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PubMed1982

[Lyme's disease. A clinical case observed in Western France (author's transl)].

The clinical story of a young woman with chronic erythema migrans followed by polyradiculoneuritis and recurrent oligoarthritis is reported. The story corresponds to the disease described by Steere et al. [7, 8, 9, 10] in 1976 and known in the U.S.A. as "Lyme's disease". The condition is epidemic and occurs during the summer. It begins with skin lesions characteristic of chronic erythema migrans, which are consecutive to tick bite. This is followed, a few days or weeks later, by neurological disorders (aseptic meningitis, encephalitis, cranial nerve paralysis and/or polyradiculoneuritis), transient and recurrent attacks or arthritis mostly in the larger joints and, occasionally, conduction disorders in the heart. The course of the disease is that of an inflammatory condition. The presence of immune complexes in the serum and synovial fluid is suggestive of local and systemic immune reaction to a hypothetically viral agent introduced by the tick bite. The fact that the incidence of DR W2 antigen is greater in patients with severe lesions suggests individual predisposition.

Adult↗
PubMed1998

[Active vaccination against early summer meningoencephalitis].

TBE is a rather rare disease (incidence in Switzerland 0.46/1,000,000 population per year). Acquisition occurs only in well known endemic areas through bites of infected ticks. The course of the disease is not trivial: 0.5-2% of cases are fatal, 2.7% have persistent serious paralysis and some 33% a postencephalitic syndrome. There is no specific therapy. An active vaccine is commercially available which is reliably immunogenic (99% of vaccinated persons develop protective antibodies) and involve only a few mild side effects. Mass vaccination seems not to be cost-effective but would be epidemiologically efficient, as a vaccination campaign in Austria has shown. Because of the increasing importance of leisure-acquired TBE infections, the Swiss recommendations could be formulated more liberally: active vaccination is recommended for everyone who regularly spends time in forests in an endemic area, be it for work or leisure.

Encephalitis Viruses, Tick-Borne↗
PubMed1986

The effect of avermectins on feeding, salivary fluid secretion, and fecundity in some ixodid ticks.

We tested the effects of the potent acaricides, avermectin B1a (AVM) and 22,23-dihydroavermectin B1 (ivermectin; IVM) when injected directly into partially fed and fully engorged female ticks. When injected into small ticks (Amblyomma hebraeum Koch), neither drug (up to 100 micrograms/kg b.w.) inhibited subsequent engorgement nor affected oviposition latency, weight of total egg mass laid nor viability of laid eggs. At higher concentrations (1000 and 5000 micrograms/kg b.w.), AVM and IVM were markedly toxic. When injected into engorged ticks, both drugs increased oviposition latency, and reduced fecundity at about 75-100 micrograms/kg b.w. Vitellogenesis, as assessed by a spectrophotometric assay of the ovaries, was not inhibited. Also at 50-100 micrograms/kg b.w., AVM and IVM caused paralysis of the abdominal dorso-ventral muscles and the leg muscles. Both drugs, at 7 days post-injection, proved detrimental to salivary gland function in both small and large ticks, but had little effect on salivary gland weight. At concentrations which did not inhibit oviposition (20-50 micrograms/kg b.w.) many of the eggs dried out even though they were kept at high RH. We then demonstrated in Amblyomma americanum, Dermacentor andersoni and D. albipictus that removal of egg wax (by extraction with hexane) induced a marked increase in water permeability. IVM neither increased water permeability of D. andersoni eggs nor diminished the amount of egg wax deposited on the surface of the eggs, when injected posteriorly through the alloscutum. However, injection of IVM, dimethylsulphoxide (vehicle for IVM) or distilled water through the articulation between the capitulum and scutum ('anterior injection'), did markedly reduce the wax coating and increased egg permeability. We suggest that anterior injection damages Gené's organ and thus causes the latter effects.

Animals↗
PubMed1982

The avermectins: A new family of antiparasitic agents.

The avermectins are macrocyclic lactones produced by fermentation of the soil micro-organism Streptomyces avermitilis. They show activity against a broad range of nematodes and arthropod parasites of domestic animals at dose rates of 300 microgram/kg or less. Unlike the macrolide or polyene antibiotics, they lack significant antibacterial or antifungal activity. By oral or parenteral administration, avermectins are active against gastrointestinal nematodes and lungworms, and important ectoparasites such as lice, mange mites, ticks and larval stages of flies. They show excellent activity against parasites resistant to existing anthelmintics or ectoparasiticides. The avermectins appear to cause paralysis of nematodes and arthropods by opening gamma-aminobutyric acid-mediated chloride channels at the neuromuscular junction.

Animals↗
PubMed1986

Joint and bone involvement in Swedish patients with Ixodes ricinus-borne Borrelia infection.

The presence of signs of joint involvement was investigated in 231 patients with erythema chronicum migrans Afzelius (ECMA), in 50 patients with acrodermatitis chronica atrophicans (ACA), in four patients with spirochete-induced facial palsy and in one patient with pericarditis and serologic evidence of Borrelia spirochetal infection. Only one of 16 untreated patients with ECMA developed arthritis. The patient with pericarditis had suffered from arthritis for 2 months when the cardiac symptoms developed. Thirteen of the patients with ACA had luxations/subluxations of small joints in the hands or feet and/or arthritis in large joints. In four of the patients with ACA, periosteal thickening of bones was found. The results indicate that joint abnormalities are not uncommon in patients with ACA. However, arthritis during the first year of tick-borne spirochetal infection was less common in Sweden than has been reported among patients with Lyme disease in the United States.

Acrodermatitis↗
PubMed1980

[Severe and prognostically unfavourable forms of tick-borne encephalitis (early-summer meningo-encephalitis) in Freiburg (author's transl)].

Eight patients with proven tick-borne encephalitis (early-summer meningo-encephalitis; central European encephalitis) were treated in 1979. The disease ran a severe course in four: one died after six weeks of coma and pneumonia with right-heart failure. Another patient is in coma for more than 40 weeks. A third patient had severe flaccid tetraplegia more than 10 weeks after initial coma. The fourth patient still had leg paresis after nine weeks, her left arm also being largely paralysed. This high incidence of severe forms of the disease differs from other published reports.

Adult↗
PubMed1985

[Erythema migrans disease. 3 case examples with neurologic complications].

The erythema-migrans-disease is closely related to Lyme-disease as described in the USA, and represents a tickborne spirochetosis with highest incidence during summer and autumn. Besides nonspecific general symptoms in its earlier stages, it is characterized by a distinctive erythema migrans; later, additional neurological, cardiac and/or arthritic symptoms may develope. Its typical neurologic complication, the lymphocytic meningoradiculitis Garin-Bujadoux-Bannwarth, was observed in three children whose clinical features illustrate the great variability of symptoms of Erythema-migrans-disease. Serological tests for specific spirochete antibodies are valuable aids in differential diagnosis, especially for cases with late complications if a tick bite is not remembered, or as is not uncommon, the typical skin lesion has not occurred, or has not been noted. Antibiotic therapy with penicillin or tetracycline is a successful treatment of the earlier stages of the disease and can prevent, or at least ameliorate, subsequent complications.

Adolescent↗
PubMed2004

An animal model for the tickborne flavivirus--Omsk hemorrhagic fever virus.

The tickborne encephalitis (TBE) serocomplex of flaviviruses consists primarily of viruses that cause neurologic disease; these viruses include Omsk hemorrhagic fever virus (OHFV), a virus that is genetically related to other TBE serocomplex viruses but that circulates in an ecologically distinct niche and causes markedly different human disease. The objective of this study was to examine a potential small-animal model for OHFV and to compare the pathology of infection with that of the neurotropic tickborne flavivirus, Powassan virus (POWV). POWV-infected BALB/c mice demonstrated typical arboviral encephalitis, characterized by paresis and paralysis before death, and viral infection of the cerebrum, characterized by inflammation and necrosis. In contrast, lethal OHFV infection did not cause paralysis or significant infection of the cerebrum but showed marked involvement of the cerebellum. Distinct pathological results in the spleens suggest that the immune response in OHFV-infected mice is different from that in POWV-infected mice. This study demonstrates a clear pathological difference between OHFV-infected mice and POWV-infected mice and supports the use of the BALB/c mouse as a disease model for OHFV.

Animals↗
PubMed1996

Tick-borne encephalitis complicated by a polio-like syndrome following a holiday in central Europe.

We report a case of Central European tick-borne encephalitis (CETE) in a 54-year-old man, presenting with fever and neurological complications following a holiday in Austria. A disease resembling paralytic poliomyelitis may develop with upper and lower extremity paralysis, as is the case in our patient. Our patient was most likely infected by eating goat's cheese, made of unpasteurised goat's milk. The diagnosis was confirmed by a positive IgM antibody response to the virus in the serum.

Animals↗
PubMed1998

Lyme disease with facial nerve palsy: rapid diagnosis using a nested polymerase chain reaction-restriction fragment length polymorphism analysis.

A 64-year-old woman with Lyme disease and manifesting facial nerve palsy had been bitten by a tick on the left frontal scalp 4 weeks previously. Erythema migrans appeared on the left forehead, accompanied by left facial paralysis. Nested polymerase chain reaction-restriction fragment length polymorphism analysis (nested PCR-RFLP) was performed on DNA extracted from a skin biopsy of the erythema on the left forehead. Borrelia flagellin gene DNA was detected and its RFLP pattern indicated that the organism was B. garinii, Five weeks later, B. garinii was isolated by conventional culture from the erythematous skin lesion, but not from the cerebrospinal fluid. After treatment with ceftriaxone intravenously for 10 days and oral administration of minocycline for 7 days, both the erythema and facial nerve palsy improved significantly. Nested PCR and culture taken after the lesion subsided, using skin samples obtained from a site adjacent to the original biopsy, were both negative. We suggest that nested PCR-RFLP analysis might be useful for the rapid diagnosis of Lyme disease and for evaluating therapy.

Adult↗
PubMed2006

Clinical features of double infection with tick-borne encephalitis and Lyme borreliosis transmitted by tick bite.

BACKGROUND: In Latvia and other endemic regions, a single tick bite has the potential to transmit both tick-borne encephalitis (TBE) and Lyme borreliosis. OBJECTIVE: To analyse both the clinical features and differential diagnosis of combined tick-borne infection with TBE and Lyme borreliosis, in 51 patients with serological evidence, of whom 69% had tick bites. RESULTS: Biphasic fever suggestive of TBE occurred in 55% of the patients. Meningitis occurred in 92%, with painful radicular symptoms in 39%. Muscle weakness occurred in 41%; in 29% the flaccid paralysis was compatible with TBE. Only two patients presented with the bulbar palsy typical of TBE. Typical Lyme borreliosis facial palsy occurred in three patients. Typical TBE oculomotor disturbances occurred in two. Other features typical of Lyme borreliosis detected in our patients were distal peripheral neuropathy (n = 4), arthralgia (n = 9), local erythema 1-12 days after tick bite (n = 7) and erythema chronicum migrans (n = 1). Echocardiogram abnormalities occurred in 15. CONCLUSIONS: Patients with double infection with TBE and Lyme borreliosis fell into three main clinical groups: febrile illness, 3 (6%); meningitis, 15 (30%); central or peripheral neurological deficit (meningoencephalitis, meningomyelitis, meningoradiculitis and polyradiculoneuritis), 33 (65%). Systemic features pointing to Lyme borreliosis were found in 25 patients (49%); immunoglobulin (Ig)M antibodies to borreliosis were present in 18 of them. The clinical occurrence of both Lyme borreliosis and TBE vary after exposure to tick bite, and the neurological manifestations of each disorder vary widely, with considerable overlap. This observational study provides no evidence that co-infection produces unusual manifestations due to unpredicted interaction between the two diseases. Patients with tick exposure presenting with acute neurological symptoms in areas endemic for both Lyme borreliosis and TBE should be investigated for both conditions. The threshold for simultaneous treatment of both conditions should be low, given the possibility of co-occurrence and the difficulty in ascribing individual neurological manifestations to one condition or the other.

Bites and Stings↗
PubMedDate not supplied

Lyme disease and seventh nerve paralysis in children.

PURPOSE: This study was undertaken to determine the frequency of Lyme disease (LD) as a cause of transient facial nerve palsy (FNP) in children. Acute onset FNP in children has been primarily associated with acute otitis media (AOM). Recently, LD has emerged in regions where the deer-tick vector is present and has been associated with multiple cranial neuropathies. PATIENTS AND METHODS: Fifty children with transient FNP were evaluated and treated at our institution over a 5.5-year period. RESULTS: The rank of etiologies confirmed LD to now be the most common (50%), followed by AOM (12%), varicella (6%), Herpes zoster (4%), and coxsackievirus (2%). Thirteen children (26%) had idiopathic FNP consistent with Bell's palsy. CONCLUSION: We conclude that transient FNP in children is most commonly caused by LD for regions with endemic infections caused by Borrelia burgdorferi.

Adolescent↗
PubMed1975

[Central european tick-borne encephalitis from 1969 to 1972 in central bohemia (author's transl)].

From 1969 to 1972 1,080 patients admitted with a diagnosis of viral meningoencephalitis were treated at the Hospital for Infectious Diseases in Prague-Bulovka. In 633 of these patients tick-borne encephalitis could be detected serologically. The epidemiological conditions and the clinical course of the disease are described. Paresis of the extremities and the cranial nerves occurred in 12.8% of the patients; the outcome was fatal in 0.8%. Treatment in hospital usually lasted 3 to 4 weeks and patients were unfit for work for a further 6 to 10 weeks after dismissal.

Adolescent↗