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neurological findings of lyme disease.neurologic involvement of lyme disease typically consists of meningitis, cranial neuropathy, and radiculoneuritis, alone or in combination, lasting for months. from 1976 to 1983, we studied 38 patients with lyme meningitis. headache and mild neck stiffness, which fluctuated in intensity, and lymphocytic pleocytosis were the common findings. half of the patients also had facial palsies, which were unilateral in 12 and bilateral in seven. in addition, 12 patients had motor and/or sensory radiculon ...20166516450
the clinical spectrum and treatment of lyme disease.lyme disease was recognized as a separate entity because of close geographic clustering of affected children in lyme, connecticut, with what was thought to be juvenile rheumatoid arthritis. it then became apparent that lyme disease is a complex, multisystem disorder. the illness usually begins in summer with erythema chronicum migrans and associated symptoms (stage 1). weeks to months later, some patients develop neurologic or cardiac abnormalities (stage 2), and weeks to years later, many patie ...20166516448
lyme disease in new jersey, 1978-1982.from 1978 to 1982, 117 cases of lyme disease were reported in new jersey. the number of cases increased each year from four in 1978 and 1979 to 56 in 1982. forty-eight percent of cases occurred in a four-township area in central monmouth county. the proportion of cases with arthritis decreased in 1982 because of early antibiotic treatment and better reporting of milder cases. the proportion of cases with positive serology increased with severity of the clinical syndrome. about 25 percent of pati ...20136393614
immunochemical analysis of lyme disease spirochetes.sera from patients with lyme disease (ld) originating in the united states and europe were examined by western blot analysis for antibodies to ld spirochete components. whereas some components reacted with antibodies from the majority of patients, other components, notably an abundant cellular protein with an apparent molecular weight of 34,000 were less commonly bound. this latter proteinaceous component was in a region of the polyacrylamide gel electrophoresis profile which demonstrated variab ...20136393610
immunodiagnostic tests for lyme disease.standardized serologic tests for lyme disease are needed, as isolation or in situ demonstration of the spirochete has proved difficult. at the centers for disease control (cdc), an indirect immunofluorescence assay (ifa) was modified from a previously described ifa, and an enzyme-linked immunosorbent assay (elisa) was developed with soluble spirochetal antigens. both tests were evaluated with sera from lyme disease patients, normal controls, and patients with other diseases. they were highly spe ...20136393608
recovery of lyme disease spirochetes from patients.since the summer of 1982, we have cultured patient specimens for lyme disease spirochetes. of 118 patients cultured, four specimens yielded spirochetes: two from blood, one from a skin biopsy specimen of erythema chronicum migrans (ecm), and one from cerebrospinal fluid. all four isolates appeared identical when examined with a monoclonal antibody. however, attempts to recover the spirochete from synovium or synovial fluid were unsuccessful. in addition, the organism could not be visualized in s ...20166393606
isolation and cultivation of lyme disease spirochetes.the successful isolation and cultivation of lyme disease spirochetes traces its lineage to early attempts at cultivating relapsing fever borreliae. observations on the growth of lyme disease spirochetes under different in vitro conditions may yield important clues to both the metabolic characteristics of these newly discovered organisms and the pathogenesis of lyme disease.20176393604
epidemiologic features of lyme disease in new york.during 1982, surveillance identified 207 cases of lyme disease in new york state. cases were clustered in two geographic areas, eastern long island and northern westchester counties. symptoms and signs of lyme disease in cases were consistent with previous reports, with erythema chronicum migrans (ecm) being the most frequently (77 percent) reported sign of disease. facial palsy was reported in a surprisingly high 18 percent of cases. of 160 cases whose sera were submitted for lyme spirochete sp ...20136334940
the pathogenesis of arthritis in lyme disease: humoral immune responses and the role of intra-articular immune complexes.we studied 78 patients with lyme disease to determine how immune complexes and autoantibodies are related to the development of chronic lyme arthritis. circulating c1q binding material was found in nearly all patients at onset of erythema chronicum migrans, the skin lesion that marks the onset of infection with the causative spirochete. in patients with only subsequent arthritis this material tended to localize to joints where it gradually increased in concentrations with greater duration of joi ...20136334939
cellular immune findings in lyme disease.from 1981 through 1983, we did the first testing of cellular immunity in lyme disease. active established lyme disease was often associated with lymphopenia, less spontaneous suppressor cell activity than normal, and a heightened response of lymphocytes to phytohemagglutinin and lyme spirochetal antigens. thus, a major feature of the immune response during active disease seems to be a lessening of suppression, but it is not yet known whether this response plays a role in the pathophysiology of t ...20166240164
leads from the mmwr. update: lyme disease--united states. 19846716612
lyme disease. 19846741124
lyme disease as an etiology of "unexplained" recurrent monoarthritis. 19846472235
lyme disease in north carolina. 19846377093
update: lyme disease--united states. 19846425627
clinical manifestations and descriptive epidemiology of lyme disease in new jersey, 1978 to 1982.clinical manifestations and epidemiologic characteristics of 117 cases (31 children and 86 adults) of lyme disease in new jersey from 1978 to 1982 are summarized. the male-female sex ratio was 1.9:1. an endemic focus in monmouth county has been recognized. erythema chronicum migrans was present in 93% of cases and was the only clinical manifestation in 25% of patients. nonspecific febrile syndrome, in addition to erythema chronicum migrans, was present in 45% of cases; 26% had arthritis. the pro ...19846708273
lyme disease: prevention of the arthritis syndrome through early recognition and antibiotic therapy. 19846427143
[acute, syncopal auriculo-ventricular block in lyme disease]. 19846231623
histologic demonstration of intradermal spirochetes in a patient with lyme disease.spirochetal organisms were demonstrated histologically in skin biopsy specimens from a patient with lyme disease and erythema chronicum migrans. the patient responded rapidly to penicillin g benzathine administration. convalescent serum contained a high titer of antibody to an lxodes dammini spirochete antigen. the finding of spirochetes in an erythema chronicum migrans lesion in a patient with clinical lyme disease supports further recent evidence that this illness is an infectious disease caus ...20046711586
lyme disease--a review of the literature.it appears that a tick introduces an agent--presumably a spirochete--into the skin (see fig. 1). immune complexes form and become systemic during the rash. some patients (identified by the presence of cryoglobulins containing igm, clq-reactive material, and depressed igg and iga levels) then alter their immune response and may develop neurologic, cardiovascular, or joint involvement. despite systemic clearing in some patients, the immune complexes localize to the joints where a chronic synovitis ...19846233699
hla-dr in meningopolyneuritis of garin-bujadoux-bannwarth: contrast to lyme disease?sixteen patients with meningopolyneuritis of garin-bujadoux-bannwarth (mpn-gbb) were examined for hla-dr antigens. in contrast to data in lyme disease (ld), which is caused by an identical or closely related spirochete, no significant association was found between the neurological disease and hla-dr. the reported association between neurological disease and hla-dr2 in ld may be due to the inclusion of cases with neurological disease and arthritis, since chronic arthritis in ld seems to be well c ...19846596406
the spirochetal etiology of acrodermatitis chronica atrophicans herxheimer.spirochetes were recovered from the skin lesion of 1 out of 10 acrodermatitis chronica atrophicans patients (aca). spirochetes from this skin isolate and from ixodes (i.) ricinus and i. dammini spirochetes were used as antigens in indirect immunofluorescence tests. all sera from 17 aca patients showed high antibody titers to the three antigens. seven of the 17 sera which had the highest titers had crossreactive antibodies to treponemal antigen detectable in the fta-abs test. the results indicate ...19846084922
[lyme disease: a new infectious disease]. 19836656464
neurologic abnormalities of lyme disease: successful treatment with high-dose intravenous penicillin.twelve patients were treated with high-dose intravenous penicillin for neurologic abnormalities of lyme disease. headache, stiff neck, and radicular pain usually began to subside by the second day of therapy and were often gone by 7 to 10 days. five of the 12 patients continued to have intermittent mild headache for several more weeks, but no patient relapsed after therapy was stopped. compared to 15 previous patients treated with prednisone alone, the duration of meningitic syndrome was signifi ...19836316826
lymphocytic meningoradiculitis in the united states.lymphocytic meningoradiculitis (bannwarth's syndrome) is a radicular neuralgia associated with a chronic lymphocytic pleocytosis in cerebrospinal fluid and frequently with unilateral or bilateral peripheral facial weakness. most reported cases have occurred during the summer among adults living in central europe. lymphocytic meningoradiculitis has occurred in the united states in a few patients with lyme disease and erythema chronicum migrans. however, it may occur independently. we describe a w ...19836685240
lyme disease.lyme disease is a recently described disease of unknown cause that may involve the skin, joints, heart, or nervous system with characteristic symptoms. the disease follows a bite from an ixodes tick. symptoms are generally self-limited and despite the varied and sometimes protracted manifestations, the outcome of the disease is favorable. the epidemiologic, clinical, and laboratory features and treatment of lyme disease are reviewed.19836353917
saturable, high-avidity monocyte receptors for monomeric igg and fc fragments increase in sle and lyme disease.we have devised an assay for quantifying high-avidity fc receptors for monomeric igg on peripheral blood monocytes. in the development of a radiolabelled ligand for the assay, we found that fc fragments offer several advantages over 7s-igg. compared to the latter ligand, the fragments interacted more cleanly with a single high-avidity binding site, appeared to have easier access to this site, and, since they showed no binding to millipore filters, their use made possible a wash procedure that wa ...20176241857
[lyme disease. a new or newly recognized clinical entity]. 19836415420
lyme disease in northern california.lyme disease is a recently described clinical entity with cutaneous, neurologic, articular and cardiac manifestations. since the original description of the disease in 1977, more than 500 cases have been reported. although the vast majority of patients have been from the area near lyme, connecticut, we have seen four patients from northern california with various aspects of lyme disease. this diagnosis should be considered in patients who have traveled to tick regions and who have a distinctive ...19836636745
[erythema migrans disease. a contribution to its clinical features and relation to lyme disease].a largely prospective study averaging 33 months was undertaken in 30 patients with and one without (chronic) erythema migrans. in one case erythema migrans disappeared spontaneously, in the 29 others it persisted up to six months, but quickly responded to antibiotic treatment. measured from the tick bite in 9 patients or from onset of the erythema migrans, arthritis and arthralgia appeared in ten patients on average 6.5 months (0.7-36), and persisted for eight months (0.2-42). in seven of these ...19836872871
spirochaetal aetiology for lyme disease. 19836135024
the early clinical manifestations of lyme disease.lyme disease, caused by a tick-transmitted spirochete, typically begins with a unique skin lesion, erythema chronicum migrans. of 314 patients with this skin lesion, almost half developed multiple annular secondary lesions; some patients had evanescent red blotches or circles, malar or urticarial rash, conjunctivitis, periorbital edema, or diffuse erythema. skin manifestations were often accompanied by malaise and fatigue, headache, fever and chills, generalized achiness, and regional lymphadeno ...19836859726
ticks and lyme disease in the united states. 19836859709
treatment of the early manifestations of lyme disease.during 1980 and 1981, we compared antibiotic regimens in 108 adult patients with early lyme disease. erythema chronicum migrans and its associated symptoms resolved faster in penicillin- or tetracycline-treated patients than in those given erythromycin (mean duration, 5.4 and 5.7 versus 9.2 days, f = 3.38, p less than 0.05). none of 39 patients given tetracycline developed major late complications (meningoencephalitis, myocarditis, or recurrent attacks of arthritis) compared with 3 of 40 penicil ...19836407378
was it lyme disease? 19836880371
lyme disease in north carolina.we report two cases of lyme disease in north carolina, further expanding the distribution of known sporadic cases of this predominantly northeastern problem in southern states. physicians in areas where lyme disease has traditionally not been recognized should be alerted to its characteristic rash (erythema chronicum migrans), tick vector (ixodes species), possible severe manifestations (neurologic, arthritic, and cardiac), and response to appropriate antibiotic therapy (penicillin or tetracycli ...19836857306
lyme disease: a new entity. 19836573608
simultaneous occurrence of babesiosis and lyme disease. 19836682178
lyme disease is a spirochetosis. a review of the disease and evidence for its cause.fourteen patients with lyme disease showed typical clinical features of erythema chronicum migrans. eighteen biopsy specimens in all were obtained from the cutaneous lesions of these patients. the predominant histologic finding was a superficial and deep perivascular and interstitial infiltrate composed mostly of lymphocytes, or lymphocytes and either plasma cells and eosinophils or both. the plasma cells were found most frequently in biopsy specimens taken from the peripheries of the lesions, w ...19836410931
lyme disease--success for academia and the community. 19836828125
spirochetes isolated from the blood of two patients with lyme disease.we isolated spirochetes from the blood of 2 of 36 patients in long island and westchester county, new york, who had signs and symptoms suggestive of lyme disease. the spirochetes were morphologically similar and serologically identical to organisms recently found to infect lxodes dammini ticks, which are endemic to the area and have been epidemiologically implicated as vectors of lyme disease. in both patients, there was a rise in specific antispirochetal antibodies in paired specimens of serum. ...19836828119
the spirochetal etiology of lyme disease.we recovered a newly recognized spirochete from the blood, skin lesions (erythema chronicum migrans [ecm]), or cerebrospinal fluid of 3 of 56 patients with lyme disease and from 21 of 110 nymphal or adult lxodes dammini ticks in connecticut. these isolates and the original one from l. dammini appeared to have the same morphologic and immunologic features. in patients, specific igm antibody titers usually reached a peak between the third and sixth week after the onset of disease; specific igg ant ...19836828118
lyme disease with neurologic abnormalities. 20046220264
demyelinating neuropathy accompanying lyme disease. 19826890169
lyme disease. 19826815444
lyme disease--"what's new in old lyme?". 19827119538
lyme disease in new jersey: a cluster of 4 cases and 13 sporadic cases. 19826956739
lyme disease first observed to be aseptic meningitis. 19827081166
lyme disease and erythema chronicum migrans in minnesota. 19827078540
lyme disease challenges australian clinicians: the implications of australia's first reported case of lyme arthritis. 19827132842
occurrence of erythema chronicum migrans and lyme disease among children in two noncontiguous connecticut counties.in may-november 1977 erythema chronicum migrans of lyme arthritis occurred in at least 12 children in new london county, connecticut, east of the original 3-town epidemic focus. the attack rate (0.15 cases per 1,000 persons under 18) was considerably lower than within the focus itself but similar to the rate in towns west of the focus. no cases were identified in litchfield county in northwest connecticut. observed rates of lyme disease varied markedly within connecticut in 1977.19817326064
lyme disease--united states, 1980. 19816793824
a case of "lyme disease" acquired in new jersey. 19816942167
symptomatic high grade heart block in lyme disease.we describe an unusual and remediable form of heart block which developed in the course of lyme disease. the diagnosis of lyme disease requires a careful clinical history pertaining to epidemiologic geography or a history of erythema chronicum migrans. in this case, a highly selective cardiac abnormality responded promptly to systemic steroids.19817460660
treatment of lyme disease. 19817447210
[erythema chronicum migrans with arthritis (author's transl)].in a 46-year-old woman arthritis developed in several large joints eight weeks after the onset of erythema chronicum migrans. the joints of the leg were swollen and painful. in addition there was painful involvement bilaterally of knee, hip and elbow joints. circulating immune complexes were demonstrated in serum and the erythrocyte sedimentation rate was moderately increased. all other laboratory and radiological tests were within normal limits. on symptomatic treatment the arthritis regressed ...19807439072
lyme disease: a new tick-transmitted illness now recognized in delaware. 19807202773
lyme disease. 19807423274
lyme carditis: cardiac abnormalities of lyme disease.we studied 20 patients, mostly young adult men, with cardiac involvement of lyme disease. the commonest abnormality (18 patients) was fluctuating degrees of atrioventricular block; eight of them developed complete heart block. thirteen patients had evidence of more diffuse cardiac involvement: electrocardiographic changes compatible with acute myopericarditis (11 patients), radionuclide evidence of mild left ventricular dysfunction (five of 12 patients tested), or frank cardiomegaly (one patient ...19806967274
antibiotic therapy in lyme disease.we studied antibiotic efficacy in 113 patients with erythema chronicum migrans, the first manifestation of lyme disease. erythema chronicum migrans and its associated symptoms resolved faster in patients given penicillin or tetracycline (median duration, 4 and 2 days, respectively) than in untreated patients (10 days; p less than 0.001 and p = 0.005, respectively). erythromycin had no significant effect. although the frequency of subsequent neurologic and cardiac abnormalities was similar in all ...19806967272
neurologic abnormalities of lyme disease. 1979449663
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