Tags

Type your tag names separated by a space and hit enter

Differential diagnoses of suspected Lyme borreliosis or post-Lyme-disease syndrome.

Abstract

The symptoms of Lyme borreliosis are similar to those of a variety of autoimmune musculoskeletal diseases. Persistence of complaints is frequently interpreted as unsuccessful antibiotic treatment of Borrelia-associated infections. However, such refractory cases are rare, and re-evaluation of differential diagnoses helps to avoid the substantial risk of long-term antibiotic therapy. In this study, we analyzed patients who presented to our rheumatology unit with previous suspected or diagnosed Lyme borreliosis. Eighty-six patients from a 3.5-year period were evaluated. The mean age of patients was 49.2 +/- 17.2 years; 60% (n = 52) reported a tick bite and 33% (n = 28) an erythema. Forty-seven percent (n = 39) had positive enzyme-linked immunoassay results and Western blots (Mikrogen, Martinsried, Germany). All but 12 patients had already received antibiotic treatment previously. Nine percent (n = 8) had ongoing or recent Lyme borreliosis. Twenty-nine percent (n = 25) showed clinical symptoms and radiographic changes compatible with degenerative disorders of the cervical and/or lumbar spine. These patients were significantly older when compared to the other patients (59.3 +/- 13.7 years vs 46.1 +/- 17.2 years, p = 0.001). Seventeen percent (n = 16) had arthropathies related to psoriasis or rheumatoid arthritis. Twelve percent (n = 10) were positive for the HLA B27 antigen. Other diseases were less frequent. Six patients (7%) could not be diagnosed conclusively, and four of these patients had negative Borrelia immunoassay results. In conclusion, Borrelia-associated diseases were rare in this study. Differential diagnoses helped to initiate a successful disease-specific therapeutic strategy.

Authors+Show Affiliations

Medical University Policlinic, Rheumatology Unit Wilhelmstr, Bonn, Germany. Matthias.Seidel@ukb.uni-bonn.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17605053

Citation

Seidel, M F., et al. "Differential Diagnoses of Suspected Lyme Borreliosis or post-Lyme-disease Syndrome." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 26, no. 9, 2007, pp. 611-7.
Seidel MF, Domene AB, Vetter H. Differential diagnoses of suspected Lyme borreliosis or post-Lyme-disease syndrome. Eur J Clin Microbiol Infect Dis. 2007;26(9):611-7.
Seidel, M. F., Domene, A. B., & Vetter, H. (2007). Differential diagnoses of suspected Lyme borreliosis or post-Lyme-disease syndrome. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 26(9), pp. 611-7.
Seidel MF, Domene AB, Vetter H. Differential Diagnoses of Suspected Lyme Borreliosis or post-Lyme-disease Syndrome. Eur J Clin Microbiol Infect Dis. 2007;26(9):611-7. PubMed PMID: 17605053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential diagnoses of suspected Lyme borreliosis or post-Lyme-disease syndrome. AU - Seidel,M F, AU - Domene,A Belda, AU - Vetter,H, PY - 2007/7/3/pubmed PY - 2007/10/12/medline PY - 2007/7/3/entrez SP - 611 EP - 7 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur. J. Clin. Microbiol. Infect. Dis. VL - 26 IS - 9 N2 - The symptoms of Lyme borreliosis are similar to those of a variety of autoimmune musculoskeletal diseases. Persistence of complaints is frequently interpreted as unsuccessful antibiotic treatment of Borrelia-associated infections. However, such refractory cases are rare, and re-evaluation of differential diagnoses helps to avoid the substantial risk of long-term antibiotic therapy. In this study, we analyzed patients who presented to our rheumatology unit with previous suspected or diagnosed Lyme borreliosis. Eighty-six patients from a 3.5-year period were evaluated. The mean age of patients was 49.2 +/- 17.2 years; 60% (n = 52) reported a tick bite and 33% (n = 28) an erythema. Forty-seven percent (n = 39) had positive enzyme-linked immunoassay results and Western blots (Mikrogen, Martinsried, Germany). All but 12 patients had already received antibiotic treatment previously. Nine percent (n = 8) had ongoing or recent Lyme borreliosis. Twenty-nine percent (n = 25) showed clinical symptoms and radiographic changes compatible with degenerative disorders of the cervical and/or lumbar spine. These patients were significantly older when compared to the other patients (59.3 +/- 13.7 years vs 46.1 +/- 17.2 years, p = 0.001). Seventeen percent (n = 16) had arthropathies related to psoriasis or rheumatoid arthritis. Twelve percent (n = 10) were positive for the HLA B27 antigen. Other diseases were less frequent. Six patients (7%) could not be diagnosed conclusively, and four of these patients had negative Borrelia immunoassay results. In conclusion, Borrelia-associated diseases were rare in this study. Differential diagnoses helped to initiate a successful disease-specific therapeutic strategy. SN - 0934-9723 UR - https://www.unboundmedicine.com/medline/citation/17605053/abstract/Differential_diagnoses_of_suspected_Lyme_borreliosis_ L2 - https://dx.doi.org/10.1007/s10096-007-0342-0 DB - PRIME DP - Unbound Medicine ER -