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Mahajan VK. Lyme Disease: An Overview. Indian Dermatol Online J 2023; 14:594-604. [PMID: 37727539 PMCID: PMC10506804 DOI: 10.4103/idoj.idoj_418_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 09/21/2023] Open
Abstract
Lyme disease, a tick-borne multisystem disease, is caused by spirochete Borrelia burgdorferi (sensu lato). It is a common illness in temperate countries, especially the United States, but the incidence is increasing across continents due to increasing reforestation, travel and adventure tourism, increased intrusion in the vector habitat, and changing habitat of the vector. Transmission primarily occurs via bite of an infected tick (Ixodes spp.). The appearance of an erythema migrans rash following a tick bite is diagnostic of early Lyme disease even without laboratory evidence. Borrelia lymphocytoma and acrodermatitis chronica atrophicans along with multisystem involvement occur in late disseminated and chronic stages. A two-step serologic testing protocol using an enzyme-linked immunosorbent assay (ELISA) followed by confirmation of positive and equivocal results by Western immunoblot is recommended for the diagnosis. Transplacental transmission to infant occurs in the first trimester with possible congenital Lyme disease making treatment imperative during antenatal period. The treatment is most effective in the early stages of the disease, whereas rheumatological, neurological, or other late manifestations remain difficult to treat with antibiotics alone. Treatment with oral doxycycline is preferred for its additional activity against other tick-borne illnesses which may occur concurrently in 10%-15% of cases. New-generation cephalosporins and azithromycin are alternative options in patients with doxycycline contraindications. No vaccine is available and one episode of the disease will not confer life-long immunity; thus, preventive measures remain a priority. The concept of post-Lyme disease syndrome versus chronic Lyme disease remains contested for want of robust evidence favoring benefits of prolonged antibiotic therapy.
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Affiliation(s)
- Vikram K. Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. Radhakrishnan Government Medical College, Hamirpur, Himachal Pradesh, India
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Myszkowska-Torz A, Tomaszewski M, Kotowski M, Witczak C, Figlerowicz M, Mazur-Melewska K. Cutaneous Manifestations of Lyme Borreliosis in Children-A Case Series and Review. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010072. [PMID: 36676022 PMCID: PMC9864164 DOI: 10.3390/life13010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the disease, which are mainly neurological. The cutaneous presentation in borreliosis is heterogeneous. There are typical lesions that constitute the basis for the diagnosis of Lyme disease, and atypical ones, which cause significant diagnostic difficulties especially when the patient does not remember the tick bite. This study aims to describe the heterogeneous skin symptoms of Lyme borreliosis, as well as offer a practical approach for the recognition of the disease. Based on pediatric cases from clinical practice, rare cutaneous presentations of Lyme disease at various stages of illness and therapy are presented. Diagnostic recommendations for recognizing individual forms are discussed.
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Affiliation(s)
- Agnieszka Myszkowska-Torz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Mateusz Tomaszewski
- Department of Orthodontics and Temporomanidbular Disorders, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Michał Kotowski
- Department of Pediatric Otolaryngology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Cezary Witczak
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznań, Poland
- Correspondence:
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Sandhu S, Pathania V, Vashisht D, Sengupta P. Disseminated secondary erythema migrans: Typical and atypical presentation of a rare disease in India. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_484_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Trevisan G, Cinco M, Trevisini S, di Meo N, Chersi K, Ruscio M, Forgione P, Bonin S. Borreliae Part 1: Borrelia Lyme Group and Echidna-Reptile Group. BIOLOGY 2021; 10:biology10101036. [PMID: 34681134 PMCID: PMC8533607 DOI: 10.3390/biology10101036] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 12/17/2022]
Abstract
Simple Summary Borreliae are spirochaetes, which represent a heterogeneous phylum within bacteria. Spirochaetes are indeed distinguished from other bacteria for their spiral shape, which also characterizes Borreliae. This review describes briefly the organization of the phylum Spirocheteales with a digression about its pathogenicity and historical information about bacteria isolation and characterization. Among spirochaetes, Borrelia genus is here divided into three groups, namely the Lyme group (LG), the Echidna-Reptile group (REPG) and the Relapsing Fever group (RFG). Borreliae Part 1 deals with Lyme group and Echidna-Reptile group Borreliae, while the subject of Borreliae Part 2 is Relapsing Fever group and unclassified Borreliae. Lyme group Borreliae is organized here in sections describing ecology, namely tick vectors and animal hosts, epidemiology, microbiology, and Borrelia genome organization and antigen characterization. Furthermore, the main clinical manifestations in Lyme borreliosis are also described. Although included in the Lyme group due to their particular clinical features, Borrelia causing Baggio Yoshinari syndrome and Borrelia mayonii are described in dedicated paragraphs. The Borrelia Echidna-Reptile group has been recently characterized including spirochaetes that apparently are not pathogenic to humans, but infect reptiles and amphibians. The paragraph dedicated to this group of Borreliae describes their vectors, hosts, geographical distribution and their characteristics. Abstract Borreliae are divided into three groups, namely the Lyme group (LG), the Echidna-Reptile group (REPG) and the Relapsing Fever group (RFG). Currently, only Borrelia of the Lyme and RF groups (not all) cause infection in humans. Borreliae of the Echidna-Reptile group represent a new monophyletic group of spirochaetes, which infect amphibians and reptiles. In addition to a general description of the phylum Spirochaetales, including a brief historical digression on spirochaetosis, in the present review Borreliae of Lyme and Echidna-Reptile groups are described, discussing the ecology with vectors and hosts as well as microbiological features and molecular characterization. Furthermore, differences between LG and RFG are discussed with respect to the clinical manifestations. In humans, LG Borreliae are organotropic and cause erythema migrans in the early phase of the disease, while RFG Borreliae give high spirochaetemia with fever, without the development of erythema migrans. With respect of LG Borreliae, recently Borrelia mayonii, with intermediate characteristics between LG and RFG, has been identified. As part of the LG, it gives erythema migrans but also high spirochaetemia with fever. Hard ticks are vectors for both LG and REPG groups, but in LG they are mostly Ixodes sp. ticks, while in REPG vectors do not belong to that genus.
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Affiliation(s)
- Giusto Trevisan
- DSM—Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy; (G.T.); (N.d.M.)
| | - Marina Cinco
- DSV—Department of Life Sciences, University of Trieste, 34127 Trieste, Italy;
| | - Sara Trevisini
- ASUGI—Azienda Sanitaria Universitaria Giuliano Isontina, 34129 Trieste, Italy; (S.T.); (K.C.); (M.R.)
| | - Nicola di Meo
- DSM—Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy; (G.T.); (N.d.M.)
- ASUGI—Azienda Sanitaria Universitaria Giuliano Isontina, 34129 Trieste, Italy; (S.T.); (K.C.); (M.R.)
| | - Karin Chersi
- ASUGI—Azienda Sanitaria Universitaria Giuliano Isontina, 34129 Trieste, Italy; (S.T.); (K.C.); (M.R.)
| | - Maurizio Ruscio
- ASUGI—Azienda Sanitaria Universitaria Giuliano Isontina, 34129 Trieste, Italy; (S.T.); (K.C.); (M.R.)
| | - Patrizia Forgione
- UOSD Dermatologia, Centro Rif. Regionale Malattia di Hansen e Lyme, P.O. dei Pellegrini, ASL Napoli 1 Centro, 80145 Naples, Italy;
| | - Serena Bonin
- DSM—Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy; (G.T.); (N.d.M.)
- Correspondence: ; Tel.: +39-040-3993266
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Vinayaraj EV, Gupta N, Sreenath K, Thakur CK, Gulati S, Anand V, Tripathi M, Bhatia R, Vibha D, Dash D, Soneja M, Kumar U, Padma MV, Chaudhry R. Clinical and laboratory evidence of Lyme disease in North India, 2016-2019. Travel Med Infect Dis 2021; 43:102134. [PMID: 34216802 DOI: 10.1016/j.tmaid.2021.102134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lyme disease is endemic to parts of the Americas, Europe and Asia. However, only a handful of sporadic cases have been reported from India. In this study, we systematically evaluated the clinical and epidemiological features of Lyme disease in North India. METHOD All samples were tested by using the standard two-tiered testing algorithm (STTA). Paired serum and cerebrospinal fluid (CSF) were used for demonstrating Borrelia burgdorferi specific intrathecal IgG antibody synthesis (AI). In addition, a commercial tick-borne bacterial flow chip (TBFC) system and a real-time PCR were also used to detect Borrelia species and Anaplasma phagocytophilum in patients who were positive by STTA. RESULTS The diagnosis of Lyme disease was confirmed in 18 (7.14%) of the 252 clinically suspected cases by STTA. Neurological involvement was reported in 14 (77.78%) patients, whereas joint and heart involvement was reported in five (27.78%) and three (16.67%) patients, respectively. Lymphocytic pleocytosis (median 37.5 cells/mm3; range 12-175 cells/mm3) in the CSF was seen in 11 of 14 Lyme neuroborreliosis (LNB) patients. Intrathecal production of Borrelia specific IgG antibodies was demonstrated in 9 (64.28%, n = 14) patients, a highly specific finding for neuroborreliosis. Two patients (11.11%) were also found to be co-infected with human granulocytic anaplasmosis. CONCLUSIONS The results of this study show clinical and laboratory evidence of endemic Lyme disease in North India and thus, highlight the importance for travel medicine practitioners and physicians to evaluate for Lyme disease in patients with compatible symptoms and a history of travel to tick risk areas.
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Affiliation(s)
- E V Vinayaraj
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nitin Gupta
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India; Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - K Sreenath
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandan Kumar Thakur
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Department of Paediatric Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishakh Anand
- Department of Paediatric Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepa Dash
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Uma Kumar
- Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India
| | - M V Padma
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
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Babu K, Murthy KR, Bhagya M, Murthy PR, Puttamallesh VN, Ravi V. Seroprevalence of Lymes disease in the Nagarahole and Bandipur forest areas of South India. Indian J Ophthalmol 2020; 68:100-105. [PMID: 31856481 PMCID: PMC6951209 DOI: 10.4103/ijo.ijo_943_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose: The aim of this study was to determine the seroprevalence of Lymes disease in a population at risk in south India. Methods: Prospective ongoing study and included screening of forest workers and staff of Nagarahole and Bandipur forest ranges in South India for Lymes disease. Screening included a detailed questionnaire for Lymes disease, complete ocular and systemic examination by an ophthalmologist and infectious disease specialist and blood collection. ELISA for IgM and IgG antibodies for Borrelia burgdorferi were performed on the collected sera samples. Western blot confirmation was done on the seropositive samples. Ticks were also collected from these forest areas for future studies to detect if they harbor B. burgdorferi. Results: Seroprevalence of 19.9% was noted by ELISA. Western blot confirmation was seen in 15.6% of the seropositive samples. There was significant correlation between seropositivity and exposure to tick bites (P = 0.023). Conclusion: There is a high seroprevalence of infection with B. burgdorferi in the forest areas of Nagarahole and Bandipur ranges in south India.
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Affiliation(s)
- Kalpana Babu
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Centre, Bengaluru, Karnataka, India
| | - Krishna R Murthy
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Centre, Bengaluru; Department of Clinical Research, Institute of Bioinformatics, Bengaluru; Department of Clinical Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M Bhagya
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Centre, Bengaluru, Karnataka, India
| | - Praveen R Murthy
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Centre, Bengaluru, Karnataka, India
| | - Vinuth N Puttamallesh
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology and Prabha Eye Clinic and Research Centre; Department of Clinical Research, Institute of Bioinformatics, Bengaluru, Karnataka, India
| | - V Ravi
- Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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7
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Shrestha P, Dahal P, Ogbonnaa-Njoku C, Das D, Stepniewska K, Thomas NV, Hopkins H, Crump JA, Bell D, Newton PN, Ashley EA, Guérin PJ. Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980-2015. BMC Med 2020; 18:299. [PMID: 32951591 PMCID: PMC7504862 DOI: 10.1186/s12916-020-01745-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In the absence of definitive diagnosis, healthcare providers are likely to prescribe empirical antibacterials to those who test negative for malaria. This problem is of critical importance in Southern Asia (SA) and South-eastern Asia (SEA) where high levels of antimicrobial consumption and high prevalence of antimicrobial resistance have been reported. To improve management and guide further diagnostic test development, better understanding is needed of the true causative agents of fever and their geographical variability. METHODS We conducted a systematic review of published literature (1980-2015) to characterise the spectrum of pathogens causing non-malarial febrile illness in SA and SEA. We searched six databases in English and French languages: MEDLINE, EMBASE, Global Health (CABI) database, WHO Global Health Library, PASCAL, and Bulletin de la Société Française de Parasitologie (BDSP). Selection criteria included reporting on an infection or infections with a confirmed diagnosis, defined as pathogens detected in or cultured from samples from normally sterile sites, or serological evidence of current or past infection. RESULTS A total of 29,558 records from 19 countries in SA and SEA were screened, of which 2410 (8.1%) met the selection criteria. Bacterial aetiologies were reported in 1235 (51.2%) articles, viral in 846 (35.1%), parasitic in 132 (5.5%), and fungal in 54 (2.2%), and 143 (6.0%) articles reported more than one pathogen group. In descending order of frequency, Salmonella Typhi, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and coagulase negative Staphylococcus were the commonly reported bacteria, while dengue virus, chikungunya virus, Japanese encephalitis virus, hepatitis B virus, and hepatitis C virus were common viral pathogens reported. Reports of rarely reported or emerging pathogens included a case report of Borrelia burgdorferi (Lyme disease) in India in 2010 and reports of Nipah virus in Singapore and India. CONCLUSIONS This review summarises the reported non-malaria pathogens that may cause febrile illness in SA and SEA. The findings emphasise the need of standardising the reporting of aetiological studies to develop effective, evidence-based fever management and improved surveillance. Research and development of diagnostic tools would benefit from up-to-date epidemiological reporting of the regional diversities of non-malaria fever aetiologies. TRIAL REGISTRATION PROSPERO registration, CRD42016049281.
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Affiliation(s)
- Poojan Shrestha
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Prabin Dahal
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Chinwe Ogbonnaa-Njoku
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Debashish Das
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kasia Stepniewska
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Nigel V. Thomas
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Heidi Hopkins
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - John A. Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | | | - Paul N. Newton
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos
| | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos
| | - Philippe J. Guérin
- Infectious Diseases Data Observatory (IDDO), University of Oxford, NDMRB, Old Road Campus, Oxford, OX3 7FZ UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Trevisan G, Bonin S, Ruscio M. A Practical Approach to the Diagnosis of Lyme Borreliosis: From Clinical Heterogeneity to Laboratory Methods. Front Med (Lausanne) 2020; 7:265. [PMID: 32793606 PMCID: PMC7390863 DOI: 10.3389/fmed.2020.00265] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/14/2020] [Indexed: 12/05/2022] Open
Abstract
Clinical evaluation of Lyme Borreliosis (LB) is the starting point for its diagnosis. The patient's medical history and clinical symptoms are fundamental for disease recognition. The heterogeneity in clinical manifestations of LB can be related to different causes, including the different strains of Borrelia, possible co-infection with other tick transmitted pathogens, and its interactions with the human host. This review aims at describing the heterogeneous symptoms of Lyme Borreliosis, as well as offering a practical approach for recognition of the disease, both in terms of clinical features and diagnostic/research tools.
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Affiliation(s)
- Giusto Trevisan
- DSM-Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Serena Bonin
- DSM-Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Maurizio Ruscio
- ASU GI-Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
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9
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Dutta Majumder P. Commentary: Tick talk: A glimpse into the literature. Indian J Ophthalmol 2019; 68:104-105. [PMID: 31856482 PMCID: PMC6951136 DOI: 10.4103/ijo.ijo_1539_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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10
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Chavda V, Patel S. Lyme Neuroborreliosis - The Mystifying Pitfall: "Neuropathology and Current Therapeutics". ACTA ACUST UNITED AC 2019; 14:49-68. [PMID: 30919784 DOI: 10.2174/1574891x14666190327114641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/28/2019] [Accepted: 03/18/2019] [Indexed: 11/22/2022]
Abstract
Lyme's Disease (LD) is a severe, rapidly growing, broad spectrum chronic infection caused by the bacterium 'Borrelia (B.) burgdorferi', which can be easily transmitted through the bite of certain species of ticks. The prevalence of LD is swiftly mounting in the present scenario in many countries from species to species. Although Lyme's infection is now detectable via serologic examination of early and late Lyme neuroborreliosis (LNB), the management of persistent symptoms is still fraught with quora of doubt and debate. LD is a multisystem spirochete which results after the dissemination of B. burgdorferi from a dermal inoculation site after a tick bite. Lyme's infection can easily get transmitted to the central nervous system and develop various neurological symptoms due to inflammation and an autoimmune response from body may lead to life-threatening "Lyme Borreliosis". The neurological symptoms are well mixed in presentation, late and confusing to get differentiated easily from other diseases. The use of antibiotics in post Lyme infection with neurological complications is still a topic of debate. Babesiosisstates, and human ehrlichiosis' the two other diseases, are associated with the same ticks that spread the LD. However, the prevalence of diagnosed human cases is usually much lower than that of actual cases of LD due to misdiagnosis, late diagnosis or undiagnosis at y such lateral neuroinfection stage after the tick bite. The current review focuses on the molecular neuropathology and current advancements in LD. There are very few patents or discoveries made on borrelia infection, drawing attention towards more focused and targeted research for the cure.
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Affiliation(s)
- Vishal Chavda
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmadabad 382481, Gujarat, India
| | - Snehal Patel
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmadabad 382481, Gujarat, India
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11
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Law RWY, So E, Chu AKC, Logan DB. Pitted keratolysis: a case report and review of current literature. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105818767167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The article offers a brief history of pitted keratolysis (PK), research regarding PK etiology, evaluation of PK, and current treatment modalities. The main objective of this article focuses on the current literature on PK, its presentation and symptomatology, prevalence, and available therapeutic options. We present a case report and review on PK of a patient treated with an over the counter antiperspirant, topical erythromycin, oral erythromycin, and proper education on hygiene, with complete resolution and without recurrence after a follow up of greater than 12 months.
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Affiliation(s)
| | - Eric So
- Grant Medical Center, Columbus, OH, USA
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12
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Tevatia P, Ahmad S, Gupta N, Shirazi N. Lyme disease in north India: a case for concern. Trop Doct 2018; 48:352-355. [DOI: 10.1177/0049475518789552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report Lyme disease in a young man from north India who presented with progressive diminution of vision, severe headache, quadriparesis, seizures, dermatological and pulmonary lesions, lymphadenopathy and a hypocellular bone marrow. This is the first case report of Lyme disease with multi-system involvement from India, confirmed twice by positive serology.
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Affiliation(s)
- Pavit Tevatia
- Junior Resident, Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Sohaib Ahmad
- Professor, Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Neeti Gupta
- Associate Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
| | - Nadia Shirazi
- Professor, Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India
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13
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Pun SB, Agrawal S, Jha S, Bhandari LN, Chalise BS, Mishra A, Shah R. First report of Lyme disease in Nepal. JMM Case Rep 2018; 5:e005128. [PMID: 29623212 PMCID: PMC5884958 DOI: 10.1099/jmmcr.0.005128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/27/2017] [Indexed: 11/27/2022] Open
Abstract
Introduction Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published. Case presentation A 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi. She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy. Conclusion To the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.
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Affiliation(s)
- Sher Bahadur Pun
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
- *Correspondence: Sher Bahadur Pun,
| | - Sumit Agrawal
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Santoshananda Jha
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Lila Nath Bhandari
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | | | - Abadhesh Mishra
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Rajesh Shah
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
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