Aim. Clinical, epidemic and laboratory characterisation of ixodic tick-borne borreliosis in order to improve the early diagnosis of the disease and the timely etiotropic therapy.Materials and methods. The medical histories of 257 patients with ixodic tick-borne borreliosis treated in the regional infectious diseases hospital in Krasnodar from 2004 to 2018 were analysed. The data of the epidemiological history, the clinical manifestations of the disease, the results of laboratory and instrumental studies, as well as the principles of therapy were analysed. Results. The incidence of ixodic tick-borne borreliosis in the Krasnodar Krai is characterised by spring-summer seasonality, the predominance among women over 45, and urban residents. The disease has an acute course (85.9%), occurs mainly in the erythema form with little pronounced symptoms of intoxication, a typical ring-shaped erythema, which large dimensions remain longer in women. During the non-erythemic form of the disease, the development of serous meningitis and encephalomeningitis with impaired cerebral blood fl ow as well as the changes in corticocortical relationships were observed. During the sub-acute course, radiculopathy and polyneuropathy, as well as diffuse changes of the myocardium with conduction disturbance and the development of atrioventricular block, arthralgia and arthritis/arthrosis were registered. The increase in LDH, CPK and transaminase was observed for all forms of the disease.Conclusion. In connection with the formation of a natural ixodic tick-borne borreliosis focus on the territory of the Krasnodar Krai, it is necessary to exclude this disease in patients with the signs of fever, weakness, and erythema at the site of tick suction. The tendency of ixodic tickborne borreliosis to the long course with the development of multiorgan pathology causes the need for follow-up observation of recovered patients both by an infectious disease specialist and narrow specialists (a neurologist, rheumatologist or cardiologist).
Background. Ixodes tick-borne borreliosis (TBB) is a clinically multifaceted disease posing a serious threat in most territories of the Russian Federation. New TBB outbreaks emerge and spread to the country’s south.Objectives. The review highlights the TBB clinical diversity to physicians in order to improve the diagnosis quality and opportune aid. It focuses on the early and late clinical presentation of localised and disseminated polysystemic TBB.Methods. Sources were mined in the MEDLINE, PubMed and national electronic databases (Сyberleninka, eLibrary, etc.) with keywords “tick-borne borreliosis” [клещевой боррелиоз], “Lyme disease” [болезнь Лайма], “Lyme arthritis” [Лайм-артриты], neuroborreliosis [нейроборрелиоз] for the period of 2014–2020. Selected impactive publications within 2007–2013 were also included. Research was considered eligible if borreliosis was diagnosed using specific techniques like immune-enzyme assays, immunoblotting or PCR.Results. TBB is a common and cross-disciplinary situation. The disease may progress occult or manifest in a variety of forms, from annular erythema to cardiac, peripheral and central nervous system involvement or arthritis. The polysystemic nature of lesions, often long-term of the tick bite, forces multiple specialist visits ending with misdiagnoses, late aetiotropic therapy and transition into a chronic phase through ignorance of the patient’s epidemiological record. Some patients may have the acute phase followed by irreversible neurological damage associated with memory loss, cognitive decline, arthrosis and sclerotic skin change reducing the quality of life.Conclusion. TBB can be mimicked by therapeutic, neurological, skin and ophthalmic illnesses, which warrants the physician’s attention to the epidemiological record and knowledge of specific diagnostic techniques. Further research is necessary into the pathogenesis and clinical presentation of chronic TBB and its residual manifestations.
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