11/20. Cultivation of borrelia burgdorferi from human tick bite sites: a guide to the risk of infection.BACKGROUND: The risk of acquiring lyme disease has been evaluated by xenodiagnostic procedures with laboratory strains of borrelia burgdorferi and laboratory-reared ixodes ticks, or by clinical trials in which diagnosis was based on clinical findings, culture, or serologic tests. OBJECTIVE: Our purpose was to determine the risk of infection from tick bites in a natural setting in which wild strains of B. burgdorferi were involved, by a biopsy culture technique. methods: skin biopsy specimens were obtained from ixodes scapularis tick bite sites, processed, and examined for the presence of B. burgdorferi. RESULTS: B. burgdorferi was cultivated from only 2 of 48 skin biopsy specimens. In both instances duration of tick attachment was approximately 24 hours. CONCLUSION: In a hyperendemic region for lyme disease the risk of infection after a deer tick bite appears to be low, particularly if the tick has been attached for less than 24 hours.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
12/20. Juxta-articular fibrotic nodules in Borrelia infection--ultrastructural details of therapy-induced regression.Juxta-articular fibrotic nodules in chronic borrelia burgdorferi infection commonly regress rapidly under antibiotic therapy. They may therefore serve as a good in vivo model for studying the development and regression of cutaneous fibrotic processes. As shown in a typical case of acrodermatitis chronica atrophicans, this spirochete-induced fibrosis in the upper subcutis of the elbow region is histologically characterized by broad hyalinized collagen tracts interspersed with prominent perivascular lymphocytes and plasma cells. These immune cells vanish completely after 5 days of antibiotic treatment, while fibroblasts discharge matrix vesicles and form elastic fibres.- - - - - - - - - - ranking = 0.125keywords = burgdorferi (Clic here for more details about this article) |
13/20. Recurrent erythema migrans despite extended antibiotic treatment with minocycline in a patient with persisting borrelia burgdorferi infection.Erythema migrans recurred in a patient 6 months after a course of treatment with minocycline for lyme disease. polymerase chain reaction on heparinized peripheral blood at that time demonstrated the presence of borrelia burgdorferi-specific dna. The patient was seronegative by Lyme enzyme-linked immunosorbent assay but showed suspicious bands on Western blot. Findings of a Warthin-Starry stain of a skin biopsy specimen of the eruption revealed a Borrelia-compatible structure. Reinfection was not believed to have occurred. Further treatment with minocycline led to resolution of the erythema migrans.- - - - - - - - - - ranking = 0.62705111644474keywords = burgdorferi, lyme (Clic here for more details about this article) |
14/20. Neuroborreliosis in the etiology of vestibular neuronitis.Symptoms and incidence of neuroborreliosis (NB) were studied in ambulatory patients visiting the ENT clinic in Helsinki. Especially we tried to search for possible markers indicating the connection between vestibular neuronitis and NB. A total of 350 patients were screened with the enzyme-linked immunosorbent assay (ELISA) technique for possible antibodies against borrelia burgdorferi (BB). Twelve patients had positive serological reactions for BB with sera titer levels ranging from 640-14700 (normal < 500). In 2 additional cases, NB was clinically confirmed. In 7 cases a history of tick bite and in 4 cases erythema chronicum migrans was confirmed. In 9 cases, vertigo was the predominant symptom, and in 3 cases the symptoms were linked to facial nerve paresis. Six patients suffered from hearing loss. In 7 cases, the diagnosis was initially settled as vestibular neuronitis. NB seems to be present in about 4% of cases with apparent otologic diseases in finland. In the majority of the cases, the disease resembles vestibular neuronitis in the acute stage. Since NB is tractable, all patients visiting the ENT clinic, especially those with vertigo, should be screened.- - - - - - - - - - ranking = 0.125keywords = burgdorferi (Clic here for more details about this article) |
15/20. Persistence of borrelia burgdorferi sensu lato in resolved erythema migrans lesions.Erythema migrans skin lesions resulting from a tick bite and infection with borrelia burgdorferi sensu lato eventually resolve, even without antibiotic therapy. The aim of the present study was to gauge the frequency of persistence of B. burgdorferi sensu lato in such lesions. Thus, the site of a previous lesion was biopsied and cultured in 48 patients: 39 with systemic or localized symptoms/signs and nine with no symptoms. B. burgdorferi sensu lato was isolated from biopsied skin from three symptomatic patients. Cultures of other tissues and fluids were negative. By genospecies-specific polymerase chain reaction (PCR) and pulsed-field gel electrophoretic (PFGE) analysis, two isolates were classified as Borrelia afzelii. The remaining isolate was a member of an unusual group of strains that type as B. burgdorferi sensu stricto by genospecies PCR but possess an atypical PFGE profile. All three patients had a dramatic clinical response to antibiotic treatment. These findings demonstrate the capacity of viable B. burgdorferi sensu lato organisms to persist in clinically normal-appearing skin at the site of a resolved erythema migrans rash for periods ranging from 2 months to 3.5 years. This observation may provide new insight into the organisms' ability to evade the host's immune response.- - - - - - - - - - ranking = 5.8152416638439keywords = burgdorferi sensu, burgdorferi, sensu, lyme (Clic here for more details about this article) |
16/20. Lyme carditis: a clinical presentation and long time follow-up.The acute disease and a follow-up carried out up to 7 years after definite Lyme carditis in 6 patients is described. At the time of diagnosis all 6 patients had 2-3 degrees AV block, 4 patients presented with syncopes, and 1 revealed episodes of non-sustained ventricular tachycardia. The diagnosis of Lyme carditis was confirmed by borrelia burgdorferi-specific IgM and IgG antibody determinations in consecutive serum samples. All patients were treated with antibiotics. At follow-up, a clinical examination, a 2D and M-mode echocardiogram, and an exercise test did not reveal sequelae to Lyme carditis.- - - - - - - - - - ranking = 0.125keywords = burgdorferi (Clic here for more details about this article) |
17/20. Atypical Lyme borreliosis in an hiv-infected man.We report the fourth case of Lyme borreliosis in a man infected with human immunodeficiency virus (hiv). The erythema chronicum migrans was persistent, overlapping with meningoradiculitis. Repeated immunofluorescence tests for borrelia burgdorferi sensu lato remained negative in both sera and cerebrospinal fluid (CSF), the enzyme-linked immunosorbent assay was weakly positive in serum and CSF and a Western blot was positive. The skin infiltrate was composed mostly of T lymphocytes with a CD4/CD8 ratio of 0.5. The course of the disease was favourable after treatment with intravenous ceftriaxone. Further studies are necessary to evaluate whether hiv infection influences, as does syphilis, the course and response to treatment of Lyme borreliosis. Serological tests are insufficiently sensitive and the Western blot assay is necessary to confirm Lyme disease in hiv-positive patients.- - - - - - - - - - ranking = 0.64591006082213keywords = burgdorferi sensu, burgdorferi, sensu (Clic here for more details about this article) |
18/20. lyme disease in taiwan: first human patient with characteristic erythema chronicum migrans skin lesion.We report herein the first laboratory-diagnosed case of lyme disease in a human in taiwan. A 45-year-old Taiwanese man living in Taipei, in northern taiwan, had an expanding skin lesion (measuring 23 by 15 cm) on his abdomen for 2 to 3 weeks and recurrent attacks of pain and swelling of the knee joint. serologic tests indicated a significantly elevated titer of antibody to borrelia burgdorferi. After appropriate antibiotic treatment for 3 weeks, the skin lesion was cured and the joint swelling was improved. Although several strains of Borrelia spirochetes had been isolated from rodents (Rattus losea) in taiwan, the tick vector responsible for the transmission remains to be identified.- - - - - - - - - - ranking = 0.125keywords = burgdorferi (Clic here for more details about this article) |
19/20. Use of the C3H/He lyme disease mouse model for the recovery of a Spanish isolate of Borrelia garinii from erythema migrans lesions.A skin biopsy from a patient with erythema migrans was inoculated into C3H/He mice and into culture medium. A Borrelia garinii strain named Rio1 was isolated from both a direct BSK medium culture and a mouse ear-punch biopsy culture. Inoculating human tissue into mice produced a disease resulting in severe inflammation of the left tibio-tarsal joint, development of perivascular infiltrates as seen in ear-punch biopsies and the spread of spirochaetes along the skin, far from the inoculation site. The isolation of this strain confirms the circulation of this Borrelia species in spain as a human pathogen, as well as its arthrogenicity in an animal model. The method used to recover strain Rio1 from human tissue is described as rapid and sensitive compared to direct inoculation of tissue into BSK medium.- - - - - - - - - - ranking = 0.0044236596259664keywords = spirochaete (Clic here for more details about this article) |
20/20. Differential expression of borrelia burgdorferi genes during erythema migrans and Lyme arthritis.borrelia burgdorferi, the agent of lyme disease, selectively expresses genes in the arthropod vector and mammalian host. Specific B. burgdorferi gene expression during human infection was examined in tissue specimens, using rna-polymerase chain reaction, from 3 patients with lyme disease. ospA was investigated because OspA is down-regulated by B. burgdorferi in ticks during engorgement and is a vaccine candidate in phase III clinical trials. p35 and p37 were also assessed because these genes are induced by spirochetes during murine Lyme borreliosis and play roles in protective immunity. p35 and p37 mRNA were detected in erythema migrans biopsy specimens from 2 patients and in the synovium of 1 patient with Lyme arthritis. ospA mRNA was not identified in any of these tissues. These data show that ospA is repressed while p35 and p37 are induced in human infection; these results are the first direct demonstration of differential B. burgdorferi gene expression during lyme disease.- - - - - - - - - - ranking = 1.0020511164447keywords = burgdorferi, lyme (Clic here for more details about this article) |
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