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Biomedical subjects

B Svenungsson

Publications and source records attributed to B Svenungsson.

At least 37 records · Page 2Linked to original sources
PubMed1993

Antibody prevalence and clinical manifestations of Lyme borreliosis and tick-borne encephalitis in Swedish orienteers.

Antibody prevalence and clinical manifestations of Lyme borreliosis (LB) and tick-borne encephalitis (TBE) were studied in 362 orienteers from the county of Stockholm during a large relay race in October 1990. From all participating orienteers, a blood sample was collected and a questionnaire completed. Antibody activity to Borrelia burgdorferi was measured using a sonicated whole spirochete antigen in an ELISA, and to TBE virus (TBEV) by ELISA and haemagglutination inhibition (HI) test. A past history of LB was reported by 6% of the orienteers and antibodies to B. burgdorferi were found in 9%. Antibody reactivity to B. burgdorferi was found in 1-2% of the sera from 3 different control groups comprising 502 persons living in non-endemic areas. The corresponding value was 9% in sera from a fourth control group consisting of 150 persons living in the city of Stockholm. A past history of TBE was reported by 1 orienteer (0.3%) and detectable antibodies to TBEV in non-immunized individuals were found in 1%. No antibody activity to TBEV could be detected in sera from the control individuals living in the 3 non-endemic areas, but in 5% of the controls from Stockholm. In this study, there was no indication that frequent or severe manifestations of LB or TBE are common among orienteers in Sweden.

Adolescent↗
PubMed1992

Two-year survey of the incidence of Lyme borreliosis and tick-borne encephalitis in a high-risk population in Sweden.

A survey was made over a two-year period (September 1987 to August 1989) of a population living in an area endemic for Lyme borreliosis and tick-borne encephalitis in Sweden. For each patient a blood sample was collected and a questionnaire completed annually. All sera were tested for an antibody response to Borrelia burgdorferi in an EIA using sonicated antigen and for an antibody response to the tick-borne encephalitis virus using an EIA and a haemagglutination inhibition test. Antibodies to Borrelia burgdorferi and tick-borne encephalitis virus were detected in 89 (25.7%) and 40 (11.6%) respectively of 346 samples collected in August 1987. In the first year of the study 14 of 303 subjects (4.6%) developed Lyme borreliosis and in the second year 9 of 277 subjects (3.2%). A significant increase in the antibody titre for Borrelia burgdorferi was seen in 14 of 303 (4.6%) subjects in the first year and 8 of 277 (2.9%) subjects in the second year. An earlier episode of Lyme borreliosis or an elevated antibody titre did not seem to protect against reinfection. One case of tick-borne encephalitis was seen each year. Seroconversion for tick-borne encephalitis virus was found in 3 of 258 (1.2%) subjects in the first year and 5 of 211 (2.4%) in the second year, excluding subjects who had undergone successful immunisation or had earlier been hospitalised for tick-borne encephalitis. The study thus demonstrated a high yearly incidence of tick-borne infections in a population at risk.

Adolescent↗
PubMed1992

Intestinal symptoms and serological response in patients with complicated and uncomplicated Yersinia enterocolitica infections.

Clinical course, serological response and effect of antibiotic treatment were evaluated in 34 patients with uncomplicated enterocolitis and in 27 patients with reactive arthritis (ReA) due to Yersinia enterocolitica. Patients participating in this prospective multicentre trial were randomised to treatment or no treatment with antibiotics. Only 3 (11%) of the patients who later developed ReA asked for medical care because of intestinal symptoms and fever and they all developed arthritis within 2 days after admission to hospital, i.e. before an etiological diagnosis was obtained. Patients with ReA had a history of milder intestinal symptoms than patients with uncomplicated enterocolitis. The peak IgA titer to Y. enterocolitica, as measured by enzyme linked immunosorbent assay, was higher in ReA patients and it was not affected by the presence of HLA-B27 antigen. On the other hand, untreated patients with uncomplicated enterocolitis had the longest duration of IgG antibodies. The duration of IgG antibody response was shortened in uncomplicated enterocolitis patients treated with antibiotics, but not in ReA patients. Treatment did not influence intestinal or ReA symptoms. It is concluded, that patients with uncomplicated enterocolitis due to Y. enterocolitica differ in intestinal symptoms and serological response, compared with patients who develop ReA. These parameters could however not be used to predict the development of arthritis in individual patients.

Abdominal Pain↗
PubMed1992

[Prevention and treatment of traveler's diarrhea].

Travelers' diarrhea (TD) affects 20-50 per cent of individuals going to developing countries in Asia, Africa, or Latin America. The etiology varies but is dominated by enterotoxigenic E. coli, found in 30-50 per cent. TD is usually a mild disease, self-limiting in 3-4 days, but 10 per cent of those afflicted have symptoms for one week or more. Prophylaxis of TD involves dietary restrictions and, in selected medical risk groups, antimicrobial drugs. The most important treatment of TD is oral rehydration and loperamide in mild to moderate, non-invasive illness. Antibiotics for self-treatment shall be restricted for medical risk groups and individuals travelling far from medical service.

Anti-Bacterial Agents↗
PubMed1990

Early antibiotic treatment of reactive arthritis associated with enteric infections: clinical and serological study.

OBJECTIVE: To find out whether a 10-14 days' course of antibiotics early in the course of reactive arthritis associated with enteric infections could reduce the severity and duration of the disease and whether the antibody response in patients with reactive arthritis associated with yersinia infection differed between those treated and those not treated with the antibiotics. DESIGN: Prospective multicentre trial in which patients were randomised to treatment or no treatment with antibiotics. Patients were seen at three and six weeks and three, six, nine, 12, and 18 months after their first visit. SETTING: Departments of infectious diseases in three hospitals in Linköping, Malmö, and Stockholm, Sweden. PATIENTS: 40 Consecutive patients who had had symptoms of reactive arthritis associated with enteric infection for less than four weeks. INTERVENTIONS: 20 Patients were allocated to treatment with antibiotics and 20 patients did not receive antibiotics. All patients received non-steroidal anti-inflammatory drugs, and four also received intra-articular steroid injections after at least six weeks' observation. MAIN OUTCOME MEASURES: Arthritic symptoms assessed clinically and by using Ritchies' index; blood measurements reflecting inflammatory activity; serum IgG, IgM, and IgA antibody titres; HLA tissue type. RESULTS: No difference was observed concerning duration of arthritis, grade of inflammation, and number of joints affected between patients treated and those not treated with antibiotics. Furthermore, there was no significant difference between the two groups in erythrocyte sedimentation rate and haptoglobin, IgG, and IgA concentrations. All values had returned to normal within three months. No patient developed chronic arthritis, but sustained slight arthralgia occurred in three patients. The HLA-B27 antigen was found in 23 (58%) of the patients, and its presence did not affect clinical outcome. The IgG, IgM, and IgA antibody responses were similar in patients treated with antibiotics and those not treated. CONCLUSION: Short term antibiotic treatment has no beneficial effect on the clinical outcome of reactive arthritis associated with enteric infection.

Adult↗
PubMed1990

Cultivation and characterization of spirochetes from cerebrospinal fluid of patients with Lyme borreliosis.

Attempts were made to culture spirochetes from cerebrospinal fluid samples of 105 patients suspected of having Lyme borreliosis with neurological complications. At the final evaluation, only 38 patients fulfilled the criteria of neuroborreliosis. Spirochetes were cultured from cerebrospinal fluid samples of four of these patients. All four patients had pleocytosis in their cerebrospinal fluid and a history of neurological symptoms of only 4 to 10 days in duration. Two of them had no detectable antibodies against any of the isolated spirochetes in their cerebrospinal fluid, both when tested with an enzyme-linked immunosorbent assay and when tested by immunoblotting. An antibody reaction against the homologous isolate that was distinctly stronger than that against the heterologous isolates was found in the serum and cerebrospinal fluid samples from one patient. The cells of the isolates were morphologically similar and showed a very similar protein pattern when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Cells of all isolates reacted with the monoclonal antibodies H5332 and H9724, which also react with Borrelia burgdorferi B31, the type strain. One isolate lost a major protein of 23 kilodaltons after subcultivation for 4 months. We conclude that isolation of spirochetes from cerebrospinal fluid might prove successful in clinically selected cases of Lyme borreliosis.

Adult↗
PubMed1990

Persistent excretion of Salmonella in foreign-born adopted and native Swedish children.

The duration of salmonella excretion in 162 foreign-born adopted children and 132 native Swedish children was studied. Of the adopted children (96% being less than 1 year of age) 54% still excreted salmonella at 12 weeks, 32% at 6 months, and 12% at 1 year after arrival in Sweden. The carrier state was more prolonged in the age group 0-3 months compared to the age group greater than 6 months. In the group of native Swedish children, aged 0-5 years, 18% still excreted salmonella at 12 weeks, 4% at 6 months, and none at 1 year after the gastroenteritis episode. A majority of these children were older than 1 year. Intrafamilial transmission of salmonella seemed to be uncommon. Only 6% of the adopted children infected another family member.

Adoption↗
PubMed1990

Prevalence of tick-borne encephalitis and Lyme borreliosis in a defined Swedish population.

Sera from 346 individuals living on Lisö, an area south of Stockholm, endemic for tick-borne encephalitis (TBE) and Lyme borreliosis, were tested for antibody activity to TBE-virus (TBEV) and Borrelia burgdorferi, using a sonicate antigen, by haemagglutination-inhibition and ELISA, respectively. 10/346 (3%) individuals had a history of previous serologically confirmed TBE with encephalitic symptoms, and 33/346 (10%) had a history of previous erythema chronicum migrans (ECM). Four individuals (1%) had been treated for neuroborreliosis and another 4 (1%) for acrodermatitis chronica atrophicans (ACA). Antibodies to TBEV and B. burgdorferi were detected in 40/346 (12%) and 89/346 (26%) individuals, respectively. The seroprevalence of Lyme borreliosis increased with age, time spent on Lisö, and number of reported tick-bites. For TBE there was a correlation between seropositivity and time spent on Lisö only. In sera from 50 healthy blood-donors, living in a non-endemic area, no antibody activity to TBEV could be detected and only 1/50 (2%) had antibodies to borrelia. In sera from 150 age and sex matched control individuals, living in the city of Stockholm, antibody activity to TBEV and borrelia was found in 8/150 (5%) and 13/150 (9%), respectively.

Adolescent↗
PubMed1990

Pivampicillin/pivmecillinam in the treatment of shigella carriers.

24 patients (4-65 years old; median age 29 years) excreting shigella bacteria greater than 8 weeks were treated with the combination pivampicillin (0.25 g)/pivmecillinam (0.20 g), 2 tablets 3 times a day for 14 days. 23/24 patients (96%) were culture negative after treatment. The one patient that did not respond to treatment carried a strain with intermediate sensitivity to mecillinam and resistance to ampicillin. It is concluded that pivampicillin/pivmecillinam is effective for patients excreting shigella bacteria.

Adolescent↗
PubMed1988

Clinical manifestations and diagnosis of neuroborreliosis.

Lyme borreliosis has in a few years turned out to be a health problem not only in the United States, but also in many European countries. When it affects the nervous system, Lyme borreliosis acts as the great disease imitator. Because of this characteristic it is often difficult to diagnose on clinical grounds. Patients with neuroborreliosis might appear within all medical disciplines. Clinical markers, such as preceding tick bite and/or ECM, are important clues to the diagnosis. Mononuclear pleocytosis and elevated CSF protein are present in most patients with neuroborreliosis. Final evidence for the diagnosis is the demonstration of specific antibodies in serum and/or CSF. Measurement of antibody titers should be carried out in both serum and CSF, since these methods are complementary when trying to obtain a serological diagnosis of neuroborreliosis.

Adolescent↗
PubMed1988

Treatment of Lyme borreliosis with emphasis on neurological disease.

We have studied 113 patients with neurologic Lyme borreliosis and meningitis who were treated with intravenous high-dose antibiotics (penicillin G, 12 g, mostly for 14 days in 47 patients; penicillin G, 9 g, mostly for 10 days in 58 patients; doxycycline, 200 mg, in 5 patients; and cefuroxime, 4.5-9 g, in 3 patients). Seventy percent of the patients had peripheral nerve symptoms and 13% had central nervous symptoms. Almost half of the patients were treated more than 4 weeks after the onset of symptoms and 15% of the patients had persisting or progressive symptoms between 4 and 11 months. There seemed to be clinical benefit as well as a decrease of spinal fluid pleocytosis and spinal proteins. No significant symptoms of Herxheimer reaction were demonstrated.

Anti-Bacterial Agents↗
PubMed1987

Clinical manifestations of Borrelia infections of the nervous system.

Clinical, treatment and laboratory parameters were analyzed in 46 consecutive Swedish patients with Borrelia infections of the nervous system. The importance of age in the clinical symptoms, the wide spectrum of disease, and the chronic behaviour of the Borrelia infection of the nervous system was stressed, as well as the benefit of high-dose intravenous antibiotics, especially penicillin G. Borrelia infection of the nervous system can imitate other diseases. When associated with meningitis it can mimic psychosomatic disorders, when associated with radiculoneuritis it may imitate herniated discs and when central nervous involvement of the Borrelia infection occurs, it can mimic a non-infectious, thrombotic or haemorrhagic cerebro-vascular disease.

Adolescent↗