Lyme disease ( Ixodes tick-borne Lyme disease or systemic ) - Causes, Symptoms and Treatment .MF .
Lyme disease (borreliosis Iskodovy tick, tick-borne Lyme System) - a chronic, natural focal bacterial infection predominantly transmissible mechanism of transmission, characterized by skin lesions, nervous and cardiovascular systems.
reasons Ixodes tick borreliosis
Activators are Grammy-negative spirochete complex Borrelia burgdarferi sensu lato.
prevalence coincides with the geographical area encephalitis, so it is possible the development of mixed infections.Sensitivity is high, under the threat of all age groups.The reservoir of infection is contact with animal nature, and source - ticks that later and infect humans.Seasonality - spring and summer (March to September).transmission path - transmissivyny, ie through a tick bite.
Symptoms Ixodes tick borreliosis
The incubation period lasts from 5 to 30 days, at which time no symptoms is not observed, and only in the area of the tick bite slight redness (migrans kaltsevidnaya erythema), which can notnotice, because the
Annular erythema migrans
As the reproduction of the pathogen, it takes place in the lymphatic and hematogenous way, infect the internal organs, joints, central nervous system, with a partial destruction of the pathogen with endotoxin release.Isolation of endotoxin gives rise to the next period with the clinical manifestations.
nonspecific clinical manifestations period, because in addition to erythema no specific symptoms are not present.Getting sharp, and in the foreground feverish intoxication syndrome: fatigue, chills, fever, rise in temperature, headache, dizziness, fatigue, aching muscles, pain in bones and joints, frequent catarrhal phenomena (sore throat, dry cough).Because of these non-specific symptoms, the probability of diagnostic errors.Over time, the site erythema at the site of the bite begins to grow in all directions, so it is often called "migrating".
When to start treatment at this stage, it increases the chance of recovery, otherwise, the disease may progress to a stage disseminirovaniya.
Stage disseminirovaniya develops within a few weeks or months after the end of the stage of early localized infection.Hematogenous drift often occurs in the area of the nervous system, cardiovascular, skin and joints, but the infection of other organs and systems is not excluded.
• The defeat of the nervous system is expressed in the development of neuritis of the cranial nerves, meningitis and flowing with it symptoms radiculoneuritis, lymphocytic meningoradikulonevrita (Bannwart syndrome) which manifests itself in the form of predominantly nocturnal radicular pain and lymphocytic pleocytosis in the CSF.
• Cardiac involvement is often manifested in violation wiring system and inflammatory formations of the heart tissues (myocarditis, pericarditis).
• Joint damage manifested first attack of arthritis: joint swelling (s) and the restriction of movement due to the accumulation of fluid in the cavity, pain can not be.After calming down the inflammation process, relapses occur in the same joints that have been affected.Specific features of Lyme arthritis is not yet determined.
• Displays of the skin characterized by multiple erythematous rash.Much less common eye disease (conjunctivitis, iritis, retinitis, Panophthalmitis), respiratory system (pharyngitis, traheobronghit), genitourinary system.
Upon infection of Lyme disease, the immune response is weak and there is one feature - Borrelia stimulate the production of various inflammatory mediators (IL-1, IL-6, TNF), involved in the development of Lyme arthritis and autoimmune reactions.At the time of developing the disease, forming circulating immune complexes, which were later deposited in the synovial membrane, the dermis, kidney, myocardium.
Often the disease takes a chronic course, which is characterized by arthritis, limfotsitomy skin in the form of nodules in the skin cells, atrophic skin atrophy akrodermatita manifested.Chronicity of the nervous system is manifested in the form of encephalomyelitis, polyneuropathy, spastic paraparesis, ataxia, chronic axonal radiculopathy, dementia or a memory disorder easy.
ELISA, PCR, MSP (lumbar puncture)
Treatment Ixodes tick borreliosis
Adherence and diets, which are determined by the weight of the state.Drug therapy, which consists in the appointment of the following antibiotics: doxycycline or ceftriaxone (depending on severity) - as the basic drugs to him in the attached complex drugs of choice (amoxicillin, cefixime, azithromycin, amoxiclav, penicillin, tsefatoksim).The main thing is not to apply bactericidal and bacteriostatic drugs at the same time, otherwise you can cause the strongest toxicosis, t.kbudet effects occur endotoxin pathogen destruction, and drugs will act antagonistically without work in full force.In the case of mixed infections, along with medication, apply and tick-borne encephalitis immunoglobulin in the calculated doses.Detoxification therapy is carried out according to general rules.
Complications Complications associated with chronicity of infection, which was described above.
specific prophylaxis has not been developed.The non-specific infection is prevention: akartsidnaya processing forest parks, wearing protective clothing, personal use of repellents.For emergency prevention of the different groups used antibiotics: doxycycline, bitsilin-3, amoxicillin clavulanic acid.
therapists Shabanova IE