Enfermedad de Lyme en la Ciudad de México / Lyme disease in Mexico City

Resumen: Se comunica el caso de una paciente de 29 años de edad, originaria y residente de la Ciudad de México, que inició su padecimiento con dolor en el segundo dedo de la mano izquierda posterior a una visita al bosque de Aragón, que progresó con náusea y diarrea, así como artralgias incapacitantes con predominio en las manos y los pies sin eritema multiforme en la mano. A su ingreso al hospital tuvo marcadores de inflamación de 19 x 103/μL leucocitos y proteína C reactiva de 28 mg/dL, que se elevaron durante su estancia hospitalaria; ante la falta de respuesta al tratamiento médico y múltiples pruebas negativas se decidió realizar Western Blot para ricketsias con lo que se obtuvo resultado positivo para Borrelia burgdorferi, con lo que se estableció el diagnóstico definitivo de borreliosis de Lyme; la paciente recibió tratamiento adecuado y tuvo mejoría clara. La enfermedad de Lyme es una zoonosis transmitida por las garrapatas del género Ixodes causadas por la espiroqueta Borrelia burgdorferi. La Ciudad de México no se ha reportado como zona endémica por lo que comunicamos este caso.

Abstract: This paper reports the case of a 29-year-old female patient, who was originally from Mexico City and began her condition with pain in the second finger of left hand after a visit to the Aragon forest in Mexico City, progressing with nausea and diarrhea, as well as incapacitating arthralgias with predominance in hands and feet without erythema multiforme in hand. Upon admission, she had inflammation markers of 19 x 103/μL leukocytes and C-reactive protein of 28 mg/dL, which were elevated during her hospital stay; due to the lack of response to medical treatment and multiple negative tests, a Western Blot test for ricketsias was done obtaining a positive result for Borrelia burgdorferi, establishing the definitive diagnosis of Lyme borreliosis, receiving adequate treatment and presenting clear improvement. Lyme disease is a zoonosis transmitted by the ticks of the genus Ixodes caused by the spirochete Borrelia burgdorferi. Mexico City has not been reported as an endemic area, which is why we report this case.

Horses as a Potential Reservoir of Lyme Borreliosis in Jeju-do, Korea / 예방의학회지

Lyme borreliosis (LB) is the most common tick-borne infectious disease in North America, and it was designated as a national notifiable infectious disease in Korea in December 2010. While no cases in Jeju-do were recorded from 2012 to 2016, a recent survey reported that the seroprevalence of Borrelia burgdorferi using enzyme-linked immunosorbent assays in horses in Jeju-do was 19.0% (95% confidence interval, 12.0 to 28.3%). This fact suggests that horses may be a potential reservoir of LB in Jeju-do and that individuals in close contact with horses may be a high-risk group. Thus, a serological study in this high-risk group is urgently needed.

Evaluation of Six Recombinant Proteins for Serological Diagnosis of Lyme Borreliosis in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>In this study, we evaluated the diagnostic efficiency of six recombinant proteins for the serodiagnosis of Lyme borreliosis (LB) and screened out the appropriate antigens to support the production of a Chinese clinical ELISA (enzyme-linked immunosorbent assay) kit for LB.</p><p><b>METHODS</b>Six recombinant antigens, Fla B.g, OspC B.a, OspC B.g, P39 B.g, P83 B.g, and VlsE B.a, were used for ELISA to detect serum antibodies in LB, syphilis, and healthy controls. The ELISA results were used to generate receiver operating characteristic (ROC) curves, and the sensitivity and specificity of each protein was evaluated. All recombinant proteins were evaluated and screened by using logistic regression models.</p><p><b>RESULTS</b>Two IgG (VlsE and OspC B.g) and two IgM (OspC B.g and OspC B.a) antigens were left by the logistic regression model screened. VlsE had the highest specificity for syphilis samples in the IgG test (87.7%, P<0.05). OspC B.g had the highest diagnostic value in the IgM test (AUC=0.871). Interactive effects between OspC B.a and Fla B.g could reduce the specificity of the ELISA.</p><p><b>CONCLUSION</b>Three recombinant antigens, OspC B.g, OspC B.a, and VlsE B.a, were useful for ELISAs of LB. Additionally, the interaction between OspC B.a and Fla B.g should be examined in future research.</p>

Borrelia burgdorferi sensu lato in humans in a rural area of Paraná State, Brazil

This study describes the detection of Borrelia garinii and Borrelia burgdorferi sensu stricto (s.s.) in Brazilian individuals using PCR and DNA sequencing. Our results suggest that these species are emerging pathogens in this country, and additional studies are necessary to determine the epidemiological characteristics of this disease in Brazil.

Actualización acerca de Borrelia burgdorferi sensu lato y enfermedad de Lyme / Update on Borrelia burgdorferi sensu lato and Lyme disease

Introducción: Borrelia burgdorferi sensu lato es el agente etiológico de la enfermedad de Lyme, zoonosis emergente de difícil diagnóstico, prevención y control, reportada fundamentalmente en el hemisferio norte. Objetivo: facilitar información actualizada acerca de Borrelia burgdorferi. Métodos: se realizó una revisión de la literatura científica y especializada sobre los principales aspectos relacionados con este agente y su enfermedad; como son las características de las borrelias y el ciclo de vida, epidemiología, manifestaciones clínicas en humanos, diagnóstico de laboratorio, definición actual de caso, tratamiento, profilaxis, prevención y control. Resultados: se expone información actualizada y valiosa sobre los temas seleccionados, útil para el personal interesado en las enfermedades infecciosas transmitidas por vectores. Se muestra además información sobre los estudios realizados en Cuba. Conclusiones: se aporta información de utilidad para el manejo epidemiológico, clínico y microbiológico de casos con sospechas de la infección por Borrelia burgdorferi sensu lato

Introduction: Borrelia burgdorferi sensu lato is the causative agent of Lyme disease, an emerging zoonosis, whose diagnosis, prevention and control are difficult and it is mainly reported in the northern hemisphere. Objective: to provide updated information about Borrelia burgdorferi. Methods: a review of scientific and specialized literature on the key aspects of this agent and the disease such as characteristics and life cycle of borrelias, epidemiology, clinical manifestations in humans, laboratory diagnosis, current case definition, treatment, prophylaxis, prevention and control. Results: current valuable information on selected items was set forth, which is useful for the personnel involved in vector-borne infectious diseases. Additionally, information about studies conducted in Cuba was provided. Conclusions: this paper offers updated information for the epidemiological, clinical and microbiological management of suspected cases of infection with Borrelia burgdorferi sensu lato

Enfermedad de Lyme: historia, microbiología, epizootiología y epidemiología / Lyme disease: history, microbiology, epizootiology and epidemiology

Objetivo: teniendo en cuenta el riesgo potencial que para Cuba constituye la presencia del agente trasmisor, los autores consideran importante la revisión del tema con vistas a una actualización de los especialistas y demás entidades del sistema de salud que puedan intervenir en la vigilancia y control epidemiológico de esta enfermedad. Desarrollo: se comenta la historia de la enfermedad, la microbiología, la epizootiología y la epidemiología, así como las manifestaciones clínicas en los principales animales domésticos. Conclusiones: la borreliosis de Lyme es una nueva enfermedad infecciosa; comparte como otras borrelias y espiroquetas su afinidad por el sistema nervioso central y el sistema nervioso periférico, y se convierte en un diagnóstico de exclusión optimista en Neurología. Conocer sus vectores, su distribución geográfica y algunas de las características biológicas específicas de esta nueva especie de borrelia es de suma importancia para el médico práctico de este nuevo siglo, donde la inmunología y la biología molecular iluminan el oscuro camino de viejas y nuevas interrogantes

Objective: bearing in mind the risk posed by the presence of the vector of Lyme disease in Cuba, the authors have considered it necessary to carry out a review of the disease with the purpose of contributing updated information to specialists and health institutions involved in its surveillance and epidemiological control. Content: a discussion is presented of the history, microbiology, epizootiology and epidemiology of Lyme disease, as well as its clinical manifestations in the main domestic animal hosts. Conclusions: Lyme borreliosis is a new infectious disease. Like other borrelias and spirochetes, it has an affinity for the central nervous system and the peripheral nervous system, thus becoming a diagnosis of optimistic exclusion in neurology. Knowledge about the vectors, geographic distribution and some specific biological characteristics of this new borrelia species is crucial for practitioners of the 21st century, a time when immunology and molecular biology shed new light on old and new questions alike

Uso de la reacción en cadena de la polimerasa para Borrelia burgdorferi en lesiones de esclerodermia localizada (morfea), en pacientes venezolanos / Using the polymerase chain reaction to Borrelia burgdorferi infection in localized scleroderma injure (morphea), in venezuelan patients

Borrelia burgdorferi es el agente causal de Borreliosis de Lyme, una enfermedad infecciosa multisistémica transmitida al humano por la picadura de garrapatas del género Ixodes. En los últimos años se ha postulado una posible asociación entre ésta espiroqueta y esclerodermia localizada (morfea). Sin embargo, los datos publicados no han proporcionado pruebas inequívocas de tal asociación. En Suramérica, incluida Venezuela (estado Zulia) se han detectado pruebas serológicas positivas en pacientes con morfea. El objetivo de este estudio fue buscar evidencia definitiva de la infección por Borrelia burgdorferi en pacientes con morfea, mediante la detección del ADN bacteriano en muestras de piel. En los 21 pacientes la PCR resultó negativa. La ausencia de amplificación de la secuencia blanco seleccionada en las muestras estudiadas no apoyan una asociación entre la infección por Borrelia burgdorferi y las lesiones escleróticas de morfea, pero tampoco descartan la posibilidad de una relación entre morfea y una genoespecie desconocida del complejo Borrelia burgdorferi sensu lato, entre morfea y una especie diferente de Borrelia o entre morfea y otra espiroqueta, como agente etiológico de la lesión en la localidad.

Borrelia burgdorferi is the causative agent of Lyme Borreliosis, an infectious multisystemic disease transmitted to humans by the Ixodes ticks bite. A possible association of Borrelia burgdorferi with localized scleroderma has been postulated. However, published data do not provide unequivocal results. Previus serologic analysis of patients with localized scleroderma in South American countries (including Venezuela), have been reported as yielding some reactivity. The present study looked for evidence of Borrelia burgdorferi infection in venezuelan patients with localized scleroderma, using the polymerase chain reaction to analyze 21 skin samples of patients with this skin condition. The results were negative in all the samples studied. Our data do not support an association of Borrelia burgdorferi infection and the sclerotic lesions of localized scleroderma; but do not rule out the possibility of a relationship between localized scleroderma and an unknown geno-specie of Borrelia burgdorferi sensu lato complex, a different Borrelia specie or a different spirochetal organism, as the etiological agents of the skin lesions in this area.

Enfermedad de Lyme. Experiencia en niños mexicanos / Lyme disease. Experience in Mexican children

La Enfermedad de Lyme o borreliosis de Lyme es una enfermedad infecciosa emergente causada por la bacteria Borrelia burgdorferi sensu lato, la cual es transmitida por la mordedura de garrapatas del género Ixodes. En esta revisión se presentan los aspectos generales de la enfermedad como los agentes etiológicos, las formas clínicas de manifestarse, los métodos de diagnóstico que se recomiendan para establecer con mayor certeza la etiología y se resume la experiencia acumulada durante 10 años en cuanto a las características clínico-epidemiológicas, serológicas y de identificación etiológica de niños atendidos en dos centros pediátricos del Distrito Federal.

Lyme disease or Lyme borreliosis is an emerging infectious disease produced by Borrelia burgdorferi sensu lato, which is a bacteria transmitted to the host organism by the bite of Ixodes ticks. In this report we present the general knowledge about the etiological agent, clinical manifestations of the disease and diagnostic laboratory tests. We offer cumulative information about Lyme disease in Mexican children treated at two children's hospitals in Mexico City during the last 10 years.

A Case of Lyme Disease with Various General Symptoms / 대한피부과학회지

Lyme borreliosis is a multi-systemic tick-borne infectious disease caused by the spirochaete, Borrelia burgdorferi. It has many non-specific symptoms affecting the skin, eye, musculoskeletal system, cardiovascular system, and central and peripheral nervous system. Typical cutaneous manifestations of lyme borreliosis include erythema chronicum migrans, borrelia lymphocytoma appearing a few weeks after the tick bite, and acrodermatitis chronica atrophicans developing a few years after. The diagnosis is based on clinical findings with detection of specific Ig M and Ig G antibodies to Borrelia burgdorferi. A 50-year old woman presented with an erythematous to violaceous annular patch with central scaly hyperpigmented patch on the right arm and an erythematous indurated patch on the right thigh for a month. She did not recall a deer tick bite. She had severe arthralgia on the right shoulder and myalgia on the right thigh at the first visit. Three months later, she complained of chest pain, and mild dyspnea on exertions. Serologic examinations revealed increased levels of Ig M and Ig G antibodies to borrelial antigen via ELISA, and Western blot test for Borrelia burgdorferi was positive. Her general symptoms as well as skin lesions subsided with an antibiotics (Doxycycline) and steroid therapy over 4 weeks.