The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the disease, which are mainly neurological. The cutaneous presentation in borreliosis is heterogeneous. There are typical lesions that constitute the basis for the diagnosis of Lyme disease, and atypical ones, which cause significant diagnostic difficulties especially when the patient does not remember the tick bite. This study aims to describe the heterogeneous skin symptoms of Lyme borreliosis, as well as offer a practical approach for the recognition of the disease. Based on pediatric cases from clinical practice, rare cutaneous presentations of Lyme disease at various stages of illness and therapy are presented. Diagnostic recommendations for recognizing individual forms are discussed.
Autoimmune encephalitis is rare in children and develops as a manifestation of a parainfectious or paraneoplastic syndrome. The disease is characterised by a sudden or subacute onset and a broad spectrum of neurological and/or psychiatric disorders. We present a case of a 17-year-old girl with anti-N-methyl-D-aspartate receptor encephalitis. The patient was admitted to hospital in a severe condition, unconscious, with injuries indicating a recent status epilepticus. Previous infection was found to be the most likely causative factor. Antiviral, antibacterial, immunosuppressive and anticonvulsant treatments were used with good outcomes. The aim of the paper is to point out the need to include autoimmune processes in the differential diagnosis of neuroinfections in children, which will allow for prompt implementation of appropriate treatment and improve prognosis.
Aim: The aim of the study was to assess the suggested biomarkers’ usefulness in diagnosing central nervous system infections in order to optimise treatment and minimise adverse outcomes. The study included a comprehensive comparison of the known parameters and a search for correlations with proposed biomarkers. Materials and methods: The data of 73 hospitalised children were reviewed. According to their final diagnoses, 42 participants were assigned to the control group, 13 to the cohort with bacterial and 18 to the cohort with viral neuroinfections. The children underwent clinically indicated blood and cerebrospinal fluid tests. The serum interleukin (IL)-1β, IL-6 and neopterin concentrations, and S100B protein and matrix metalloproteinase (MMP)-9 levels in the cerebrospinal fluid were determined. The results were compared between the groups and correlations were sought. Results: Serum IL-6 levels were found to have increased in viral (p = 0.0412) and bacterial (p < 0.0001) infections, with a predominance of the latter (p = 0.0403). In terms of serum neopterin and IL-1β, the neuroinfection cohort did not differ from the control group. The level of S100B in the cerebrospinal fluid in bacterial disease was higher compared with the viral aetiology (p = 0.0325). The cerebrospinal fluid S100B correlated positively with serum IL-6 (p = 0.0138, R = 0.6396) and reversely with IgA and IgG levels (p = 0.0499, R = −0.5325; p = 0.0022, R = −0.7451, respectively) in the neuroinfection cohort. The cerebrospinal fluid MMP-9 was linked with cerebrospinal fluid cytosis in patients with viral (p = 0.0018, R = 0.7547) and bacterial (p = 0.0124, R = 0.6935) disease. The serum IL-6 levels correlated with IgA in the viral aetiology (p = 0.0374, R = 0.9). Conclusions: The MMP-9 level correlated with blood–brain barrier permeability, expressed by cerebrospinal fluid proteins and cytosis, which may indicate the possibility of sequelae. The higher serum concentrations of IL-6 and S100B in bacterial neuroinfections may reflect a more intense immune reaction associated with this aetiology.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.