Cases reported "Lyme Disease"

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1/7. Antibody response to IR6, a conserved immunodominant region of the VlsE lipoprotein, wanes rapidly after antibiotic treatment of borrelia burgdorferi infection in experimental animals and in humans.

    Invariable region (IR)(6), an immunodominant conserved region of VlsE, the antigenic variation protein of borrelia burgdorferi, is currently used for the serologic diagnosis of lyme disease in humans and canines. A longitudinal assessment of anti-IR(6) antibody levels in B. burgdorferi-infected rhesus monkeys revealed that this level diminished sharply after antibiotic treatment (within 25 weeks). In contrast, antibody levels to P39 and to whole-cell antigen extracts of B. burgdorferi either remained unchanged or diminished less. A longitudinal analysis in dogs yielded similar results. In humans, the anti-IR(6) antibody titer diminished by a factor of > or =4 in successfully treated patients and by a factor of <4 in treatment-resistant patients. This result suggests that the quantification of anti-IR(6) antibody titer as a function of time should be investigated further as a test to assess response to lyme disease therapy or to determine whether a B. burgdorferi infection has been eliminated.
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2/7. arthritis following recombinant outer surface protein A vaccination for lyme disease.

    As more individuals receive outer surface protein A (OspA) vaccination, adverse effects not detected during phase III clinical trials may become apparent. Although arthritis has been described following other human vaccines, we found no reports of human cases after lyme disease vaccination. We describe 4 males (2 children, 2 adults) who developed arthritis following recombinant OspA vaccination. The potential arthritogenic effect of OspA suggested by in vitro and animal studies finds a clinical correlate in these 4 cases.
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3/7. Gonarthritis in the course of lyme disease in a one-and-a-half-year-old child.

    A case of a one-and-a-half-year-old girl is reported in whom gonarthritis in the course of lyme disease was diagnosed. The girl was brought up in an urban environment. She never was in a forest and had no contact with animals (except for a healthy pet-dog, which was under veterinary supervision). She did not attend a nursery, and went for walks only within urban area under the careful guidance of her parents. In spite of the negative family history the level of antibodies against borrelia burgdorferi was estimated. A very high level of IgG antibodies and a low level of IgM borrelia burgdorferi antibodies, accompanied by physical symptoms allowed to diagnose the second stage of lyme disease. We considered the described case as worth presentation due to the child's very early age. Moreover, the infection was caused supposedly due to the contact with a dog (which may be unusual carrier of ticks), and not--as in most cases--in a forest.
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4/7. MPGN secondary to lyme disease.

    lyme disease is a multisystem disorder with protean clinical manifestations that is caused by the tick-transmitted spirochete borrelia burgdorferi. infection caused by B burgdorferi is known to induce glomerulonephritis in animals. We report a patient with acute postinfection membranoproliferative glomerulonephritis after the clinical multisystem manifestation of lyme disease, which was confirmed serologically. Although the patient was dialysis dependent for a protracted period of 5 months, the final outcome was excellent.
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5/7. Newly recognized leptospira species ("leptospira inadai" serovar lyme) isolated from human skin.

    leptospira strain 10, which represents a new leptospira species, was isolated from a skin biopsy of a patient with lyme disease. Although pathogenic for laboratory animals, the organism was not considered to have a significant role in the patient's illness.
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6/7. babesiosis in wisconsin. A new focus of disease transmission.

    A confirmed case of human babesiosis was identified in August 1983 in a 54-year-old asplenic wisconsin resident. babesia microti was identified as the causative agent by blood smear morphology and hamster inoculation techniques. The patient's wife had clinically confirmed lyme disease in 1981 and had serologic evidence (immunofluorescent antibody to a B microti titer of 1:1,024) of recent Babesia infection in August 1983. mice (peromyscus species) trapped on the patients' property and elsewhere in their wisconsin county of residence were infected with B microti. lyme disease and babesiosis have the same tick vector and animal reservoir; serum samples from 116 wisconsin and minnesota residents with clinically confirmed lyme disease between 1980 and 1983 were tested, and none were found to have concurrent Babesia infection. This area of wisconsin is identified as a new focus for babesiosis transmission, but the risk of transmission seems to be low.
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7/7. lyme disease: a review for the otolaryngologist.

    lyme disease is an important consideration in the differential diagnosis of patients seen by the otolaryngologist. facial paralysis is the most common sign. The otolaryngologist may also see patients with temporal mandibular joint pain, cervical lymphadenopathy, facial pain, headache, tinnitis, vertigo, decreased hearing, otalgia and sore throat. The incidence is increasing and known to be endemic to certain areas of the united states and abroad. This paper reviews the various ways lyme disease appears to the otolaryngologist. Three cases along with a discussion including epidemiology, vector, animal host relationship, clinical manifestations and pathophysiology are included. The literature is reviewed and the treatment discussed.
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