borrelia in ticks i. ricinus in the urban environment and the possibility of infection of the urban popu ...19902144477
[the experience of a serological examination of the rural population in a territory endemic for lyme borreliosis].serological surveys have been performed in two communities (kirovsk district, leningrad province) endemic for lyme's borreliosis. 736 individuals (51% of the population) have been examined. standard capillary blood samples (drops from the finger on a filter paper) have been investigated by indirect immunofluorescence. blood sera of residents from nonendemic territories and patients with various rheumatic diseases served as a control. serum dilution 1:80 was considered as a reliable screening tit ...19902145501
[the identification of borrelia isolated in the soviet union and czechoslovakia from ixodes ricinus (l.) ticks].seven strains of the causative agent of lyme borreliosis have been isolated from ticks of the species ixodes ricinus (l.) obtained at the territories of leningrad province, lithuania and czechoslovakia. the strains have been studied in reactions with 5 types of monoclonal antibodies. all isolated strains belong to serotype ii according to barbour's system and are typical for european strains.19902145716
[the current status of foci of tick-borne relapsing fever in the western pamirs].for the first time in the last 20-50 years foci of tick-borne relapsing fever have been surveyed in the western pamirs. settlements in the piandzha valley were shown to be (as in the 1930s and 1960s) affected by ornithodoros papillipes bir., the carrier of the infection. though the number of ticks is still rather high, it is nowadays considerably reduced. the findings suggest a tendency towards a decrease in the infestation of the carrier population with the agent of the disease. the traditional ...19902149736
the bascom palmer eye institute lyme/syphilis survey.serologic screening of patients for lyme borreliosis began at the bascom palmer eye institute (bpei) in september 1987. this report reviews the data on 641 sera from that date up to january 1, 1990. initially only immunofluorescent (ifa) igg and igm titers were obtained. because of increasing numbers of borderline and positive ifa tests, a lyme enzyme linked immunosorbent assay (elisa) was added in april 1988. also, because of significant serologic cross reactivity in patients exposed to trepone ...19902150843
[therapy of polyneuropathies]. 19902154367
in-vitro and in-vivo susceptibility of borrelia burgdorferi to azithromycin.the in-vitro and in-vivo susceptibility of borrelia burgdorferito tetracycline, erythromycin and azithromycin was investigated. a macrodilution broth technique was used to determine mbcs. b. burgdorferi was most susceptible to azithromycin (mbc 0.04 mg/l) followed by erythromycin (mbc 0.16 mg/l) and tetracycline (mbc 1.6 mg/l). syrian hamsters were used to determine ed50s for the three antimicrobials. azithromycin was most effective in the elimination of spirochaetes from experimentally infected ...19902154436
saliva of the tick ixodes dammini inhibits neutrophil function.pilocarpine-induced saliva of adult female ixodes dammini ticks inhibits the function of peritoneal-derived rat neutrophils, as measured by anaphylatoxin-induced aggregation, fmlp-induced granule enzyme secretion, zymosan-induced superoxide secretion, and phagocytosis of borrelia burgdorferi spirochetes. inhibition ranged from 40 to 80% when saliva was diluted 20 times into the assay medium. this neutrophil-inhibiting activity of i. dammini saliva may aid in tick feeding and facilitate pathogen ...19902157607
[recent information on tick-borne diseases (i)].tick-borne encephalitis (central european encephalitis) and lyme disease (erythema chronicum migrans) are diseases mainly transmitted by ticks of the ixodes ricinus species. the tick-borne encephalitis, a virus infection, can produce severe encephalitic symptoms. there is no specific treatment but the infection can be prevented by active or passive immunization. lyme disease is caused by a spirochete (borrelia burgdorferi). due to the variety of often uncharacteristic symptoms this infection is ...19902158155
chronic neurologic manifestations of lyme disease.lyme disease, caused by the tick-borne spirochete borrelia burgdorferi, is associated with a wide variety of neurologic manifestations. to define further the chronic neurologic abnormalities of lyme disease, we studied 27 patients (age range, 25 to 72 years) with previous signs of lyme disease, current evidence of immunity to b. burgdorferi, and chronic neurologic symptoms with no other identifiable cause. eight of the patients had been followed prospectively for 8 to 12 years after the onset of ...19902172819
early diagnosis of enteroviral meningitis by a solid-phase reverse immunosorbent test and virus isolation.45 cases of aseptic meningitis/meningoencephalitis were studied with regard to enteroviral etiology by virus isolation and solid-phase reverse immunosorbent test (sprist), a cross-reacting test for enterovirus igm. an etiological diagnosis was reached in 37/45 (82%) patients. etiological diagnoses other than enteroviruses were found in 8 patients: borrelia burgdorferi in 4, varicella-zoster virus in 2, herpes simplex virus in 1 and mumps virus in 1 patient. enteroviruses (echovirus 6, 21 and 30) ...19902175448
cefotaxime versus penicillin in the late stage of lyme disease--prospective, randomized therapeutic study.the low responsiveness of lyme arthritis to high dose intravenous penicillin g therapy has evoked the demand for new drugs for the treatment of late stage borreliosis. as can be deduced from in vitro susceptibility data, third generation cephalosporins are far more effective on borrelia burgdorferi spirochetes than penicillin g. the study presented here was designed to compare cefotaxime at a dosage of 2 x 3 g/day with penicillin g at a dosage of 2 x 10 megaunits/day, for ten days in a prospecti ...19902179134
effects of bovine serum albumin on the ability of barbour-stoenner-kelly medium to detect borrelia burgdorferi.the ability of decreasing inocula of borrelia burgdorferi to grow in otherwise identical barbour-stoenner-kelly (bsk) media containing different lots of bovine serum albumin (fraction v) was determined. these media differed significantly in ability to detect b. burgdorferi. some bsk media required inocula of 2 x 10(5) organisms per ml for detection, while other media could stimulate growth after inoculation with less than 2 organisms per ml. in addition, organisms from the less sensitive bsk med ...19902179264
management of lyme disease.the microbiology, transmission, epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of lyme disease are reviewed. lyme disease, a tick-borne syndrome, was first described in 1975. the etiologic agent of lyme disease is borrelia burgdorferi, a slow-growing spirochete. lyme disease is the most prevalent tick-borne disease in this country; endemic areas in the united states include the northeastern, north central, and western regions. both infectious and immunologic mechan ...19902180624
[epidemiology of borrelia burgdorferi infection. relation of the prevalence rate on determination by serologic procedures].investigation of subclinical infections with borrelia burgdorferi in risk groups in switzerland, austria and southern germany showed an infection rate of 16%-27%. random samples of patients admitted to the neurological department of a hospital on the outskirts of hamburg gave the following results: in 100 sera there was in 27% a positive elisa-test, in 77 sera the ift-test was positive in 13%, and in 210 sera 6% showed a positive ift-test after absorption; the ift- and ift-abs. were compared in ...19902181330
[clinical value of antibody titers to borrelia burgdorferi and titer course in neurologic disease pictures].over a period of 3 years, antibody titres against borrelia burgdorferi in serum were determined for 492 patients with a wide spectrum of neurological diseases. using the elisa technique, we found elevated titres against borrelia burgdorferi in about 20% of these patients. cranial nerve paresis was often the leading symptom of an acute neuroborreliosis. in a number of cases the diagnosis was indicated only by an elevated igg titre in the patient's serum, or a decrease in the titre level following ...19902181331
[scleroderma. which tests should be performed?]. 19902181910
complement fixation test for the diagnosis of lyme disease.sera from 43 patients were tested for complement-fixing antibodies to borrelia burgdorferi; these patients included 8 with confirmed lyme disease, 21 who were serologically positive but not likely to have lyme disease, and 14 who were serologically negative. seven individuals, all confirmed lyme disease patients, had complement-fixing antibodies. complement fixation may be a useful confirmatory test for lyme disease.19902182679
serologic tests for lyme disease. interlaboratory variability.the serologic test for the detection of antibodies to borrelia burgdorferi is the most frequently used laboratory method for the diagnosis of lyme disease. however, the insensitivity of the assays and the interlaboratory variability are frequent problems. to determine the extent of this variability, one aliquot of serum from each of nine patients with a history of lyme disease was sent to nine reference laboratories, including national, university, state, and local hospital laboratories. a secon ...19902183731
range of atrioventricular conduction disturbances in lyme borreliosis: a report of four cases and review of other published reports.four patients with lyme borreliosis had atrioventricular conduction disturbances. all four were positive for specific antibodies against borrelia burgdorferi measured by indirect immunofluorescence tests. biopsy specimens, which were obtained in three patients, showed band-like infiltrates of plasma cells and lymphocytes in the endocardium. there was diffuse infiltration of the interstitium of the myocardium by lymphocytes, plasma cells, and macrophages. in two patients single fibre necrosis was ...19902183859
antimicrobial agents in lyme disease. 19902184157
a randomized trial of ceftriaxone versus oral penicillin for the treatment of early european lyme borreliosis.in a prospective randomized multicenter trial for the therapy of erythema migrans, 40 patients received ceftriaxone 1 g daily for 5 days and 33 patients obtained phenoxymethylpenicillin, 1 million units 3 times daily, for 12 days. follow-up was for a mean of 10 +/- 5 months. eight oral penicillin recipients (24%) and six ceftriaxone recipients (15%) developed minor consecutive manifestations. two ceftriaxone and one penicillin recipient(s) still had elevated igg antibody titers 10 to 20 months a ...19902185158
serologic testing for lyme disease.serologic testing for antibodies is, at present, the only practical means of diagnosing borrelia burgdorferi infection. however, specific igm spirochetal antibodies may not be at detectable concentrations in the early stage of lyme disease (within 6 weeks of onset). western blot analysis may be used to confirm indirect fluorescent antibody staining or enzyme-linked immunosorbent assay results, but it is laborious and expensive. false-positive reactions caused by cross-reactivity do occur. in pat ...19902186396
treatment of lyme disease. best use of antibiotics.lyme disease is a tick-borne illness caused by the spirochetal bacterium borrelia burgdorferi. recognition of the clinical manifestations and geographic range of this illness has expanded rapidly in recent years. although much remains to be explained about this infection, most patients can be treated effectively on the basis of the clinical experience gathered to date. antibiotics are the mainstay of therapy for all stages of illness. development of a vaccine and improvement in laboratory diagno ...19902186397
comparison of flagellum and sonicate antigens for serological diagnosis of lyme borreliosis.a sonicate antigen and two concentrations of a purified flagellum antigen of borrelia burgdorferi were compared for serological diagnosis of lyme borreliosis by an enzyme immunoassay (eia). generally, the higher concentration of flagellum antigen was found to be superior to the lower concentration, which was diluted eight times compared to the higher concentration. the diagnostic sensitivity for igg antibody detection increased from 13% in the sonicate eia to 31% in the best flagellum eia assay ...19902186910
[scleroderma].sclerodermas may occur in two basic forms: localized sleroderma (lsc) and systemic scleroderma (ssc). pseudoscleroderma as well as overlap syndromes have to be differentiated from these two variants. from the clinical point of view, localized scleroderma can be subdivided into type i = plaque-like lsc (= morphea), type ii = linear lsc, and type iii = deep lsc. according to the degree of the cutaneous involvement, systemic scleroderma can likewise be classified into type i = sclerodactylia, type ...19902187309
[lyme borreliosis. the manifestations of the disease from the internal medicine and rheumatology viewpoints].lyme disease is an infectious syndrome transmitted by tick bites. of the multiple manifestations, cardiac and joint involvement are of primary interest for internists and rheumatologists. up to 10% of patients develop cardiac symptoms, most frequently a disturbance of atrioventricular conduction. the characteristic presentation of the disease, however, are of symptoms of arthritis in one or several large joints. this review summarizes lyme disease with emphasis on presenting symptoms important t ...19902187777
[lyme borreliosis in neurology and psychiatry].neurological manifestations of lyme disease are as multifarious as the entire spectrum of this common infection. in stage i, fibromyalgia and, more rarely, painful muscular fasciculation, dominate the clinical picture. in the individual case, mild psychic abnormalities may already be observed. characteristic of the 2nd stage is lymphocytic meningopolyneuritis. involvements of the cns are expressed not so much in focal deficits, as in diffuse psychopathological disorders. in stage 3, cns manifest ...19902187778
[the laboratory diagnosis of borrelia burgdorferi infection].the multiplicity of the clinical appearance of lyme disease makes it necessary to confirm the diagnosis by detecting the pathogen or specific antibodies. isolation of the pathogen from infected tissue or body fluids is difficult, so that, to date, only serology is feasible for routine diagnosis. in view of a lack of standardisation of borrelia serology, the clinician must expect false negative, and--even more so--false-positive, results. future laboratory diagnosis should be markedly improved by ...19902187779
[morphaea profunda].a 47-year-old woman with a solitary morphoea profunda on the flexor aspect of the left thigh is described. clinically the lesion is characterized by a circumscribed, deeply indurated sclerotic plaque. the main histopathological features were sclerotic collagen changes and a striking accumulation of inflammatory cells in the deep dermis as well as in the subcutaneous tissue. plasma cells and t- and b-lymphocytes were the predominant cellular components of the infiltrate. the patient had an elevat ...19902188936
[an evaluation of different methods for making vital preparations for the detection of borrelia in ixodid ticks].comparative assessment of suitability of darkfield microscopy of the preparation from the ticks dissected by needles in a drop of saline for evaluation of spontaneous infection rate of unfed imago ticks--vectors of lyme disease--has been made, by using ix. persulcatus and ix. ricinus collected in leningrad province as models. examination of 100 individuals by parallel exploration of the glass-covered drops and the preparations from the middle intestine of the ticks demonstrated the presence of b ...19902191203
[diagnosis of lyme disease]. 19902192136
[lyme borreliosis: underdiagnosed?--overtreated?].lyme borreliosis is a tick-borne mediated systemic inflammatory disorder caused by a newly recognized spirochete, borrelia burgdorferi. its clinical hallmark is an early expanding skin lesion, erythema chronicum migrans (ecm) which may be followed weeks to months later by neurological, cardiac, or joint abnormalities. symptoms may be associated with any of these systems alone or in combination. all stages of lyme borreliosis may respond to antibiotics, but treatment of early disease is the most ...19902192269
[the man behind the syndrome. arvid afzelius. the first to recognize the key symptom in tick-transmitted borreliosis]. 19902194080
characterization of the heat shock response and identification of heat shock protein antigens of borrelia burgdorferi.the heat shock response of borrelia burgdorferi b31 cells was characterized with regard to the heat shock proteins (hsps) produced. five to seven hsps were detected by sodium dodecyl sulfate-gel electrophoresis and fluorography of proteins from cells labeled with [35s]methionine after shifts from 33 degrees c to 37 or 40 degrees c or from 20 degrees c to 33, 37, or 40 degrees c. analysis of [35s]methionine-labeled hsps by two-dimensional electrophoresis and autoradiography revealed 12 hsps. west ...19902194963
an update on the serodiagnosis of canine lyme borreliosis.the first report of canine lyme borreliosis was published in 1984, and since that time there have been numerous reports. clinical manifestations have varied, and serology is often used to make the diagnosis. this review is designed to inform veterinary clinicians about the current serologic tests and their limitations. in endemic areas, the fact that up to 50% of the canine population can be asymptomatic, yet seropositive, suggests that positive antibody titers do not necessarily indicate the pr ...19902195165
lyme disease.lyme disease is a complex multisystem disorder recognized on six continents that is epidemic in some parts of the world during spring, summer, and fall seasons. it is an infectious disease caused by a spirochete, b. burgdorferi, which is transmitted chiefly by i. dammini and pacificus ticks in the united states and i. ricinis in europe. it is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. diagnosis i ...19902195920
tick parasitism and antibodies to borrelia burgdorferi in cats.ticks were removed from naturally infested cats, and serum samples from these cats were tested for antibodies to borrelia burgdorferi. twenty-two of 93 cats (23.7%) had one or more motile stages of ixodes dammini attached. of 2 larvae and 20 nymphs removed from cats, 1 larva and 2 nymphs were infected with b burgdorferi. spirochetes were not found in tissues of 13 female and 4 male ticks. ten of 71 serum samples analyzed by indirect fluorescent antibody staining or elisa contained antibodies to ...19902196252
a clinical approach to lyme disease.lyme disease (also known as lyme borreliosis) is an emerging, newly described infectious disease with diverse clinical manifestations. the disease is caused by the spirochetal agent borrelia burgdorferi, which is transmitted to humans by the bite of certain species of ixodes ticks harboring the organism. the most readily identifiable clinical feature is the distinctive skin lesion, erythema migrans. if recently infected patients go untreated, approximately 15% will develop neurologic conditions ...19902196462
[recent information on tick-borne diseases (ii)].tick-borne encephalitis (central european encephalitis) and lyme disease (erythema chronicum migrans) are diseases mainly transmitted by ticks of the ixodus ricinus species. the tick-borne encephalitis, a virus infection, can produce severe encephalitic symptoms. there is no specific treatment but the infection can be prevented by active or passive immunization. lyme disease is caused by a spirochete (borrelia burgdorferi). due to the variety of often uncharacteristic symptoms this infection is ...19902198681
detection of borrelia burgdorferi using the polymerase chain reaction.segments of the ospa gene of borrelia burgdorferi were amplified by the polymerase chain reaction (pcr). oligonucleotide primers used in the reaction flank a 309-base-pair segment within the ospa gene. after 35 cycles of amplification, the product could be detected by agarose gel electrophoresis or dot hybridization with a 32p-labeled probe. this segment was amplified in all strains of b. burgdorferi tested, but it was not detected in other bacterial species. an additional primer pair which has ...19902199482
characterization of a tick isolate of borrelia burgdorferi that possesses a major low-molecular-weight surface protein.an unusual strain of borrelia burgdorferi (dn 127 cl 9-2) that was isolated from an ixodes pacificus tick did not react with monoclonal antibodies (mabs) to ospa and ospb surface proteins, which are found in most u.s. strains. the strain exhibited an abundant protein with an apparent molecular weight of 25,000 (25k protein). a mab, 86 dn-1, that was prepared to the 25k protein was used in studies on the effect of proteases on the intact spirochetes, immune electron microscopy, and western blot ( ...19902199499
evaluation of three commercial tests for lyme disease.a commercial indirect immunofluorescence assay (ifa), enzyme-linked immunosorbent assay (elisa), and a passive hemagglutination kit were evaluated and compared with our in-house ifa and elisa methods. both ifa methods gave identical results but were less sensitive than elisa methods. likewise, the elisa methods were comparable. the hemagglutination method gave a statistically significant difference when compared with our elisa method (p = 0.018 mcnemar test). it is recommended that the passive h ...19902200637
immunology of lyme disease.b. burgdorferi is an organism capable of modifying the immune response of its human hosts in a number of specific and nonspecific ways. an understanding of immune changes can help with diagnostic and therapeutic decisions in lyme disease.19902200983
stroke in neuroborreliosis.a 20-year-old man suffered two thalamic infarctions during the course of neuroborreliosis and was successfully treated with intravenous ceftriaxone. review of 11 additional cases of stroke and cerebral vasculitis in neuroborreliosis suggests that there is a meningovascular form of the infection with predilection for the posterior circulation and an association with the european strains of borrelia burgdorferi.19902202096
interlaboratory and intralaboratory comparisons of indirect immunofluorescence assays for serodiagnosis of lyme disease.a conventional indirect immunofluorescence assay (ifa) and an anticomplement indirect immunofluorescence assay (acif) for detecting serum antibodies to borrelia burgdorferi in humans were evaluated during a prevalence survey in northern california. sera obtained from 119 current or former residents of an area in which lyme disease is endemic were split and tested by the ifa in two laboratories and the acif in a third. the seropositivity rate ranged from 15 to 20% with 88 to 93% agreement among l ...19902203813
[the clinical aspects of lyme disease]. 19902204134
episcleritis, conjunctivitis, and keratitis as ocular manifestations of lyme disease.a 35-year-old woman presented with a bilateral palpebral follicular conjunctivitis. subsequently, she developed a bilateral keratitis and, on a separate occasion, an episcleritis that was associated with a recrudescence of lyme disease and poor compliance with the antibiotic regimen. both the keratitis and episcleritis cleared completely after topical corticosteroid therapy and reinstitution of appropriate antibiotic treatment. this report emphasizes the importance of collaboration between inter ...19902205817
spirochetal arthritis, including lyme disease. 19902206804
[lyme disease: clinical and sero-epidemiological study of borrelia burgdorferi infections in belgium].lyme disease is a multi-systemic infection caused by the spirochaete borrelia burgdorferi: this bacterium, discovered in 1982 in the united states, is mainly transmitted by a tick bite, ixodes ricinus in europe. in belgium, a first seroepidemiological study of 3 years has revealed 190 patients and the whole spectrum of clinical pictures was observed, including the early stage of this infection in the skin (erythema chronicum migrans), neurological involvement and arthritis. the lyme borreliosis ...19902207461
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