Incidence and characteristics of Lyme neuroborreliosis in adult patients with facial palsy in an endemic area in the Netherlands.

Making a distinction between facial palsy due to Lyme neuroborreliosis (LNB) and idiopathic facial palsy (IFP) is of importance to ensure timely and adequate treatment. The study objective was to assess incidence and patient characteristics of facial palsy due to LNB. Hospital records were reviewed of adult patients with facial palsy visiting the departments of neurology and/or otorhinolaryngology of Gelre hospitals between June 2007 and December 2017. Gelre hospitals are located in an area endemic for Lyme borreliosis. Patients with LNB had pleocytosis and intrathecal antibody production or pleocytosis with positive IgG serology. Patients with IFP had negative serology. Clinical characteristics were compared between patients with LNB and patients with IFP. Five hundred and fifty-nine patients presented with facial palsy, 4.7% (26) had LNB and 39.4% (220) IFP. The incidence of facial palsy due to LNB was 0.9/100 000 inhabitants/year. Over 70% of patients with facial palsy due to LNB did not report a recent tick bite and/or erythema migrans (EM). Patients with facial palsy due to LNB presented more often in July to September (69.2% vs. 21.9%, P < 0.001), and had more often headache (42.3% vs. 15.5%, P < 0.01). To reduce the risk of underdiagnosing LNB in an endemic area, we recommend testing for LNB in patients with facial palsy in summer months especially when presenting with headache, irrespective of a recent tick bite and/or EM.

Meigs syndrome and ovarian fibroma: CT findings.

We present a case of ovarian fibroma with associated Meigs syndrome, Even though the CT findings of ovarian fibroma have been reported previously, our case, with associated meigs syndrome, demonstrated a broader spectrum of CT findings.

A retrospective study of 375 patients with genital herpes simplex infections seen between 1973 and 1980.

A retrospective survey was performed to study the clinical course of 375 patients with genital herpes simplex infections seen between 1973 and 1980. Genital herpes simplex is increasingly being recognized as a disease of the affluent middle class. Recurrences in this study were most frequently associated with emotional stress (85.9 percent) and by coital friction (66 percent). The enormous psychological burden of this disease resulted in 42 percent of the patients withdrawing from sexual encounters. The study suggests a relatively low index of communicability (25.3 percent) to sexual partners even though neither topical nor systemically administered therapeutic agents seemed to significantly influence the course of disease. When curves were constructed based on patients' statements as to when they experienced a period of protracted remission from disease, 50 percent of those with genital herpes simplex were found to be essentially free of frequently recurring episodes within seven years after the onset of disease.

A proposed biologic cure for recurrent genital herpes simplex through injection of neurolytic agents into cutaneous sensory nerves.

It may be possible to eliminate Herpes simplex virus (HSV) from the skin of patients with chronic recurrent genital infections through destruction of the cutaneous sensory nerves of the genitals by injecting absolute alcohol into the affected areas. In so doing the latency of the virus in the sensory ganglia may be influenced, the immediate source of reinfection suppressed, and reactivation of HSV inhibited in the skin.

Clinical efficacy of ribavirin in the treatment of genital herpes simplex virus infection.

48 patients participated in a double-blind placebo-controlled study conducted to evaluate the efficacy of ribavirin in the treatment of herpes simplex virus genital infection. Study design did not allow a conclusion regarding usefulness of the drug in preventing recurrences. Ribavirin treatment (800 mg/day p.o) for 10 days reduced disease severity and promoted recovery as compared with placebo treatment.

Double-blind cross-over study of levamisole as immunoprophylaxis for recurrent herpes progenitalis.

A double-blind cross-over study of the immunoprophylactic influence of levamisole was undertaken in a study of forty patients with chronic, recurrent herpes progenitalis. Clinical records failed to show significant reduction in the frequency or severity of attacks in levamisole-treated patients when compared with placebo-treated control patients. At evaluation six months after levamisole administration, there was no essential alteration in the course of the disease in the initial treatment group.

BCG immunoprophylaxis of recurrent herpes progenitalis.

Thirty-eight patients with severe, recurrent herpes progenitalis were treated by immunoprophylaxis with repeated BCG inoculations. Results of the study demonstrated no significant prophylactic benefit of BCG when contrasted to other homologous or heterologous antigens or to control patients receiving placebos. Caution is warranted in the use of homologous vaccines from Germany because theoretically, tumor growth might be enhanced by immunologic means, although the vaccine apparently has no intrinsic oncogenic qualities.