the diagnosis of lyme disease: rewards and perils. 19892647012
lyme disease: a review for primary health care providers.late spring and summer are the times when tick exposure is the greatest. lyme disease, a spirochete infection, usually follows a bite from an ixodes (hard bodied) tick; the symptoms of infection frequently occur between the months of may and august. classically, lyme disease begins with a characteristic skin lesion (erythema chronicum migrans) along with flu- or meningitis-like symptoms. if not recognized or if left untreated, lyme disease may progress with neurologic, cardiac and arthritic mani ...19892648207
third-generation cephalosporins. a plea to save them for specific infections.third-generation cephalosporins are indicated for treatment of sexually transmitted diseases, resistant salmonellosis, and infections in the febrile leukopenic host. the practicing physician must weigh the expanding role of these agents against their limitations. some potential problems include bleeding (confined to the use of moxalactam [moxam] or cefoperazone [cefobid]), a reaction like that to disulfiram (antabuse) when combined with alcohol (also confined to the use of moxalactam or cefopera ...19892648353
lyme disease. the hidden pandemic.physicians will recognize lyme disease faster if they maintain a high index of suspicion in a young patient with arthritis accompanied by negative rheumatoid factor and antinuclear antibody in combination with cardiac conduction problems or lymphocytic meningitis. the lyme spirochete (borrelia burgdorferi) has notable sensitivity to tetracycline, penicillin, and erythromycin; therefore, proper and complete treatment of the disease, once it is identified, can be easily achieved. finkel observed t ...19892648375
human necrotizing splenitis caused by borrelia burgdorferi.a 25-year-old hispanic male presented to the emergency room with complaints of severe left upper quadrant pain. physicians determined that the patient had an acute inflammatory process with a possible diagnosis of splenic abscess. a splenectomy was performed. histologic examination of the tissue sections revealed extensive necrosis and inflammation, but no etiologic agent was discernible. microbiologic cultures of the tissue had negative results. a dieterle silver stain revealed an overwhelming ...19892648803
meningopolyradiculitis (bannwarth syndrome) as primary manifestation of a centrocytic-centroblastic lymphoma.a 65-year-old female presented with bannwarth's syndrome. symptoms initially responded to antibiotics but soon progressed despite further adequate antibiotic treatment. consistently absent antibody titres to borrelia burgdorferi, repeated csf examinations combined with an extensive search for tumour, revealed leukaemic meningitis secondary to uterine centrocytic-centroblastic lymphoma. the diagnostic steps required to elucidate the aetiology of meningopolyradiculitis, especially when chronic and ...19892651571
efficacy of the urinary bladder for isolation of borrelia burgdorferi from naturally infected, wild peromyscus leucopus.the efficacy of culturing urinary bladder tissue for borrelia burgdorferi from naturally infected, wild peromyscus leucopus mice was determined. the urinary bladder cultures were as efficient as spleen, kidney, and blood tissue cultures. the rapid b. burgdorferi isolation (mean, 6 days) from mouse urinary bladders should aid in defining new lyme disease foci.19892656749
[neurologic manifestations of lyme borreliosis].the authors report on recent concept of lyme borreliosis. the disease is caused by borrelia burgdorferi transmitted by tick bite. as with other spirochetal illnesses, lyme borreliosis occurs in stages. the dermatological, rheumatological, cardiological and especially neurological aspects in the course of disease are described and the principles of immunodiagnosis and treatment are explained.19892657824
[neurologic forms of lyme disease. 12 cases].twelve cases of lyme's disease with neurological complications are reported. seven patients had meningoradiculitis of the garin-bujadoux-bannwarth type, with facial palsy in 2 cases. in 1 case the radiculitis involved only the cauda equina. two more patients had meningomyelitis. of the remaining 3, 1 had subacute inflammatory polyneuritis with albumino-cytologic dissociation, 1 had probable dorsal epiduritis, and the last one developed parkinsonism and communicating hydrocephalus after an otherw ...19892662339
[lyme disease: biological diagnosis and treatment].in daily practice the diagnosis of lyme disease is confirmed in the laboratory by serological tests the specificity and sensitivity of which are not fully satisfactory. there are false-positive results due to antibodies directed against antigens others than borrelia burgdorferi, but the main problem is that most people living in endemic areas have specific antibodies while being, and remaining, asymptomatic. in addition, the sensitivity of the current tests is mediocre at the onset of the diseas ...19892662364
[lyme disease, erythema migrans disease, borreliosis (review)].an increasing rate of infections with borrelia burgdorferi seems to endanger humans and domestic animals. this may be due to increase of the main vectors ixodids, of their infection with borrelia, of exposure of humans in nature, of climate influences, changes of the virulence or resistance et cet. enforcement of research in this spirochaete and information of the public are recommended for diminishing the risk of this disease.19892662959
[sense and nonsense of examinations in hematogenous and exogenous intra-ocular infections].diagnosis of intraocular inflammations can be difficult, particularly if the patient is suffering from immunodeficiency. among the endogenous inflammations this applies mainly to cases of hyaloretinitis caused by candida or other fungi, often presenting as an acute hyalitis with sudden onset; the various ocular complications of aids, especially those due to toxoplasmosis (rare) and cytomegalovirus, and lyme disease, which can occasionally cause chronic panuveitis. among the exogenous cases it ap ...19892664327
taking a hard look at borrelia burgdorferi. 19892666370
lyme arthritis presenting as adult onset still's disease.lyme disease and adult onset still's disease share several clinical characteristics such as fever, lymphosplenomegaly, skin involvement, and arthritis. borrelia burgdorferi has been recognized as the cause of lyme disease and an infectious agent has been suspected, at least as triggering factor, in adult onset still's disease. this work is concerned with a patient affected by atypical lyme disease originally diagnosed as adult onset still's disease. b. burgdorferi infection must be suspected in ...19892667831
laboratory analyses for lyme disease.numerous techniques are available for the laboratory diagnosis of lyme disease. assays for the detection of antibodies to borrelia burgdorferi are the most practical means of confirming infection. false positive reactions can occur, but the more serious disadvantages are low sensitivity and lengthy processing time. nonetheless, serologic tests are being improved and remain valuable research and diagnostic tools. serologic test results for antibodies to b. burgdorferi should be considered along w ...19892667886
ecology of lyme disease.borrelia burgdorferi is transmitted from wild animals to humans by the bite of ixodes dammini. this tick is common in many areas of southern connecticut where it parasitizes three different host animals during its two-year life cycle. larval and nymphal ticks have parasitized 31 different species of mammals and 49 species of birds. white-tailed deer (odocoileus virginianus) appear to be crucial hosts for adult ticks. all three feeding stages of the tick parasitize humans, though most infections ...19892667888
transmission of lyme disease spirochetes (borrelia burgdorferi).the field and laboratory evidence incriminating nymphal ixodes dammini as the main vectors of borrelia burgdorferi is substantial. furthermore, other members of the ixodes (ixodes) ricinus 'complex', including i. ricinus, i. persulcatus, i. pacificus, and i. scapularis, are competent vectors of the lyme disease spirochete. although ticks in other genera are also naturally infected with b. burgdorferi, experimental evidence suggests that amblyomma and dermacentor ticks are inefficient vectors of ...19892667921
ehrlichiosis--"spotless spotted fever".ehrlichia canis, a canine rickettsia, produces an acute infection in humans characterized by thrombocytopenia, leukopenia, and anemia. patients should be closely questioned and examined for tick bites. rash is not prominent, leading to the interesting if somewhat inaccurate label of "spotless spotted fever." the diagnosis is made by clinical presentation, absence of positive lyme disease or rocky mounted spotted fever (rmsf) serology, and positive e. canis titers. tetracyclines are preferred tre ...19892668039
clonal polymorphisms of outer membrane protein ospb of borrelia burgdorferi.the outer membrane protein ospb of borrelia burgdorferi, the lyme borreliosis agent, differs in relative molecular weight (mr) among strains. to determine whether antigenic variation occurs in b. burgdorferi, a cell population of the human isolate hb19 was cloned first by being diluted in broth and then by being plated on agar medium. several clones were obtained and characterized by polyacrylamide gel electrophoresis, in situ protease treatment, and western (immunoblot), southern, and northern ...19892668185
latent lyme neuroborreliosis: presence of borrelia burgdorferi in the cerebrospinal fluid without concurrent inflammatory signs.borrelia burgdorferi, the etiologic agent of lyme borreliosis, was isolated from the csf of a patient with elevated serum igg antibody titers against b burgdorferi and a history of multiple tick bites. the absence of concurrent inflammatory signs of csf as well as intrathecal antibody production indicates a phase of latent lyme neuroborreliosis in which no tissue infection or reaction has yet occurred. bilateral tinnitus was the only clinical symptom in this patient. the persistence of the bilat ...19892668788
an adsorption procedure to increase the specificity of enzyme-linked immunosorbent assays for lyme disease without decreasing sensitivity.previous efforts to use adsorption techniques to enhance the specificity of enzyme-linked immunosorbent assays for antibodies to the spirochete that causes lyme disease resulted in unacceptable reductions in assay sensitivity. we present here evidence that preadsorption of serum with escherichia coli can enhance test specificity without significantly reducing test sensitivity.19892669768
lyme disease: neurologic manifestations.lyme disease is a multisystem infectious, inflammatory, and immune-related disorder that follows the bit of an ixodes dammini tick infected with borrelia burgdorferi. subsequent manifestations are protean. this is particularly true concerning the nervous system. it is estimated that 15% of patients with lyme disease have neurologic complications. it is very possible that nervous system manifestations of lyme disease are even more common, and these can occur from weeks to many years following the ...19892670400
fluoroimmunoassay studies with solubilized antigens from borrelia burgdorferi.sodium deoxycholate-solubilized borrelia burgdorferi antigen was prepared for use in a solid-phase fluoroimmunoassay (fia-l) to detect antibodies in lyme disease. serum specimens were tested by fia-l and by a microimmunofluorescence test. the fia-l results are comparable to those of the standard microimmunofluorescence test. the overall agreement was 0.98. moreover, the fia-l procedure is simple and rapid; fluorescence is objectively determined and is proportional to antibody titer.19892671034
comparison of immunofluorescence and enzyme linked immunosorbent assays for diagnosing lyme disease.a new enzyme linked immunosorbent assay (elisa) method was assessed in parallel with an indirect immunofluorescence assay (ifa) for the serological testing of specimens submitted for detection of lyme disease. wells of an elisa microtitre plate were coated with sonicated whole cells of borrelia burgdorferi in carbonate buffer. after overnight incubation at 4 degrees c the plates were washed three times, then incubated at 37 degrees c for an hour sequentially with a blocking solution, diluted tes ...19892671054
lyme disease: a confusing multisystem borreliosis.lyme disease, a tick-borne infection caused by the spirochete borrelia burgdorferi, involves many organ systems. three clinical stages of involvement have been described; patients with the disease may have cutaneous, arthritic, neurologic, or cardiac symptoms, or a constellation of manifestations. specific antibody testing and antibiotic agents are available for lyme disease, but a high index of suspicion must be exercised to recognize atypical manifestations.19892672356
lyme disease--another transfusion risk?lyme disease (or lyme borreliosis) is caused by a spirochetal bacteria, borrelia burgdorferi. increased recognition of the disease and increased exposure to the vector (ticks) capable of spreading b. burgdorferi from animal hosts have resulted in a rise in the number of cases of lyme borreliosis reported in the united states. there are three stages of the clinical course of lyme borreliosis; however, not all those infected will have typical manifestations of each stage, such as the arthritis of ...19892672435
n-terminal amino acid sequence of the borrelia burgdorferi flagellin.the 41 kda flagellar protein of borrelia burgdorferi appears to be an immunodominant antigen producing an early and strong response in most, if not all, individuals during infection in humans. it would represent a very good antigen for serodiagnosis of lyme disease, if its crossreactivity with flagella of other bacteria was low. to gain information on this point we isolated the b. burgdorferi flagellin by preparative two-dimensional electrophoresis for n-terminal amino acid analysis. by comparin ...19892676703
[borrelia burgdorferi-induced pseudolymphoma with pathogen cultivation in an hiv-1 positive patient].cutaneous symptoms and skin diseases are common findings in almost all hiv-1-positive patients. in many cases the clinical presentation and course of the skin diseases are atypical, and occasionally the development of the appropriate circulating antibodies is lacking or impaired. in this report we present a patient seen in our multidisciplinary outpatient clinic for hiv patients. this patient had a borrelia burgdorferi infection with an unusual course. the acute inflammatory phase of the arthrop ...19892676912
lyme disease: a review for the occupational physician.lyme disease, a multisystem illness caused by a spirochete (borrelia burgdorferi) and transmitted to humans by ticks, is increasing in incidence. outdoor workers in areas of endemic disease are at increased risk of infection. increased recognition of this fact will be necessary to prevent the disease in working populations.19892677268
immunoblot analysis of antibody binding to polypeptides of borrelia burgdorferi in children with different clinical manifestations of lyme disease.we analyzed by means of immunoblot technique the patterns of antibodies binding to polypeptides of borrelia burgdorferi b31 in the sera of 21 children with different stages of lyme disease. all sera but one recognized the flagellar protein 41 kd and all but two the 83-kd protein. the number of proteins recognized rose from clinical stage i to stage iii. the polypeptides of the mol wt 55 and 31 kd were exclusively bound by igm and the proteins 66, 58, 39, and 36 kd exclusively by igg. based on th ...19892677950
[borrelia burgdorferi, clinical aspects, cultivation and identification of the pathogen in erythema migrans in berlin].among other manifestations, the following diseases caused by borrelia burgdorferi in europe are transmitted by ticks of the species ixodes ricinus: erythema migrans (em), lymphadenosis benigna cutis (lbc), lymphocytic meningo-radiculitis (bannwarth's syndrome), and acrodermatitis chronica atrophicans (aca). we report on a female patient, who developed em 10 days after a-tick bite in berlin. borrelia burgdorferi could be cultivated from a skin biopsy specimen taken from the periphery of the em. t ...19892678789
[clinical aspects of borrelia burgdorferi infections].skin lesions due to borrelia burgdorferi-like erythema migrans, lymphadenosis cutis benigna, and acrodermatitis chronica atrophicans - are hall-marks of a systemic infection, which tends to a chronically relapsing course. even if the skin lesions are missing, or disappear spontaneously, the infection may persist and affect other organs. this presumption is supported by the outcome of a long-term follow-up study on seropositive forest workers. in association with meningopolyneuritis (garin-bujado ...19892678790
[morphea--a tick transmitted borreliosis of the skin? a contribution to the pathogenesis of circumscript scleroderma].we report on a 34-year-old patient suffering from erythema chronicum migrans, who developed clinically and histologically typical morphea, which was confined to the area previously involved by the erythema migrans. the patient's serum antibody level against borrelia burgdorferi spirochetes was significantly elevated. by means of the silver impregnation technique, we were able to identify spirochetal organisms both in the lower dermis and within the septa of the subcutaneous fatty tissue. in froz ...19892678791
the effect of storage of antigen-coated polystyrene microwells on the detection of antibodies against borrelia burgdorferi by enzyme immunoassay (eia).qualitative and quantitative changes in the antigenic mosaic of coated solid-phase matrices occurring during storage may have a pronounced effect on the comparability of results obtained by enzyme immunoassay (eia). we have used, as a model antigen for studying the effects of storage, a sonic extract of borrelia burgdorferi and a totally automatic eia procedure. the igm antibody concentrations of the sera originally determined to be high decreased by almost one half during 1 week's storage of th ...19892681426
[atrioventricular block caused by tick bite--lyme's carditis].the authors present the case of a 44-year-old patient who was admitted to the hospital because of av block of degree iii. six weeks earlier a tick was removed from the left foot of the patient. two weeks later an erythema of 8 cm in diameter, spreading peripherally as well as painful inguinal lymphadenitis developed at the site of the bite with transient arthralgia and myalgia in the region of the waist and left lower limb. after the temporary use of pacemaker, steroid and atropine therapy appli ...19892682445
pathophysiology of the lyme disease spirochete, borrelia burgdorferi, in ixodid ticks.the pathophysiology of borrelia burgdorferi, the lyme disease spirochete, is unique in tick/vector relationships, differing substantially from that of other spirochetes, e.g., borrelia duttonii, the agent of tick-borne relapsing fever, and borrelia recurrentis, the agent of louse-borne relapsing fever, in their respective vectors. following ingestion by a tick, b. burgdorferi lodges in the midgut diverticula, in some instances penetrating the gut wall and invading various tissues. certain invest ...19892682956
epizootiology of borrelia in ixodes tick vectors and reservoir hosts.four north american and two european species of ixodes ticks harbor borreliae. three of the north american species--ixodes dammini, ixodes scapularis, and ixodes pacificus--and two old world species--ixodes ricinus and ixodes persulcatus--feed on a wide range of hosts, including humans; the north american ixodes dentatus has a predilection for cottontail rabbits and rarely parasitizes humans. in lyme disease foci in north america where i. dammini is common, borrelia burgdorferi or similar types ...19892682957
epidemiology and clinical similarities of human spirochetal diseases.lyme disease, first identified in 1975, is the most recently recognized of the seven human spirochetal diseases; the evolving clinical picture of lyme disease indicates it shares many features with the other diseases. these similarities are striking in view of the diverse epidemiology of the seven diseases, which are caused by treponema species (spread by human-to-human contact) or leptospira or borrelia species (zoonoses). these similarities include the following: (1) skin or mucous membrane as ...19892682958
the molecular biology of borrelia.borrelia burgdorferi, the cause of lyme disease, has two major outer-membrane proteins, ospa and ospb, which act as surface antigens. a 49-kilobase linear plasmid contains the genes that encode for these surface proteins. direct examination of denatured plasmid molecules has revealed single-stranded circles with a circumference of approximately 100 kilobases (about twice the length of the linear duplex molecule), a finding that indicates the plasmid strands have covalently closed ends. this form ...19892682959
neurologic manifestations of lyme disease, the new "great imitator".the causative agent of lyme disease, borrelia burgdorferi, is a highly neurotropic organism that not only can produce symptomatic neurologic disease but also can exist dormant within the central nervous system (cns) for long periods. two distinct types of neuroborreliosis occur at different stages of lyme disease. second-stage lyme meningitis resembles aseptic meningitis and is often associated with facial palsies, peripheral nerve involvement, and/or radiculopathies. lyme meningitis may be the ...19892682960
immunologic aspects of lyme borreliosis.immune responses to borrelia burgdorferi infection are now well characterized. following infection there is an early t cell response and a more slowly evolving b cell response. igm antibodies appear first and are followed by igg and iga. early antibodies are primarily against a 41-kilodalton flagellum-associated antigen; responses to other spirochetal antigens develop later. serologic assays that use whole b. burgdorferi preparations are not always able to detect an early rise in antibodies abov ...19892682961
abnormalities of the nervous system in lyme disease: response to antimicrobial therapy.objective measures of neurologic function were used to assess response to treatment in patients with late lyme borreliosis. neurophysiologic evidence of peripheral neuropathy was present in 64 of 137 patients tested. measures of distal axon function (sensory amplitude and conduction velocity, motor terminal latency) were most affected. repeat studies following 60 patients receiving antimicrobial therapy demonstrated significant improvement in these values. before and after therapy 17 patients wi ...19892682962
isolation techniques for spirochetes and their sensitivity to antibiotics in vitro and in vivo.leptospira interrogans can be cultured from blood and cerebrospinal fluid during the first week of leptospirosis and from urine thereafter. studies of in vitro sensitivity indicate that these organisms are sensitive to most antibiotics. tetracycline and penicillin g are most often used clinically, although laboratory studies suggest that the bactericidal activity of penicillin g may be inadequate. treponema pallidum cannot be satisfactorily cultured. it is identified by dark-field microscopy. st ...19892682963
a clinical and sero-epidemiological study of 190 belgian patients suffering from lyme borreliosis.we present a sero-epidemiological study of 190 belgian cases of lyme borreliosis, a multisystemic disease caused by the spirochaete borrelia burgdorferi and transmitted by a tick bite. the whole spectrum of clinical pictures was observed in these patients, including "erythema chronicum migrans" (63%), neurological involvement (47%) and arthritis (22%), frequently in combination. our results are compared to findings in other countries. among the 437 ixodes ricinus ticks collected in the sambre an ...19892683538
[lyme disease and borrelia burgdorferi infections in europe].lyme disease is endemic in europe. the strains of the causative agent, borrelia burgdorferi, seem to be antigenically more heterogeneous than the north american isolates. the only documented vector for this bacterium in europe is ixodes ricinus, but other vectors might be involved as observed in the united states. the tick hosts are not yet well documented in europe. human infection occurs principally during summer months. the clinical aspect of the disease has particular features in europe: at ...19892683896
cefotaxime vs penicillin g for acute neurologic manifestations in lyme borreliosis. a prospective randomized study.we randomly assigned 21 patients with painful lyme neuroborreliosis radiculitis (bannwarth's syndrome) and neuroborreliosis meningitis to a 10-day treatment with either penicillin g. 4 x 5 million u/d (n = 10) or cefotaxime sodium, 3 x 2 g/d (n = 11), intravenously. we were not able to demonstrate clinical differences between groups, either during the 10-day treatment period or at follow-up examination a mean of 7.7 months after antibiotic therapy. cerebrospinal fluid cefotaxime concentrations r ...19892684107
suspected lyme disease in a cow. 19892684126
class-specific and polyvalent enzyme-linked immunosorbent assays for detection of antibodies to borrelia burgdorferi in equids.class-specific and polyvalent elisa were developed to detect igm antibody or total immunoglobulins to borrelia burgdorferi in equine sera. analyses of 122 serum specimens, collected during 1985 from horses and ponies in tick-infested areas of connecticut, revealed igm antibody in 41 (34%) samples; titration end points ranged from 1:160 to 1:2,560. in polyvalent elisa, 73 (16%) of 454 serum specimens contained igm and/or igg antibody. seropositivity was highest (32%) for blood samples collected d ...19892684937
cross-reaction with borrelia burgdorferi antigen of sera from patients with human immunodeficiency virus infection, syphilis, and leptospirosis.we have studied the cross-reaction with borrelia burgdorferi of sera positive for leptospirosis, syphilis, or human immunodeficiency virus by using the microimmunofluorescence test (micro-if). the percentage of sera reactive in the micro-if before absorption varied from 7 to 37% and was reduced to 3 to 8% after absorption with a commercial reiter treponemal antigen. the cross-reaction of sera positive for syphilis or human immunodeficiency virus was distinguished from the homologous reaction wit ...19892685016
antigenic characteristics of borrelia burgdorferi isolates from ixodid ticks in california.twenty (1.4%) of 1,421 adult ixodes pacificus ticks and 2 (20%) of 10 adult ixodes neotomae ticks collected in five counties of northern california were found to contain spirochetes by direct immunofluorescence examination of their tissues with a polyvalent conjugate. borreliae isolated from the tissues of nine of these ticks (i. pacificus, 8; i. neotomae, 1) were identified as borrelia burgdorferi with specific monoclonal antibodies and characterized further by polyacrylamide gel electrophoresi ...19892685030
antibody testing in lyme disease. a comparison of results in four evaluate the interlaboratory and intralaboratory agreement in the performance of lyme disease serological testing, we sent serum specimens from 132 outdoor workers in new jersey to as many as four independent laboratories. these included one state department of health laboratory, one large commercial laboratory, and two research laboratories. the measurement of agreement employed, the kappa statistic, ranged from .45 to .53 among the four laboratories and from .50 to .54 within the commercial ...19892685383
cutaneous manifestations of lyme borreliosis.erythema migrans is the distinctive cutaneous marker of lyme borreliosis. the clinical picture is variable but at some point in its evolution, erythema migrans presents as a red, centrifugally expanding, annular plaque. erythema migrans may appear as a solitary lesion or in multiplicity. it may be accompanied by extra cutaneous signs and symptoms as fever, headache, musculoskeletal discomfort, and regional lymphadenopathy. the diagnosis of erythema migrans is based primarily on clinical findings ...19892685922
lyme disease in children.lyme disease is an increasing health risk for children. pediatricians should become familiar with the different clinical syndromes caused by the borrelia burgdorferi. appropriate antibiotic therapy must be initiated and follow-up of these children should be a part of the management as some may develop (tertiary) chronic borreliosis. lyme disease should be considered in the diagnostic work-up of heart block, childhood arthritis and in undiagnosed peripheral and central nervous system disease. ser ...19892685925
histopathology of clinical phases of human lyme disease.acute, subacute, or chronic persistent human lyme borreliosis is an inflammatory disorder composed pathologically of lymphocytes, plasma cells, macrophages, and mast cells. the lymphoplasmocellular infiltrates can at times be seen in the skin, subcutaneous tissues, lymph nodes, spleen, liver, myocardium, brain, autonomic ganglia, and peripheral nerves. the joints in arthritic cases have proliferative synovitis, fibrinaceous deposits, lymphoplasmocellular aggregates, and mast cells. varying degre ...19892685926
immunodiagnosis of lyme borreliosis.the clinical definition of lyme disease depends on the epidemiologic association of signs and symptoms with a measureable immune response to b. burgdorferi. the dependence on the demonstration of an immune response to b. burgdorferi has made the understanding of this systemic spirochetosis critical for the physician when making a diagnosis.19892685927
laboratory diagnosis of lyme disease.different techniques have been developed to aid in laboratory diagnosis of lyme disease. the detection of serum antibodies, in particular, is relied on heavily by the medical community and is currently the most practical means of confirming b. burgdorferi infections. although most assays may not detect low amounts of igm antibody during the initial weeks of infection, application of a capture elisa method has been reported to improve test sensitivity. antibodies to borrelia and treponema spiroch ...19892685928
preventing lyme disease.five species of ixodid ticks that frequently feed on humans, ixodes dammini, i. scapularis, i. pacificus i. ricinus, and i. persulcatus, are competent vectors of b. burgdorferi. collectively, these species are distributed over vast areas of north america, europe, and asia. lyme disease is becoming prevalent because of increased human exposure to infected ticks. chemical and environmental methods of controlling these ticks over large areas will be difficult because none of these species is concen ...19892685929
vector/host relationships of the lyme disease spirochete, borrelia burgdorferi.lyme borreliosis is now occurring on several continents where its causative agent, borrelia burgdorferi, is maintained and transmitted by ticks of the "ixodes ricinus complex" namely i. dammini, i. pacificus, and possibly i. scapularis in north america, i. ricinus in europe, and i. persulcatus in asia. because all developmental stages of these ticks feed on a large variety of hosts including humans, the vector/host relationships of this spirochete is highly complex as indicated by the voluminous ...19892685930
lyme disease.neurological problems form an important part of the clinical spectrum of lyme disease. a triad of aseptic meningoencephalitis, cranial neuritis and peripheral neuritis is unique to the disease. however, the list of neurological manifestations described includes pseudotumour cerebri, hemiparesis, demyelinating disorders, optic atrophy, recurrent laryngeal nerve palsy and purulent meningitis so that lyme disease must now be considered in the differential diagnosis of a wide range of neurological d ...19892686764
lyme arthritis.evanescent arthralgias and myalgias are common early symptoms of lyme disease. transient, intermittent episodes of monoarticular, oligoarticular, or sometimes migratory polyarticular arthritis, lasting weeks to months, with disease-free intervals, are frequently observed in untreated patients with erythema chronicum migrans. a minority of patients develop chronic joint involvement, most commonly affecting the knee. antibiotic therapy given during erythema chronicum migrans is often protective wi ...19892686765
orthopaedic complications of lyme disease in children.lyme disease is transmitted by the tick ixodes dammini ("deer tick") or a related ixodid tick. early diagnosis of children with lyme disease is difficult because the bite of the ixodid tick often goes unnoticed. furthermore, erythema chronicum migrans, the characteristic rash of the disease, occurs in less than 50% of cases. however, an awareness of orthopaedic complications of lyme disease may facilitate an early diagnosis of this disease. orthopaedic complications of lyme disease include those ...19892686766
antibiotic treatment of lyme borreliosis.unlike most bacterial infections, where diagnosis is by identification of the causal organism, diagnosis of infection by borrelia burgdorferi (lyme's borreliosis) relies mostly upon indirect techniques. this situation has some short-comings. as long as no technology permits a microbiological diagnosis of this infection, controversy will exist as to the clinical symptoms and the criteria for the cure of the disease. despite the lack of consensus upon both the clinical definition and the treatment ...19892686769
comparative evaluation of three products for the detection of borrelia burgdorferi antibody in human serum.eighty human serum specimens tested concomitantly by immunoblot and an enzyme-linked immunosorbent assay developed jointly at the university of connecticut school of medicine and the connecticut agricultural experiment station were used to evaluate three commercially available diagnostic products for lyme borreliosis. the sources of the kits were hillcrest biologicals, cypress, calif.; whittaker bioproducts, walkersville, md.; and cambridge bioscience, worcester, mass. when compared with western ...19892687323
[borrelia burgdorferi from ixodes ricinus ticks on ameland].ixodes ricinus ticks collected from the north sea island of ameland, the netherlands, were screened for the presence of borrelia spirochaetes. the present authors used ifat on tick gut preparations and identified borrelia in 31 per cent of the adult ticks and 16 per cent of the nymphs collected from the dunes and 45 per cent of the nymphs collected from the forests. in vitro cultivation of borrelia sp. isolated from the adult ticks and its subsequent recognition by b. burgdorferi-specific monocl ...19892688191
[negativity of borrelia burgdorferi serology in scleroderma en plaques].the occurrence of morphea has been attributed to borrelia, burgdorferi infection, but the relationship between localised scleroderma and borreliosis remains controverted. antibodies directed against b. burgdorferi were looked for in 21 patients (18 female and 3 male, aged from 8 to 63 years) whose disease had been present for 6 weeks to 13 years. one patient had a single morphea, two had monomelic scleroderma and 18 had multiple localised morpheas. the search for antibodies was conducted in thes ...19892688515
[a review of lyme disease].lyme disease is an infectious disease caused by the spirochete borrelia burgdorferi, transmitted by certain ixodid ticks. the illness usually occurs in stages with many different clinical manifestations. the disease starts with a typical cutaneous lesion called erythema cronicum migrans, that usually develops at the site of the tick bite. after weeks or months, some patients develop neurological abnormalities, particularly meningitis, cranial nerve paralysis, peripheral radiculoneuritis, or card ...19892690198
the pathologist's view of lyme disease.lyme disease is a multisystem disease caused by the spirochete borrelia burgdorferi and is transmitted to humans primarily through ixodid ticks. the clinical spectrum of the disease is continuing to expand while in its wake the pathology and histopathologic manifestations are being uncovered. we review the pathology of lyme disease in man beginning with the tick bite. we present the pathologic changes of the rash, erythema migrans, as well as the neurologic, cardiac, and arthritic changes of the ...19892690468
pathogenesis of lyme disease.the etiology and pathogenesis of lyme disease are reviewed and the value of the condition as a human model for an infectious etiology of rheumatic disease is discussed. similarities between lyme disease and rheumatoid arthritis are considered.19892692132
[diagnostic possibilities and limitations in lyme borreliosis].in switzerland 5-35% of ixodes ricinus ticks are infested with borrelia burgdorferi (b.b.). there is a high risk of transmission of this infectious agent from any tick bite and 4-5% of affected subjects subsequently contract evident lyme borreliosis. however, both tick bite and erythema chronicum migrans are unreliable diagnostic pointers as they are not usually found in the history of lyme borreliosis patients. similarly, an increased titer of antibodies against b.b. is not evidence of lyme bor ...19892692151
[serodiagnosis of lyme borreliosis: antibody titer and specificity in the ift and western blot].out of 334 sera from healthy persons from northern bavaria 6% reacted positive in the indirect immunofluorescence test (ift, titre greater than or equal to 1:64). the percentage of positive cases in patients with erythema chronicum migrans (ecm), meningoradiculitis (m. bannwarth), or acrodermatitis chronica atrophicans (aca) was 43, 83 and 78%, respectively. in other patients with less characteristic symptoms in which an infection with b. burgdorferi was suspected the number of positive cases wa ...19892693341
clinical features and treatment of lyme disease.lyme disease is caused by the spirochete borrelia burgdorferi, which is carried by infected ticks. this disorder has a variable clinical course with multisystem manifestations, including dermatologic, neurologic, cardiac, and rheumatologic abnormalities. although lyme disease has been commonly associated with stages, the utility of staging may be limited due to the inconsistency of clinical manifestations among patients. furthermore, stages may overlap as a result of the acute and chronic phases ...19892694112
linear chromosome of borrelia burgdorferi.the dna organization of several european and american isolates of borrelia burgdorferi, the aetiological agent of lyme disease, was analysed in pulse-field agarose gel electrophoresis. the results of in situ cell lysis in agarose plugs demonstrated a unique arrangement for the dna of this spirochete. the chromosome of borrelia behaved as a eukaryotic linear chromosome with a size of around 1,000 kb. the genome also comprised several circular and linear plasmids which varied in size from 15 to 60 ...19892696058
[lyme disease].lyme disease, which is caused by the tick-borne spirochete borrelia burgdorferi, usually begins with a characteristic skin lesion erythema chronicum migrans (ecm), that may be followed by neurological or cardiac abnormalities and is accompanied by malaise, fatigue, fever, myalgia, headache, lymphadenopathy and is often followed by arthritis. the disease takes its name from lyme, connecticut, where the full spectrum of illness was first described in 1975. it is known to be a multisystemic infecti ...19892696864
lyme disease--a new disease in southern africa?lyme disease is a recently-described zoonotic disease occurring widely in the u.s.a., europe and asia. the causative organism, borrelia burgdorferi, is transmitted predominantly by ticks of the genus ixodes and infects a wide host range. the infection in humans causes the human disease syndrome erythema chronicum migrans resulting in arthritis, neurological symptoms and/or cardiac abnormalities. similar clinical signs have been described in domestic animals. the status of lyme disease in souther ...19892699499
the cutaneous manifestations of human lyme disease: a widening spectrum. 19892701793
penetration of endothelial cell monolayers by borrelia burgdorferi.the ability of borrelia burgdorferi, the agent of lyme disease, to penetrate cultured human umbilical vein endothelial cell monolayers was investigated. after 4 h of coincubation, approximately 7.7% of added bacteria passed through the host cell monolayers. electron microscopy revealed that the borreliae entered the endothelial cells and suggested that the organisms penetrated the host monolayers primarily by passing through them.19892707862
ultrastructure of borrelia burgdorferi in tissues of patients with lyme disease.spirochetal organisms were sought in 18 skin and 4 synovial membrane specimens obtained by biopsy from 22 lyme disease patients. the presence of spirochetes in body tissues was histologically demonstrated in one patient with lymphadenosis benigna cutis, one patient with acrodermatitis chronica atrophicans and in one patient with active arthritis. the organisms were 5-30 microns long and 0.12-0.25 microns thick, had 8 or 11 flagella arising from both ends of the body, and their ultrastructure was ...19892709313
competence of a rabbit-feeding ixodes (acari: ixodidae) as a vector of the lyme disease spirochete.we compared the development of the lyme disease spirochete, borrelia burgdorferi johnson, schmid, hyde, steigerwalt and brenner, in subadult rabbit-feeding ixodes dentatus marx with that in mouse-feeding i. dammini spielman, clifford, piesman and corwin. rabbits were infected with spirochetes by the bites of i. dammini that had been infected naturally in a zoönotic site. larval ticks of both species were permitted to engorge simultaneously on each of these infected hosts. spirochetes were presen ...19892709387
seronegative lyme disease. 19892710208
[atrioventricular block in lyme carditis].lyme disease, due to infection with borrelia burgdorferi transmitted by ticks, is most frequently manifested by arthritis and neurological complications. in approximately 8% of cases, however, carditis, usually reflected in av block, is the leading symptom. the case histories of 2 males and 1 female aged 23 to 37 years with av block caused by borrelia burgdorferi are presented. main symptoms were exertional dyspnea, palpitations, dizziness and syncope. one patient was treated with diclofenac and ...19892711158
serosurvey for antibodies to borrelia burgdorferi in danish estimate the regional presence of b. burgdorferi we performed a serosurvey for antibodies to b. burgdorferi in 205 healthy dogs from representative areas of denmark. blood samples were collected from november 1986 to march 1987. twenty dogs bred for research purposes served as negative controls. igg-antibodies to the b. burgdorferi strain dk-ecm 1 were measured by indirect immunofluorescens assay. antibody titers ranged from nonreactive to 640. in 33 dogs (16.1%) titres were greater than or e ...19892713138
genetic and antigenic characterization of borrelia coriaceae, putative agent of epizootic bovine abortion.borrelia coriaceae was characterized genetically and antigenically by utilizing the following techniques: restriction endonuclease analysis, southern blotting and genomic hybridization, pulsed-field electrophoresis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting. the b. coriaceae genome revealed unique and characteristic banding patterns both by agarose gel electrophoresis and by hybridization when compared with several borrelia burgdorferi isolates. pulsed-field g ...19892715314
serodiagnosis of erythema migrans and acrodermatitis chronica atrophicans by the borrelia burgdorferi flagellum enzyme-linked immunosorbent assay.the diagnostic performance of an enzyme-linked immunosorbent assay (elisa) using purified borrelia burgdorferi flagella as test antigen was compared with that of a b. burgdorferi sonic extract elisa. we tested sera from 200 healthy controls, 107 patients with erythema migrans (em), 50 patients with acrodermatitis chronica atrophicans (aca), and 98 patients with various dermatological disorders without clinical evidence of active lyme borreliosis. the flagellum elisa was significantly more sensit ...19892715325
lagomorphs as sentinels for surveillance of borreliosis in the far western united states.brush rabbits (sylvilagus bachmani) and black-tailed jackrabbits (lepus californicus) from california (usa) were assayed for antibodies to borrelia burgdorferi, the etiologic agent of lyme borreliosis. significant antibody titers were detected in 90% (range, 67 to 100%) of brush rabbits from four of six localities, and in 90% of jackrabbits from a single locality, in northern california. one of the populations of brush rabbits that did not yield seropositive individuals inhabited an oceanic isla ...19892716099
[bilateral acute confluent disseminated choroiditis in borrelia burgdorferi infection].two patients with bilateral extensive confluent choroidal lesions, exudative retinal detachments, positive lyme serology and a typical history are documented: a 32-year-old woman presented 14 days after a "flu-like" illness with bilateral acute extensive choroidal lesions and exudative retinal detachments (od from 5 to 8:30 o'clock, os from 5 to 8 o'clock, both including the macula) accompanied by a mild lymphocytic meningitis. the laboratory work-up revealed increased serum and csf titers of an ...19892716229
[lyme borreliosis--the most frequent cause of acute peripheral facial paralysis in childhood].a prospective hospital-based multicentre study in lower saxony allowed to investigate the frequency of acute peripheral facial palsy due to lyme borreliosis and its clinical and laboratory characteristics. diagnosis of lyme borreliosis was based on detection of igm antibodies against borrelia burgdorferi in serum and csf as well, using an igm capture elisa. between june 1986 and october 1987 27 consecutive cases with acute peripheral facial palsy were studied. lyme borreliosis is the main cause ...19892716745
histopathology of lyme arthritis in lsh hamsters.the authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with borrelia burgdorferi. nonirradiated hamsters injected in the hind paws with b. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. this acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and per ...19892719078
characterization of the first tick isolate of borrelia burgdorferi from italy.we report on the first isolation of a spirochetal organism from ixodes ricinus ticks of the trieste area (northern italy) which was identified as borrelia burgdorferi by its reactivity with specific monoclonal antibodies directed against the ospa and flagella proteins.19892719854
borrelia burgdorferi infections. 19892721239
[acute multifocal placoid pigment epitheliopathy with inflammatory csf findings. a special form of borreliosis?].a 24-year-old woman with acute multifocal placoid pigment epitheliopathy in both eyes had no signs or symptoms other than the impaired vision. visual evoked potentials demonstrated prolonged latency. lumbar csf showed inflammatory changes. serum antibody titres against borrelia burgdorferi were markedly elevated. cortisone treatment was without success, but intravenous penicillin quickly brought about improvement in vision. borrelia infection may thus have been the cause of the multifocal placoi ...19892721383
[prognosis of peripheral facial paralysis in lyme borreliosis (garin-bujadoux, bannwarth meningopolyradiculitis)].meningopolyradiculitis (garin-bujadoux syndrome, bannwarth syndrome) is the second stage of lyme disease, a tick-borne borrelia infection. almost 60% of these patients develop an acute peripheral facial paresis. the disease can be differentiated from bell's palsy only by finding the specific borrelia antibodies in serum and csf. other cranial nerve lesions can be found besides facial paresis. the follow-up of seven borrelia-infected patients is described: one showed bilateral, the others unilate ...19892722577
borrelia burgdorferi infection in horses. 19892722625
the ominous spread of borrelia burgdorferi infection. 19892722627
ocular manifestations of lyme disease.the incidence of lyme disease has been increasing at alarming rates in recent years. being the most commonly reported tickborne bacterial disease in the united states, it now outnumbers rocky mountain spotted fever by a ratio of almost 2:1. it is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. the ocular complications of lyme disease can present as one of the more ominous signs during the course of the illness. the detection of ...19892723324
habitat distribution of ixodes dammini (acari: ixodidae) an lyme disease spirochetes on fire island, new york.the distributions of ixodes dammini spielman, clifford, piesman, and corwin and lyme disease spirochetes were studied on fire island, n.y. adult ticks were more common in high-shrub habitats (shrubby vegetation greater than or equal to 1 m high) than in grassy and lowshrub habitats (vegetation less than 1 m) in spring and fall. in the fall, adults were also common in the woods. adults were more abundant on narrow trails than in nearby vegetation. during the summer, questing nymphs and larvae wer ...19892724316
host associations of ticks (acari: ixodidae) parasitizing medium-sized mammals in a lyme disease endemic area of southern new york.ticks of eight medium-sized mammal species were studied in an area of endemic lyme disease in westchester county, n.y., from 1 april 1984 to 31 march 1985. most (81%) of the 266 total mammal captures were raccoon, procyon lotor (l.) (47%), opossum, didelphis virginiana (kerr) (19%), and striped skunk, mephitis mephitis schreber (15%); these host species accounted for 91% of the 1,519 ticks collected. although the total number of ticks was rather evenly distributed among these mammals, species co ...19892724317
treatment of lyme disease. 19892725419
borrelia burgdorferi antibodies in multiple sclerosis patients.lyme disease is said to produce a late syndrome resembling multiple sclerosis. we analyzed serum antibodies to borrelia burgdorferi in 100 patients referred for possible ms. all lived in an area endemic for lyme disease. only 1 of 89 definite ms patients and 2 of 11 non-ms patients were antibody positive. infection with borrelia burgdorferi is rare in ms, and lyme disease is unlikely to play a significant role in the differential diagnosis of ms.19892725867
nucleotide sequence of a gene encoding the borrelia burgdorferi flagellin. 19892726494
[clinical characteristics of tick-borne spirochete infection (lyme disease)].a total of 54 patients with tick-borne annular erythema (tae) were investigated. in 41 patients different nervous system involvement signs were observed: radicular syndrome, serose meningitis, limbs paresis. epidemiological and clinical signs of tae in the ussr are much like those of laim disease in usa and western europe. laboratory investigations that were performed in 13 tae patients have detected antibodies to the infecting agent of the laim disease in 8. treatment with broad spectrum antibi ...19892728715
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