Cases reported "Lyme Disease"

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1/94. Serologically diagnosed lyme disease manifesting erythema migrans in korea.

    lyme disease is a vector-borne infection, primarily transmitted by ixodes ticks, and caused by borrelia burgdorferi. It has a wide distribution in the northern hemisphere. In korea, however, only one human case has been reported, although B. burgdorferi was isolated from the vector tick I. persulcatus in the region. A 60-year-old male and a 45-year-old female developed the clinical sign of erythema migrans. Each patients were bitten by a tick four weeks and five weeks, respectively, before entering the hospital. On serologic examination, significantly increased IgM and IgG antibody titers to B. burgdorferi were observed in consecutive tests performed at an interval of two weeks. They responded well to treatment with tetracycline.
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2/94. Diaphragmatic paralysis due to lyme disease.

    lyme disease is a tick-borne spirochaete infection which, in a proportion of patients, can lead to neuropathy. This article describes a case of diaphragmatic paralysis due to lyme disease. A 39-yr-old male presented to the hospital because of an acute left facial palsy. Six weeks prior to admission he had developed a circular rash on his left flank during a camping holiday. He also complained of shortness of breath and arthralgia for 1 week. His chest radiograph demonstrated a raised right hemi-diaphragm. Diaphragmatic paralysis was confirmed by fluoroscopy (a positive sniff test). serology revealed evidence of recent infection by borrelia burgdorferi. On the basis of the patient's clinical presentation, a recent history of erythema migrans, and positive Lyme serology, a diagnosis of neuroborreliosis was made. He received oral doxycycline therapy (200 mg x day(-1)) for three weeks. Facial and diaphragmatic palsies resolved within eight weeks. On the basis of this case, a diagnosis of lyme disease should be considered in patients from endemic regions with otherwise unexplained phrenic nerve palsy.
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3/94. Lyme arthritis in a 12-year-old patient after a latency period of 5 years.

    Lyme arthritis (LA) may be confused with other rheumatic diseases, particularly in the absence of a history of erythema migrans (EM). We report the case of a 12-year-old patient who developed a large effusion of the right knee joint. The titer for antinuclear antibodies was 1:80 and the test for rheumatoid factor was negative. Investigations for antibody response to borrelia burgdorferi demonstrated remarkable elevation of IgG antibody and no specific IgM response.These results were confirmed by immunoblotting reactivity with the bands p83/100, p58, p43, p41, p39, OspA, p30, OspC, p21, and p17. We subsequently learned that the child had suffered a tick bite followed by an EM 5 years earlier and had been treated with trimethoprim/sulfamethoxazole at that time. The patient now was given intravenous ceftriaxone, 2 g daily for 14 days. In the absence of clinical improvement 3 weeks later a knee joint aspiration was performed which resulted in a positive polymerase chain reaction (PCR) test for B. burgdorferi dna (OspA) in the synovial fluid.The patient fully recovered 2 months later without further treatment. The case indicates that the latency period between EM and onset of LA may last up to 5 years. In addition to serologic test methods, analysis of synovial fluid using PCR may be decisive for making the final diagnosis of LA.
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keywords = tick bite, tick, bite
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4/94. lyme disease: a clinical update.

    With adequate attention to specifics and details, the diagnosis and management of lyme disease are usually relatively straight-forward. Still, there can be subtleties--for instance, in determining precisely what pathogen a tick bite transmitted, whether a patient's arthralgia is truly Lyme arthritis, or whether "positive" serologies represent refractory lyme disease.
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keywords = tick bite, tick, bite
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5/94. Posterior scleritis associated with borrelia burgdorferi (lyme disease) infection.

    OBJECTIVE: To report on the clinical findings in a patient with posterior scleritis associated with infection with borrelia burgdorferi. DESIGN: Interventional case report. PARTICIPANT: A 39-year-old male ranger who experienced posterior scleritis after several tick bites with erythema migrans. TESTING: Extensive ophthalmic and systemic workup, including serologic testing and imaging techniques. RESULTS: Sonography and contrast-enhanced computed tomography showed a large scleral mass (16 x 12 x 13 mm) in a patient with painful proptosis in the left eye with episcleral vascular dilation, reduction in bulbar motility, and chorioretinal folds in the upper temporal quadrant. Treatment with high-dose corticosteroids resulted in rapid regression of clinical symptoms and of the scleral mass. Intensive workup revealed immunoglobulin m antibodies (enzyme-linked immunoassay, Western immunoblot) and a positive lymphocyte transformation assay against B. burgdorferi. No other cause for posterior scleritis could be identified. CONCLUSIONS: Posterior scleritis should be added to the list of ocular manifestations associated with lyme disease. Because corticosteroids alone resulted in rapid improvement of clinical symptoms, the scleritis might be mediated by autoimmunologic mechanisms.
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ranking = 2.2259568832654
keywords = tick bite, tick, bite
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6/94. lyme disease masquerading as brown recluse spider bite.

    We report a case of lyme disease with clinical features resembling those described from brown recluse spider bites. The most striking manifestation was a necrotic skin wound. brown recluse spider bites may be overdiagnosed in some geographic regions. Tick bite and infection with borrelia burgdorferi should be considered in the differential diagnosis of necrotic arachnidism in regions endemic for lyme disease.
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7/94. cerebellar ataxia as the presenting manifestation of lyme disease.

    A 7-year-old boy from suburban baltimore who presented with cerebellar ataxia and headaches was found by magnetic resonance imaging to have multiple cerebellar enhancing lesions. He had no history of tick exposure. He was initially treated with steroids for presumptive postinfectious encephalitis. lyme disease was diagnosed 10 weeks later after arthritis developed. Testing of the cerebrospinal fluid obtained at the time cerebellar ataxia was diagnosed revealed intrathecal antibody production to borrelia burgdorferi. Treatment with intravenous antibiotics led to rapid resolution of persistent cerebellar findings.
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keywords = tick
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8/94. Longterm decrease in the CD57 lymphocyte subset in a patient with chronic lyme disease.

    lyme disease is a tickborne illness caused by the spirochete borrelia burgdorferi. In a previous report we described a decrease in the CD57 lymphocyte subset in patients with chronic lyme disease. We have now identified a patient with chronic relapsing and remitting symptoms of lyme disease who had decreased levels of CD57 lymphocytes over 10 years. This observation represents the longest duration of an immunologic abnormality ever documented in chronic lyme disease. The CD57 lymphocyte subset appears to be a useful marker of longterm infection with the lyme disease spirochete.
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9/94. acrodermatitis chronica atrophicans affecting all four limbs in an 11-year-old girl.

    borrelia burgdorferi is a major cause of morbidity in wooded area in western europe and the eastern seaboard of the U.S.A. diagnosis of late stage infection and associated disorders may be difficult and often requires an array of different diagnostic procedures. Here we report an 11-year-old girl with acrodermatitis chronica atrophicans affecting all four limbs and parts of the trunk. The diagnosis was made on the basis of clinical appearance, serological and histopathological findings, and the lesional detection of B. burgdorferi-specific gene segments by polymerase chain reaction. This very unusual, severe case illustrates that despite being a late manifestation of tick-borne B.burgdorferi infection, usually occurring in adults, acrodermatitis chronica atrophicans may already appear at a young age and may be characterized by extensive skin involvement.
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10/94. 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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