ABSTRACT
BACKGROUND AND OBJECTIVE: Erythema migrans (EM) is the earliest and most common manifestation of the infection caused by B. burgdorferi (Lyme borreliosis). The objective of the present work was to report the clinicoepidemiological features in a series of patients. PATIENTS AND METHODS: Retrospective collection of clinicoepidemiological features of the first fifty patients diagnosed of EM at La Rioja Hospital (March 1989-September 1998). RESULTS: In our series, no differences were observed regarding sex or living in a rural or urban area. Mean age was 41 years (range 9 to 78). In 70% of patients the antecedent of a tick bite was obtained and the incubation period was 6.48 days (1 to 15 days). The mean size of the lesions was 14.3 cm (5 to 40) and in 16% of patients satellite cutaneous lesions were observed. The areas where EM appeared were lower limbs and the perineal region (60%), chest (24%), head and neck (10%) and upper limbs (6%). Forty-eight percent of patients reported extra-cutaneous manifestations. All cases occurred during the spring, summer and autumn months, with a peak in June. The most common referred antecedent was walking in forest areas. All patients responded to antibiotic therapy. CONCLUSIONS: EM is common in the studied environment and presents with a marked polymorphism.
Subject(s)
Lyme Disease/diagnosis , Lyme Disease/epidemiology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Fundamento. El eritema migratorio (EM) es la manifestación precoz y más típica de la infección por B. burgdorferi (borreliosis de Lyme). El objetivo del presente estudio ha sido la descripción de la características clínicoepidemiológicas de una serie de pacientes.Pacientes y método. Recogida retrospectiva de las características clinicoepidemiológicas de los primeros 50 pacientes diagnosticados de EM en el hospital de La Rioja (marzo 1989septiembre 1998).Resultados. En nuestra serie no observamos diferencias por el sexo ni por habitar en un medio rural o urbano. La edad media fue de 41 años (9 a 78). En el 70 por ciento se recogió el antecedente de picadura de garrapata y el período de incubación fue de 6,48 días (1 a 15 días). El tamaño medio de la lesión fue de 14,3 cm (5 a 40) y en el 16 por ciento se observaron lesiones cutáneas satélites. Las zonas de aparición del EM fueron extremidades inferiores y periné 60 por ciento; tórax 24 por ciento; cabeza y cuello 10 por ciento, y extremidades superiores 6 por ciento. Un 48 por ciento refirieron manifestaciones extracutáneas. Todos los casos se produjeron en los meses de primavera, verano y otoño con un pico en el mes de junio, siendo la práctica de riesgo mayormente referida el paseo por zonas boscosas. Todos los pacientes respondieron al tratamiento antibiótico.Conclusiones. El EM es frecuente en el medio estudiado y se presenta con un gran polimorfismo (AU)
Subject(s)
Middle Aged , Child , Adult , Adolescent , Aged , Male , Female , Humans , Retrospective Studies , Lyme DiseaseABSTRACT
Migratory Chronic Erythema (MCE), which is the distinctive and diagnostic lesion of Lyme's disease, could manifest itself under different clinical manifestations. Following a clinical and a epidemiological point of view 10 cases of MCE, diagnosed during the last three years, have been studied and described. Its wide variability of the clinical manifestations is underlined, with a mean incubation period of 5.6 days between the onset of cutaneous symptoms and the tick bite. The zones mainly affected were lower limbs followed by trunk and neck. Size of lesion varied from 5 to 30 cm, with a mean of 13 cm. In two patients satellite cutaneous lesions were observed and six showed extra-cutaneous signs. Only in four patients antibodies against Borrelia burgdorferi were detected. Regarding epidemiology we did not found differences between the sexes, or by living on an urban or rural area. The tick bite was referred in half of the cases, 30% of the patients have a job related with wood, forest, farming or cattle. The season in which MCE was most frequent was spring-beginning of summer and end of summer-beginning of autumn. All patients responded to the therapy with tetracyclines and/or macrolides.
