Lyme borreliosis is widely found in the habitat of ticks, namely in the northern hemisphere. In our country, each year about 8000 new cases of the disease, suffer from all ages, but more than 10% of cases - children. Ticks can transmit several infections at the same time, so the bite of a tick, a person is at risk of contracting a number of infections.
What is this disease?
Lyme disease (Lyme borreliosis) - infectious natural alopecia transmissible disease which is caused by spirochetes and is transmitted by ticks and have tendency to recurrent and chronic course and a primary lesion of the skin, nervous system, heart and musculoskeletal apparatus.
Causes of Lyme disease
The causative agent of the disease are several types of Borrelia - V. garinii, B. burgdorferi and B. afzelii. This Gram-negative spirochete, which grow on media containing amino acids, animal serum, vitamins.
- Borrelia natural hosts are rodents, deer and birds. When Borrelia are bloodsucking in the gut of the tick (their multiplication occurs there), and then excreted in the faeces. The circulation of the pathogen in natural foci takes place according to the scheme: ticks - wild birds and animals - mites.
- Infection of human Lyme disease occurs in natural foci borreliosis through tick bites. But there is the possibility of infection in case of skin mite faeces in the subsequent combing her. If improperly removing the tick in the event of rupture of Borrelia can get into the wound. Possible pathogen and alimentary route of transmission - in the use of raw cow or goat milk.
Infection with Lyme disease (Lyme disease) occurs when visiting the forests, forest parks inside cities, while removing ticks from pets.
The peak incidence of Lyme disease to the period from May to June.
What happens in the human body
The causative agent of Lyme disease enters the body with the saliva of the tick. With the bite Borrelia of blood flow and lymph fall in internal organs, lymph nodes, joints. Implemented the spread of the pathogen along nerve pathways with involvement in the pathological process of brain membranes.
The death of the bacteria is accompanied by the release of endotoxin, triggering immunopathological reactions. Irritation of the immune system activates the general and local humoral and cellular response. Directly output IgM antibodies, IgG and occurs later in response to a flagellar antigen flagellar bacteria.
As the disease progresses expanded set of antibodies to Borrelia antigens, which leads to a long development of IgM and IgG. The share of circulating immune complexes. These complexes are formed in the affected tissues and activate inflammatory factors. For disease characterized by the formation limfoplazmaticheskih infiltrates in the lymph nodes, skin, subcutaneous tissue, spleen, brain, peripheral ganglia.
Classification
The clinical course of Lyme disease distinguish early period (III stage) and late period (III stage):
- I - Step local infection (erythema and bezeritemnaya form)
- II - dissemination step (variants of - feverish, neuritic, meningeal, cardiac, mixed)
- III - step persistent (chronic Lyme arthritis, acrodermatitis chronica atrophicans et al.).
According to the severity of pathological reactions Lyme disease may be mild, moderate, severe and very severe.
symptoms
The incubation period for Lyme disease from infection to onset of symptoms is usually 1-2 weeks, but it can be much shorter (several days) or longer (months to years).
Typically symptoms occur from May to September, as it is being developed nymph ticks, which are the cause of most infections. Asymptomatic infection does occur, but, according to statistics, it is less than 7% of the infection of Lyme disease in the United States. Asymptomatic course of the disease is more typical for Europe.
The first symptoms of Lyme disease are nonspecific: fever, headache, chills, muscle aches, weakness. A characteristic feature is the stiffness of the neck muscles. The location of the tick bite is formed annular redness (erythema annulare migrans). In the first 1-7 days, a macula or papule, then within a few days or weeks erythema extends in all directions. Edge reddening intensely red, slightly raised above the skin in the form of a ring in the center reddening slightly paler. Erythema circular with a diameter of 10-20 cm (60 cm), most often localized on the legs, at least - on the back, abdomen, neck, armpits, groin. In the acute phase may appear symptoms of the meninges (nausea, headache, frequent vomiting, photophobia, hypersensitivity, meningeal symptoms). It is often marked by muscle pain, joint pain.
After 1-3 months may start Stage II, which is characterized by neurologic, cardiac symptoms. For systemic borreliosis typical combination meningitis with neurites cranial nerves radiculoneuritis.
The most common symptom of cardiac - atrioventricular block may develop myocarditis, pericarditis. Shortness of breath, palpitations, chest pain clutching. Stage III is formed slowly (over 0.5-2 years) and characterized by lesions of the joints (chronic Lyme arthritis), skin (atrophic acrodermatitis) chronic neurological syndrome.
What is Lyme disease: Photo
The photo below shows how the disease manifests itself in humans.
Click to view.
[Fold]
chronic symptoms
If the disease is treated ineffectively, or not treated at all, it may develop a chronic form of the disease. This stage is characterized by the alternation of remissions and relapses, but in some cases, the disease has a continuously recurrent nature. Most occurring syndrome - arthritis, which recur over several years and gained by destruction of bone and cartilage chronic.
Observed such changes as osteoporosis, thinning and loss of cartilage, at least - degenerative changes.
Among the benign lesions encountered lymphocytoma, having the form of a dense, edematous, magenta node (infiltration) and causes pain during palpation. A typical syndrome - atrophic acrodermatitis, cause skin atrophy.
Diagnosis of Lyme disease
A crucial role for the diagnosis of Lyme disease is a thorough history. It is important not to miss the evidence of the possibility of contracting tick-borne borreliosis (outings, guided tours, etc.). Also, experts have noted the presence of the primary symptoms of the disease: skin erythema and phenomena of intoxication.
Depending on the stage at which the disease develops, use different serological and immunological laboratory research (PCR, IFA, ELISA, microscopic examination, etc.). In order to identify structural abnormalities in various organs and tissues, additional methods of research used by assigning fluoroscopy, puncture and subsequent laboratory research material, electrocardiograms, tissue biopsy of the epidermis and etc.
It should make a differential diagnosis with diseases such as encephalitis, rheumatoid arthritis, dermatitis of various origins, neuritis, rheumatic fever, Reiter's disease and others having a similar symptoms. In patients suffering from syphilis and various autoimmune diseases (infectious mononucleosis or rheumatism), serological tests are false positives that require further confirmation diagnosis.
View photo.
[Fold]
complications
Among the possible negative consequences borellioza should be made irreversible changes in the nervous system, heart and inflammatory diseases joints, which in the absence of proper treatment lead to disability and, in severe cases, can become a cause of death.
Lyme Disease Treatment
Upon detection of the characteristic symptoms of Lyme disease complex treatment is conducted in a hospital infectious hospital.
In Step I It shows antibacterial therapy in 2-3 weeks:
- Doxycycline 100 mg of 2 r / d
- Amoxicillin 500 mg 3 / day (children 25-100 mg / kg / day) inside
- Antibiotic reserve - ceftriaxone on 2.0 g / m 1 r / d
Against the background of antibacterial therapy may develop Jarisch-Herkskhaymera (fever, intoxication on the background of Borrelia mass destruction). In this case the antibiotic for a short time override, then the reception is resumed at a lower dose.
In Step II Lyme disease ntibakterialnaya therapy is prescribed for 3-4 weeks:
- In the absence of changes in the cerebrospinal fluid are shown doxycycline 100 mg of p 2 / day or 500 mg amoxicillin 3 r / day orally
- When there are changes in the cerebrospinal fluid - ceftriaxone 2 g 1 r / d, cefotaxime 2 g every 8 h or penicillin G (sodium salt) at 20-24 million U / day / in
In step III used:
- Doxycycline 100 mg of 2 r / d or amoxicillin 500 mg 3 / day orally for 4 weeks
- If no effect - ceftriaxone 2 g 1 r / d, cefotaxime 2 g every 8 h or penicillin G (sodium salt) at 20-24 million U / day / for a period of 2-3 weeks.
Early treatment usually results in full recovery of man. Chronic stages may lead to disability and death (irreversible changes in the nervous and cardiovascular systems). After the treatment, regardless of its effectiveness a person is registered with an infectious disease specialist and specialists.
prevention
When you visit a forest area (park area) general prevention involves the use of insect repellents, wearing clothes covering the body as much as possible. In the case of tick bite, you should immediately go to a clinic, where he will draw correct, examine the bite and will provide further health surveillance.
If a person is often on their own summer cottage, will not be superfluous to make acaricidal activities. After walking with the dog, the pet should be checked for the presence of the mite on the body.
