11/18. lyme disease and the peripheral nervous system.lyme disease, the multisystem infectious disease caused by the tick-borne spirochete borrelia burgdorferi, causes a broad variety of peripheral nerve disorders, including single or multiple cranial neuropathies, painful radiculopathies, and diffuse polyneuropathies. Virtually all appear to be varying manifestations of a mononeuropathy multiplex. diagnosis requires that the patient should have had possible exposure to the only known vectors, ixodes ticks, and also have either other pathognomonic clinical manifestations or laboratory evidence of exposure. Treatment with antimicrobial regimens is highly effective. The mechanism underlying these neuropathies remains unclear, although interactions between anti-Borrelia antibodies and several peripheral nerve constituent molecules raise intriguing possibilities.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
12/18. magnetic resonance imaging of meningoradiculomyelitis in early disseminated Lyme disease.lyme disease, a multisystem illness caused by the spirochete borrelia burgdorferi, is the most common vector-borne disease in the united states. There are 3 clinical stages of lyme disease: early localized, early disseminated, and late persistent disease. Neuroborreliosis, infection of the nervous system by B. burgdorferi, may occur during early disseminated or late persistent disease. spinal cord involvement in early disseminated disease is extremely rare. In patients with early disseminated neuroborreliosis, treatment with antibiotics often leads to rapid recovery and may prevent further complications of lyme disease. The authors present the clinical and radiographic findings, both before and after treatment, in a patient with meningoradiculomyelitis due to early disseminated lyme disease.- - - - - - - - - - ranking = 2keywords = burgdorferi (Clic here for more details about this article) |
13/18. MR imaging in neuroborreliosis of the cervical spinal cord.The central nervous system is involved in 10-20% of cases in lyme disease. The neurological symptoms, time course of the disease and imaging findings are multifaceted. We report two patients with cervical radiculitis. magnetic resonance imaging revealed strong enhancement of the cervical nerve roots on contrast-enhanced T1-weighted images. These imaging patterns of borrelia-associated radiculitis have not been reported before. knowledge of these imaging features may help to diagnose neuroborreliosis, which presents with non-specific symptoms.- - - - - - - - - - ranking = 0.36833502493436keywords = borrelia (Clic here for more details about this article) |
14/18. Isolated monolateral neurosensory hearing loss as a rare sign of neuroborreliosis.lyme disease, or borreliosis, is a zoonosis transmitted by borrelia burgdorferi which also involves the central nervous system (CNS), in 15% of affected individuals, with the occurrence of aseptic meningitis, fluctuating meningoencephalitis, or neuropathy of cranial and peripheral nerves. Encephalopathy with white matter lesions revealed by magnetic resonance imaging (MRI) scans in late, persistent stages of lyme disease has been described. In this report, we describe a patient with few clinical manifestations involving exclusively the eighth cranial nerve, monolaterally and diffuse bilateral alterations of the white matter, particularly in the subcortical periventricular regions at cerebral MRI. This single patient study shows that the search for antibodies against Borrelia burgdoferi should always be performed when we face a leukoencephalopathy of unknown origin. An isolated lesion of the eighth cranial nerve can be the only neurologic sign in patients with leukoencephalopathy complicating lyme disease.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
15/18. Lyme borreliosis in portugal caused by Borrelia lusitaniae? Clinical report on the first patient with a positive skin isolate.BACKGROUND: Borrelia lusitaniae was isolated from an ixodes ricinus tick in portugal in 1993 for the first time. Further, this borrelia genospecies has been found in ixodid ticks collected around the coasts of southern portugal and North africa. Its reservoir has not been defined yet. B. lusitaniae was isolated once until now from a patient with a long standing and expanding skin disorder. PATIENT AND methods: A 46-year-old Portuguese woman presented with a skin lesion on the left thigh which had evolved slowly over ten years. The patient reported limb paraesthesias, cramps, chronic headaches, and cardiac rhythm disturbances. history of tick bites was negative nor had the patient ever noticed a skin lesion comparable with erythema chronicum migrans. skin biopsies were taken for histological evaluation, culture and dna detection. antibodies to borrelia were searched by indirect immunofluorescence assay and Western-blot. RESULTS: A bilateral carpal tunnel syndrome and local synovitis was diagnosed. Dermato-histology was normal, serology was negative. Spirochaetal organisms were cultured from a skin biopsy and identified as B. lusitaniae. The patient improved after a 2-week course of intravenous ceftriaxone; the skin lesions did not expand further. CONCLUSIONS: This culture confirmed skin infection by B. lusitaniae in a patient from portugal suggests an additional human pathogen out of the B. burgdorferi sensu lato complex in europe, particularly in portugal.- - - - - - - - - - ranking = 5.7884050245255keywords = burgdorferi sensu, burgdorferi, borrelia, sensu (Clic here for more details about this article) |
16/18. Paralytic strabismus as a manifestation of lyme borreliosis.lyme disease is a multi-system organ disorder caused by borrelia burgdorferi. Although ocular manifestations have been reported, these remain a rare feature of the disease. This report shows a 49-years old patient that has been bitten by a tick and as consequence of which developed symptoms of the lyme disease. In 1998 the patient was hospitalized in our Eye Clinic due to operating treatment of the paralytic strabismus (abductal nerve paralysis), as a rare feature of the lyme disease. Postoperative squint angle was significantly reduced, but without any temporal movement. diplopia was still present, though slightly reduced with the use of prism eyeglasses. The improvement of the quality of life was achieved, as well as the patient's satisfaction.- - - - - - - - - - ranking = 1.5091680638211keywords = burgdorferi, lyme (Clic here for more details about this article) |
17/18. subarachnoid hemorrhage due to borrelia burgdorferi-associated vasculitis.We report the case history of a patient who suffered a subarachnoid hemorrhage (SAH) in association with early lyme neuroborreliosis. After a tick bite, this patient developed erythema chronicum migrans and complained of stinging radicular pain in both legs. A computed tomography (CT) scan was performed because of acute headache and nuchal rigidity, which revealed an occipital SAH. cerebrospinal fluid analysis provided further evidence of acute neuroborreliosis. Digital substraction angiography showed irregularities in the right posterior cerebral artery, which might be due to vasculitis, but no aneurysms.- - - - - - - - - - ranking = 4keywords = burgdorferi (Clic here for more details about this article) |
18/18. cerebrospinal fluid-infiltrating CD4 T cells recognize borrelia burgdorferi lysine-enriched protein domains and central nervous system autoantigens in early lyme encephalitis.Neurological manifestations of lyme disease are usually accompanied by inflammatory changes in the cerebrospinal fluid (CSF) and the recruitment of activated T cells into the CSF compartment. In order to characterize the phenotype and identify target antigens of CSF-infiltrating T cells in early neuroborreliosis with central nervous system (CNS) involvement, we combined T-cell cloning, functional testing of T-cell responses with positional scanning synthetic combinatorial peptide libraries, and biometric data analysis. We demonstrate that CD4 gamma interferon-producing T cells specifically responding to borrelia burgdorferi lysate were present in the CSF of a patient with acute Lyme encephalitis. Some T-cell clones recognized previously uncharacterized B. burgdorferi epitopes which show a specific enrichment for lysine, such as the heat shock-induced chaperone HSP90. Degenerate T-cell recognition that included T-cell responses to borrelia-specific and CNS-specific autoantigens derived from the myelin protein 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) could be demonstrated for one representative clone. Our results show that spirochetal antigen-specific and Th1-polarized CD4 lymphocytes infiltrate the CSF during monophasic CNS symptoms of lyme disease and demonstrate that cross-recognition of CNS antigens by B. burgdorferi-specific T cells is not restricted to chronic and treatment-resistant manifestations.- - - - - - - - - - ranking = 7.8775030887555keywords = burgdorferi, borrelia, lyme (Clic here for more details about this article) |
| <- Previous | |