Publication details
Klinické a laboratorní projevy borreliózy
| Title in English | Clinical and laboratory manifestations of Lyme borreliosis |
|---|---|
| Authors | |
| Year of publication | 2013 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Clinically, Lyme (tick-borne) borreliosis among children is manifested at an early localized or early disseminated stage whereas late stages are rarely diagnosed. Expanding spectrum of genomic species has been described in Europe in recent years. New genospecies Borrelia spielmanii, B. lusitaniae, and B. valaisiana have been detected as human pathogens. Erythema migrans (EM) occurs in 77% to 90% of children with Lyme borreliosis. Median of incubation period is 17 days among children with EM caused by B. afzelii. Homogenous redness, annular erythema with central clearing or concentric lesion may be seen. Borrelial lymphocytoma is a rare condition occurring more frequently in children, usually as a painless bluish-red nodule localized on the ear lobe, ear helix, scrotum or nipple. Neuroborreliosis typically presents itself as meningitis and cranial neuritis. Mild headache, minimal meningeal signs occur, but, surprisingly, inflammatory changes are found in cerebrospinal fluid. Facial or abducens palsy may be unilateral or bilateral. Lyme arthritis is manifested as recurrent attacks of joint swelling. One or a few large joints are involved. Arthralgia may accompany any borrelial manifestation. Laboratory evidence of early localized infection (EM) is not essential for the diagnosis. Early and late disseminated Lyme borreliosis requires laboratory examination. Direct detection of borreliae: cultivation and PCR, are not applicable in clinical practice. Serology can contribute to diagnosis. Lymphocytic pleocytosis and specific intrathecal IgM/IgG production belong to the diagnostic criteria of nervous system manifestations. In Lyme arthritis, anti-borrelial antibodies in synovial fluid are sufficient for confirmation of the diagnosis. Autoimmune joint involvement should be excluded. |